HomeMy WebLinkAboutBLD2024-00532 - BLD CD Environmental Health Review - 5/24/2024 I Permit NR: CDC V
MASON COUNTY RECc
COMMUNITY DEVELOPMENT
f<rmitkssm nme Wr.BdInnLNannlN MAR 18 2824 3
BUILDING PERMIT APPLICATION 8tder Street m
PROPERTY OWNER INFORMATION: ONT RINRMATIO
NAME:
FSvdRmfiw NAME:TI romw (LD O
CITY:B &NP1 SS:1w2ATPxrtPN MAILINGADDRE55: B2aBns1
PHONE
Nlma STATE" ZIP:wt1D PHONE:mM STATLL: ZIP:wIw
PHONE 02:2 T1aA210 PHONE:mu 09 CELL:
PHONEAIL:Eg EMAIL G 4TOEUU; scam
EMAIL:Epo®.mlirAmm L&I REC MTOELLcssmM EXP._/ 9124
PRIMARY CONTACT: OWNER❑ CONTRACTOR El aFxER❑ 1
EMAIL 1-1W
dl.mm ENTAL
MAILINGADDRESS22w S2 d OTYd� STATE
PHONE
PARCEL INFORMATION_
PARCEL NUMBER(12 Digit Numba)1331BAUgmg2 ZONINGI2'�
LEGAL DESCRIPTION(Abbm ) Qma 0TR2a 2 HREDISTRICTN
SITE ADDRESS211 Nan PdNIM 1x. CITYlidPd
DIRECTIONS TO SITE ADDRESS 1iO°°rw"xurdlRwru�ramemrvru rlrpm.rrpremm.amrur
ISTN¢PROIRCT WITHIN 3EB FTOFSLOPEIA)GREATLRTHAN IA%: YESQ NO Di SNOW LOAD:��d
ISPROPERTYWOHINMFTOFTHEFOLUOWING: ft'lmT'Mlldv olMry:
SALTWATERQ LAKE[] RIVERrCREEK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAMD
TYPEOF WORK: NEW❑ ADDITION a ALTERATION❑ REPAIR[] OTHER ❑
USEOFSTRUCTURE(AapAme.(hope,('mmertxd X*WB R
ISUSE: PRIMARY" SEASONAL2, NUMBEROFBEDROOMS2 NUMBEROFBATHROOMS2
HEATEDSTRUCTUREV, YES~AW0 YES(,"/,/4BW0 NO[]
DESCRIBE WORK••^""'�"'m®'�'®'°.®.me.�® � e
30UARE FOOTAGE: I
ISTFLGOR�T sq.tl. 2NDFLOORI0.2 N.IL 3RDFLOOR aq.R BASEMENT_N.R
DFCK�aq.R COVEREDDECK_rq R. STORAGE N.R OTHER_p.R
GARAGE sq.D. Au"hed❑ Dewbed0 CARPORT N.ft AR.W0 Da ae []
I MANUFACTURED HOME INFORMATION: eA COPIES OF THE FLOOR PLAN REQUIRED'
1
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERW.NUMBER
ENVIRONMENTAL HEALTH:
SEWAGFJSEWER SOURCE: SEPTIC El SEWER / NEW El EXISTING
PLUMBING IN STRUCTURE? YES 0 NO❑ ff s,a M wmp'e(N Waver Ade Farm
PERIMETERNOUNDATION DRAINS PROPOSED? YEE NOD EXISTING SQ.FT.01 �
EXISTING BEDROOMS 2 PROPOSED BEDROOMS q TOTAL BEDROOMS 2
DW NFR rtblvdM W f Nd auMvien d Inrm.da FfonneMon maY weuX F e Mp eM a W r m pmX leumuon.MnoMmpemm�d mm m q
WriYge pabw.l eetlemtlW I mNM mMreae I NMaleazfem nd I Yn nti1W m remlee Nb wn�m and b tlo IMxwk m pOpomd I Nr!
drum•va�mNma�umnmmeruw.Y paum,mdwme ariy.wemam odes orvanx.mmlmed reye�w.moiem.m.o..rrmlapd
Im..maegw, Pemmsumnm lmmmmw vmmem is.U.�mm ens ammsmNowmdrwson canny mme mow eeaaem lmPero
�p�eddmcpan woa li[wwwn blae Panoedtw�s�gnull&wiertwM vaWwAzen wnamtlrs bnd wmmnmE VAM1n 1w
eeyem
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICAjIONa
IN DAYS OF MORE WILL CAUSE THE APPLICATION TOM EXPIRED.(MASON
/yPc"'.,�(V` c�coDEuEE.aI3�/edOWxERTALREVIEW APPROVED GATE DENIED DATE TAGSINOTESIC'ONDRIONS
PARTMENTEPARTMENTALLTH
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