HomeMy WebLinkAboutBLD2024-01095 - BLD CD Environmental Health Review - 9/10/2024 MASON COUNTY Permit ND: �L_�2112/4—bILxS
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION SFP 10 2024
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 'L5 pa��
NAdHABFMHm1u YL TJAME;IBFM Hmr LLL Olt W. ASM9Bt
MAE.INOADORBSS:821E.eEA014m MARAJGADDRESS:e71 EBEACHDR.
CITY:udm STATE:M ZIP:0' CITY:LS STATE:M 21P:e9592
PHONE#1:36(1300=5.3 PH0NE:3mM =5aa13 CELL:
PHONE#2: EMAIL:mwmqu.amlmmpwnam
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PRIDLIRY4aamamCONTACT: owNERp CONTRACTOR ElOTRER❑ 9 .
NAME GAD W4MMf EMAIL�E T
PHONEGADDRBSS WIEBEACH I3E CITY Imm STATE WA R J8 Wi
PHONE wwwtlma CELL Jed' J
PARCEL INFORMATION: „a(� O Q
PARCBLNUhElER(12 Digit Numhr) 323g450ABBM ZONINGS V T
LEGAL DESCRD'TION(AbMeviercd)/�0+eR001(GalFacouNiRv cwBLois:Beam-FIRE DISTA1Cf etmnta�ev Ob i
SIE ADDRESSftt EJmlt Pine to CITY union,wa >
DIRECT[ MMSIFEADDRESg ^^ ^Ib,bm rpnmb.wxPxe Ol,Nnumer mn M1ene¢iae. Z
W
IST PROIF4CTWfFBIN3Nn OFS M(S)GREATERn 14%; Me NO[] SNOWLOAD:2�¢!
ISPROPFRTYWIT®N2WFTOFTMZ1OLLOWD4G: ( aad:Wo,
SALTWATER❑ LAKE❑ RIVEWCREEK❑ POND❑ WETLAND[] SBASONALRUNME] STIR []
TYPE OF WORK: NEW p' ADDTION p ALTERAn0N p REPARt p mnMR. n
USE OF STRUCTURE(ka0d,Gm o,Coaaa a At 2Y) R�
)SUS& PEDARYp+ SEASONAL[] NUMBER OF BEDROOMS 3 NumiuoROFBAME:xudS 3
NEATEDSTRUCTEMEt YES(P8mAW0 YESf/MAW❑ NO[]
DESCRME WORK NxebpMbmiNmmRtea
SQUARE FOOTAGE:6,ap
ISTFLOOR2a p.ft 2NDFLOOR_aq.ft 3RDFLOOR aQ.ft. BASEMENT q.ft
DECK q.ft COVERED DECK 182 Xq,ft STORAGE R.ft OTHER R.R
GARAGE'en 1.ft AMd d 0 D ,Jkd❑ CARPORT eq.ft.AwoW p Das o []
MANUFACTURED HOME INFORMATION: - '4 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WMTII BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SBWAGMEWERSOURCE: SRPTICE SEWER❑ NEWp+ RXISTING❑
PLUMBINGINSTRUCIURHI YPSQ NO[I If3m,=doi,oda hod WawAdegaary Form
PERAffiTEIt/R031NDATIONDRAIN3PROPOSIR)1 M NOO EaSTDIGSQ.".
EXISTINOREDROOMS PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
IXVXER xkmMtlpeeMwElllhabndlnxcureammmanmay—.lne"wri,aNeror pxmX nwcatlon.Ab imNatpematld JIBW
eIgNWR CC .I EmeR[M I an Mewmer and I wmar EOCbT Mat I am enided to rtWva Ph pant and to do me xnk m Popxe].I lwe
Mldned mtm"Onfrom Arm muapry'..InaWlne mr eawnem nddm or wrtie¢dm..on ardms M.I..The✓.s a—Itmad
repeseMeu e,norn amb.1,@ iMmma4on plovMat is emireb aA amp emplanmm dMason County ams¢m Me akaw dewlBM gmmy
ap¢bufunla)la rv.YwaM itwpe]b,llib mmNapplbtldn pecgnp rN14wM ilvMrveWodzed mnsW tllm 4�¢mmemaE mM1F 180
days dr amrewctlm.mA I.¢uapaVd fae wrod or tea den.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF TNIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
DOUN1 Y CODE 14.08A2)
Xft'Ma'}� 8/27/2024
SlBnelum WONME0.1Mualbalaned ba Bte OWNER) Data
DEPARTMRNTAL REVHr,W APPROVED I DATE I DEN® I DATE I TAC"ClOS ONNDFPIONS
BUDDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PURUCHEALTH {D 1
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