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HomeMy WebLinkAboutBLD2024-01169 - BLD CD Environmental Health Review - 10/1/2024 MASON COUNTY PermitNo: &( 1 Q0e24-alwi COMMUNITY DEVELOPMENT RECEIVED Permit Assistance Center,Building,Planning SEP 25 2024 BUILDING PERMIT APPLICATION 615 Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAIvffi:cA a^D Fdn3om.m NAME'JD Lonswo9an MAE.INGADDRESS:n°slWmyvaxt,D," MAILING ADDRESS:Res lvaalireIN CHY:Dlympe STATE:WA ZIP-matst CHY:cmM1eos STATE:WA ZIP;08532 PHONE MI:slWassaee8 PHONE:380a8rrroT CELL: 394re0&I0 J PHONE#2: EMAI.:1°ON°Nm"°m'ctlw1100'"an.`°'n -- Q EMAIL:d119730yaledi L&I REG#sav loops PRIMARY CONTACT: OWNER[] CONTMMR13 OTHER❑ NAME--"°"a 10 BE Y Rob CITY Lwu" ka cer�aasn STATE mm WA DP0a5M C J MAILING ADDRESS annlam G PHONE atwvan CELL O W PARCEL INFORMATION: _ PARCELNUMBER(12 Digit Number)22t3321E0Wt TONING LEGAL DESC3U'TION(Abbreviazd)LatlL1IID2 FIRE DISTRICT SITE ADORES51ae1 E Pkkenilg Rose C)Tyslnbn DIRECTIONS TO SITE ADDRESS OOT IS�PROH:CT WITHDq 300 Ff OFSIAPE(5)GREATER TITAN I4-16: YES[] NOB SNOW IOAD:x O, M IROPERTYATI IN1200FTOFTHEFOLLOWING: (Gartdt YK�PIy): SALTWATER❑ LAKE❑ /C RWERREEK 0 POND 0 WETLAND[ISEASONAL RUNOFF❑ SiRHAM❑ R�CFN �74 TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION 0 REPADL❑ OTHER O FO USE OF STRUCTURE Gangs CaanvavdaMa[e)R°aU'n09 MUSE: PRIMARYO SEASONAL❑ NUMBER OF BEDROOMS4 NUMBER OF BATHROOM52 HEATED STRUCTURE? YF3 lwhwa amet B YES(PaaP17RMr1❑ NO DESCRIBE WORKNK°Mandaen'etl Rome Pm7edt SQUARE FOOTAGE:f poeeao ISTFLOOR !I aq R. 2NDFLOORO K.R 3RDFIOORO KfL BASEMENTD aq.R DECK.0 aq.R COVEREDDECKO aq.R STORAGEO aq.R OTHERO p.ft GARAGED aq.It, Aamched0 Detached0 CARPORTO sq.R Andi[] Detached[I MANUFACTURED HOME INFORMATION: a4 COPIES OF THE FLOOR PLAN REQUIRED' MAKENtaemm Nwrea MODEI.2^4°rcnrD"2a93 YEAR= LENGTHM WIDTRNW BWROOMS4 BATHS2 SERIALNumSEP2D ENVIRONMENTAL HEALTH: SEWAGFISEWER SOURCE: SEPTIC SEWER❑ / NEW© EXISTING❑ PLUMBwGwsnucru IE? YESO NOO Tjyee,attach mrepleted Wahl Adequary Form PERNO=TRIMUNDATION DRAINS PROPOSED? YES N EUSTINGSQ.FT.� EXISTING BEDROOMS O PROPOSED BEDROOMS 4 TOTAL BEDROOMS 4 OWNER acknwMtlge i that subidene-d Inaccurate iMmmaw met,result In a smp vroA omeror pennM1raumWn.fdawMa33emeM olau in Ia by atgnutumbeloa.l dederatFal l am the wma and IIUMar Eecbre WtIem entibetl to mwive Mls pailandlotlo..,ed,asmaade.I lwe obtelnetl paimissbn Imm all Ne necauary pamu,ircNOing enyeuwnenl MMerw penles of Irtlerest mgeNly Nb prgaK Tat w.ner ia"el andswdure( formieaVld a Ne In Adth. poNtled baccurate and gnnls mmgoyees of Meson LwnryawesbNe abveEesciba]p�opMy dqz p immt)nwlicn vvlk niuepentlM 1we penotl d 1 W EaYs��es w18 vdE ilwoM w aWMZM wnsauaCon Is mtmtmimceEx+Wn 18D PROOF OF CONTINUA ION OF WORK ON THIS PERMIT 15 BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT AP ICATI OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE%08.42) X Date SiPnatuteM NERIM be i aAb M1 OWNER) DEPARTMENTAL REVIRW APPROVED DATE DENIED DATA TAGSdNOTMC7ONDPHONS BULLRING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH IgL � LS , � ( � � ( > � x \|\{ \ ( sin | � � k \ \ ( \ /J . $ \{ ( § 15 §\ \ CL \� ^ �