HomeMy WebLinkAboutBLD2024-0576 - BLD CD Environmental Health Review - 5/14/2024 MASON COUNTY Permit Na: LDaoa -IX75�(o
COMMUNITY DEVELOPMENT RECEIVED
PianitAaalat.Iea�mad.Balldlr,Pl.adn, MAY 082024 m
BUILDING PERMIT APPLICATION z
615 W. Alder Steet <
PROPERTY OWNER INFORMATION: RII IATIO�I`N:
NAME: D� 1) NAME: I U M 0
MAILING ADDRESS: �. MAILIN ADDRES : l > Z
CITY: S TE:Jp�A ZIP:! $57{•y STATE. a�
PHO Ml: -2k0�015'L PHO CELL LO- �a$�
PHON EMAIL = M
ci 'c6.di In CO L&I REG# EXP. /_/_ z
PRII1 YCONTA t-`�OWNER CONTRACFO OTHER❑
NAM6 NrS EMAIL r
MAILINGADDRESS CITY SPAT ZIP
PHONE CELL
PARCEL INFORMATION:
PARCELNUMBER(12 Digit Number) +-l2'zl - ,$7 " 0012) ZONING 3
LEGAL DESCRIPTION(Abb rtviated) a IREFIREDIS CP
SITE ADDRESS 60
DIRECVONSTOSUEADDRESS
L
IS THE PROJECT WITHIN 300 PT OF SLOPES)GREATER THAN 14%: YESM NO❑ SNOW LOAD:_ if
ISPROPERTYWITHINI00FTOFTHEF0LLOWING: (Chddl s5m oygy):
SALTWATER D LAKE❑ RIVEIVCREEK I] POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM D
TYPE OF WORK: NEW K ADDITION❑ ALTERATION❑�R�EPAIR S❑ OTHER
USE OF STRUCTURE(evmmv.ra gas coamamw eug Prc) YIPA.] RT+'S I(VP ,n
ISUSE: PRIMARY SEASONAL[] NUMBEROFBEDROOMS�_ NUMBER OF BATHROOMS .Z
HEATED STRUCfURE1 YES f`wlw B&Wjr M h,,np/q'JaylO NO[]
DESCRIBE WORK vl CJ! OO MtYa�
SOUARE FOOTAGE:Sais saes ISTFLDOR,L e_", . 3NDFLOORSJCoo
7yq.R 3RDFLOOR q.fl. BASEMENT_ eq.ft.
DECK :q.ft COVERED DECK_ .eq.R STORAGE N.ft OTHER sq.ft
GARAGE p.& Aaachd❑ Detachd❑ CARPORT 1.ft Attached❑ Detached❑
ME INFORMATION: e4 COPIES OF THE FI.O QUIREDe
MAKE YEAH LENGTH
WIDTH BEDROOMS BATHS SERIAL ER—'
ENVIRONMENTAL HEALTH:
SEWAOMEWER SOURCE: SEPTICK SEWER❑ / NEW EXISTINGA
PLUMBING IN STRUCTURE? YES❑ NO❑ lj3as.attach camPferd Ware,Adequary Fa.m .
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOJZ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS_
QYNER alnw dogs that audnlxon a inaanaea Infametim may naul In a sbp wM antler or permh revocat'm-i.PcbavleJPemeris W auch b Ly
m,mmune hams I..ae that eta the W.Mn end I hdM1er tladare that Iamimbsedbnam-IMa memniand to tlo Ne—*ea propoaM.I haw
retained penmualm firm all tha nettaeery grfim,indudiy any meemmt M1dder vprWs of lntereel regeNing Ihla pmjaq. The wmv ia Ie,od
na's talive,represents Nat me IMpmalion pouted is ecwnle and Brame mpbyaea of Mewn County aruns W he move desimead ondoi
"eauctumhs)Immvbwandim,mom. Tdu panmNapplvatlan Mccmes null8MOIlvrorM or eutMrizetl wnatmctlon bnd comma 1wMln1�
days w tl condruction xwk'c a�pendatl M a parlod o1180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APP 1 ORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
HIT CODE 14.08A21
'5:- 3 ' 'V
WNER(Mutla,sianad W the(diti Date
DEPARTMENTAL REVIEW APPROVED :JM
TAGSINOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL PUBLIC HEALTRjpt— UkdNAA
s
r ,
I i r
j 1
r
Ii qE�
If
= 05$ .
'ii° i0 y_ @�Y°Y3 � gig E! ��Y'�je7j �Y t e Irt�I's Ijd t 9� a Ya yp
s '6` »
d`��ll�
Sa•
"L Y u jFF pe° !e jl I a�rt l i g tr a BI�
pp
i I!j16! 1 lot
l 6f f ! I if F will
MINI
l f F
.a.ex.pp tea:uice, !g t !
jYB E 9 gSl { 1 g E : Y oil lr rt
{ { � a !tIf
jj , tadda� �! f sj aYal I �
EEYj9Efi i�� W n s
D t IIYBW 7�05� P.B.Q.
Jul
o.e