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HomeMy WebLinkAboutBLD2024-00685 - BLD CD Environmental Health Review - 6/6/2024 ENVIRONMENT/' nWtNo:p'7 0,9h4—R`J MASON COUNTY HEALTH{ RECEIVED COMMUNITY DEVELOPMENT MAI 0 2024 Permit Assistance Center,Building,Planning 615 W. Ider BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: NTRACTOR IN�^FO�' 1A NAME: VGrr115 %.rjormot Se.I�Q,fS NAME: 6JI, Gn fr1 MAILINGDRESS:PoI30X 13D MAII.INGADD SS: 3 LRne C11'Y:Lo- YiNP_ STATE: O ZIP: 7734 CITY: O o l� STATE:WA ZIP: 8 PHONE#1: 5'{l- 407- 14.9.5 PHONE: - 90-31 3 CELL: 3kd'79d•-4/83 PHONE#2: EMAIL: 4641LOU44pprow/ r:ofn EMAIL: Qr we .het 7 -T RIG11 U rd 40 Q EXP. PRIMARY CONTACT' � p WNER❑ CONTRAcfOR. THER❑ NAME Gru4la HD' 2"nc EMAIL r r ADD • MANINGSS 2-- n (O 11ViP A/1.� CITY 4 STATE —V, ZIP1K2a;2- PHDNE. (o0-_740• .31$a cELL3(2_b- - p PARCEL INFORMATION: Q /1 `I PARCEL NUM13ER(12 Digit Number) 31q 114170 ZONING / S LEGAL DESCRIPTION(Abbreviated) Lol O-� FIRE DISTRICTJr SITE ADDRESS Q CITY P h iWA 29-4 DIRECTIONSTO SJ I h ADDRESS rvt nor — / % A x IS THE PROJE WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ N SNOW LOAD:sTpsf IS PROPERTY WITHIN M FT OF THE FOLLOWING: (Chaekmrrfat ppy): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NBW3Z ADDTTTON❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Pu iderrr..,Gmag.,ComnretrWBMk,Eta) IS USE: PRIMARS�g SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS, S HEATED STRUCTURE? YES(Md.Bldg)❑ YES(Pu N o/Blsk))K NO❑ DESCRIBE WORK 3u i 1 S F W 0. SQUARE FOOTAGE: hr,pa.�) �r11 1ST FLOOR�2o4 sq.R 2ND FLOOR �Dd- sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.R DECK sq.R COVERED DECK -q0 sq.It. STORAGE sq.I OTHER sq.fL GARAGE 938 sq.fL Attachdo Detached❑ CARPORT sq.R Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: •4 COPIES OF THE FLOOR PLAN REQUIRED" MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ ! NEWWW`g� EXISTING❑ IPLUMBING IN STRUCTURE? YE90 NO❑ If)w,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ , , NN EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS_[-L/ TOTAL BEDROOMS 5 `/ OWNER acknowledges that submission of Insomovte Informstion may result In a stop work onleror permit revoratlon.Acknowledgement of such is by signature below.I decare that I sm the owner and I further declare Met I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the nareasumy parses.Inducing any easement holler or parties of Interest regarding the protect. The owner or legal nv.waanfalNe ranrnenMe fhN Mn InM, Winn x is a11.nM nmMu emnlnvaaa of Mown m th.nrmrn rlwvrlMl mm�eM O W NFA ebnw4eapes tivl xuanlsslm N Inemrtxb YiMmelbn mry reeWr In a alep unA oNm¢palm&rewstlm AunvrMdpemant or xua k by elpna W re Nlow.I Gotten iM1xl I eta the wnler eM I furlM1et tlxGere Ibe[I eta mitltletl b repave Ni pemA eM b tlo Me w.k a pmpesatl.I brve obtalneE pmiheMn M1nn e0 tM1e neccnerypaN®A IdQu waryeometR MWx orpvtlesof IMxeetleema wtfts dcvnerorlegel repnmW We,rePeam�Ne[1M1e hifwmehn pvuidM eamnNentl pzN emPMexe of Mml Cawyexm MNeeMie tlrsglbetl pmPNy ®axwmeh)rerre+ln.ana mapecson lma pamltlegaratlmbeamonwlswm.vaka.wnnMa�xwwon hea�mmcm vNln tm my,arce mMnrnkace/cpe�aeafae�aavw a.ye. PR F FCOI INU IflO OF WORK ON THIS PERNRIS BY MEANS OF INSPECTION. INACTIVITY OF THIS P AP AT N F ISO GAYS OF MO CAUSE THE APPLICATION TO BE EXPIRED.(MASON OdNIYCO0E 10.0eA2, �/ ^ Slp d ER(NeatMalaned WthaowN Dift 7LDWG�DrWARD�rr RTbM,'r f K" i 7©� ) mmm9 6 .2. ■ } \ ( � § m | / llW \ | | J / G | . 3 301 0 N Approved . . 9 h \ / 06/12/2024 Development e , � • ! ] � \| m . � / \\M4 Jill /a | |[ ( m \ /| ■ % % „ m• ƒA17 @� E >| §•- § � ! � | | \ # - D | a) ( ( � } { \ ƒ! ' L � �\ ƒ q; .: