HomeMy WebLinkAboutBLD2024-00597 - BLD CD Environmental Health Review - 5/14/2024 MASON COUNTY PermltNo:
COMMUNITYDEVELOPMEN RECEIVED
PomRAsslstanee Canter,B.11din4Phimem, �"a/ 1 3 2024 z
BUILDING PERMIT APPLIC IONMA� 6 EW Alder Steet <
PROPERTY OWNER INFORMATION:- CONTRACT =
NAME Kern Sign e,L.oeneri NAME:tevrxames M O
MAMINGADDRESS:m Meth MAILING ADDRESS:1213 S Yew M D Z
CITY:teeemy STATE:WA y-:maoE CTTY:Gammne STATE: ZIP:( Sit ri
PHONE#1:206436i022 PHONE:330a07-1e49 CELL:aeoa6smse = (TI
PHONE#2:253d5362n EMAIL.xannean®Ieaemomea.wm z
EMAI.:rennMlc®Ymtamm L&1 REGWL---f30203 EXP.___ ---I
PRIMARY CONTACT: OWNER El CONTRACTOR❑ OTHER❑ r
NAME EMAIL
MAILING ADDRESS CITY STATE_ZIP_
PHONE CELL
PARCEL INFORMATION:
PARCELNUMBER(121)i9it Nander) 520037Se3163 ZONING
LEGAL DESCRIPTION(Abbreviated)Pi 2 OF asa 0 Pi TR 1e S IM,S liar9a FIRE DISTRICT .
SITE ADDRESS w Reewa wu or C[PYSIMI1on
DIRECTIONS TO SITE ADDRESS cwa.mlaxrr adi n mwwamawb ae-afay,ree aewreeoywaae .Mewln
Mina SInNn MalMck M In Re res Hid R.Dntlna4on lean your right.
IS TBE PRO3F.CI'WITHIN 300 FT OF SLOPES)GREATER TRAN 14%: YESQ NO Q SNOW LOADn_paf
IS PROPERTY WPTUIN 2110 FT OF THE FOLLOWING: Iceek ffemresrM:
SALTWATER❑ LAKE❑ RIVENCIUE ❑ POND[] WETLANDja SEASONALRUNOFF❑ STREAM
TYPE OF WORK: NEW El ADDITION[] ALTERATION❑ REPAIR❑ OTHER n
USE OF STRUCTURE(EaaMwaa Oman,commanded Beii Ear)gendarme
IS USE: PRIMARY[] SEASONAL❑ NUMBEROFBEDROOMS2 NUMBEROFBATNROOMS25
HEATED STRUCTURE? YES lghat au2l YES ryarc//yeuy 0 NO❑ —
DESCRIBE WOE,rese caunumm SFR
SOUARE FOOTAGE:ro firamp
1STFLOOR14d3 p.ft 2NDFLOOR_p.ft 3RDFLOOR p.R. BASEMENT
MI.
DECK_p.ft COVEREDDECK250 p.ft STORAGE p.R. OTHER ii
GARAOER2 R.R. AvachedEl DemchM❑ CARPOET aq.R Anached13 Dnached❑
MANUFACTURED HOME INFORMATION: f0 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
W1DT1T BEDROOMS BATHS SEJUAL NUMBER
ENVIRONMENTAL HEALTH-
SEWAGE/SEWER SOURCE: SEP71C0 SEWER[I / NEW El IDDSTING13
PLUMBING IN STRUCTURE? YES❑ NO❑ Iff di aaacb t,kW fitmen-AdeOoary,Fort
PFRIMETER/FOUNDATION DRAINS PROPOSED? YESB NOCI EXIMNGSQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 2 ��TOTAL REDROOMS 2 "—
(XWNER a J:moMami that¢uMnizsan allregvreN mlumation may result In a mry fear order or pmmil rermticn.IdrpxbJPement of auU b W
¢gnaWR bei I Eetlare that I am Me tamer and I hMer declare that I am eniNM b RCgVe Wa pmnit and to an Me Work as ar4roaN.I ttae
W tamed permission hen LI im remwry peNn InzluSn9 any eezemenl hdtler an Pnlye adeami rryaNirq Mae projeri Tan camar m legal
npre¢e "re.rePmenlsImltan iicare. npwNe]is acnrele anE BraMa dnpbyee¢d Mewn Cwn1Y arims1t th above Eeavimi PrWer1Y
ertl NucNre(s)br raviawantl in¢pection. Tltia petmNepgietim[er es nulBroW tlfpk waNMtvelro'¢tniW^r.tls ml pynmeraeE fi1Nn 180
hew a ticanawa5tn fan b aaaPandea Tor a Pnia3 d 1ea dew.
PROOF OF ONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
X MIT 710N F 380 DAYS OF MORE WILL CAUSE THE APPO!TON O B�E%PIREO. MASON
CODE WILLCODE I<.08,42)
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SlgnaWm d(OWNER(Ruin bar monad bathe OWNER) Dade
DEPARTMENTALREVIEW APPROVED I DATE DENIED DATE I TAGSINOTESXONDTEONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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