HomeMy WebLinkAboutBLD2024-01230 - BLD CD Environmental Health Review - 10/22/2024 Amol
MASON COUNTY Permit Na: Dil A0911-g AM E I V E D
COMMUNITY DEVELOPMENT c
Permit Assistance Center,Building,Planning OCT 162024
BUILDING PERMIT APPLICATION 1d t et
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: v{ L4-.^I 1 eT L/lW NAME: L t
MAR ING AI)DRESS: • - 0 MAILING ADDRESS: fA Qf VWj2
C17Y:OG,✓KlO ret STATE: ZLP: CITY:OL ,o 11Kt STATE:L1 ZBa. 'A
PHONE gI: - O 2 PHONE:�t1"CELL: n� 1
PHONE 02: u EMAIL 6F F,1u(6 /` 1p
EMAIL: Ad d fN . 4ol L&I REGA W1W AVAl
PRIMARY CONTACT: OWNEREY CONTRACTOR NIT OTHER❑
NANE A EMAIL
MMMNGADDRESS CITY /N STATEZW_
PHONE gip. . yore CELL U Z z =
PARCEL INFORMATION: tJ
PARCEL NUMBER(12 Di®t Number) ' UZ'I.-7�I (j OD /I ZONING
LEGAL DESCRWTION(Abbemiated) 13" W -310 ^ '(i(p1L'r' HAS DISTRICT
O W
SITE ADDRESS CRY
Efflk IONSTOSIT6 ADDRESS brst 7i to ON FDS s[/tom 1/ (!
NTHEPRMJ WITRIi3ESFPOFSLOPE(S)GREATERT 14%: YESD NOBL SNOWLOAul Z
ISPROPERn Vi TEN200FTOFTHEMII.LOWING: )JAL
SALTWATER❑ LAKE❑ RIVERIUREER❑ POND❑ WEO. O SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW D ADDITION❑ ALTERATION❑ REPAIR❑ OTHER n
USE OF STRUCTURE/Reade.w rl CaOelwaa,E]e)
ISOM: PRI.tARY❑ SEASONAL❑ NUMBEROFBEDRCOMS NUMBEROPBATHROOMS_
HEATED sTRUCTugil YES lRlbleamE❑ YES IPmsfj/plp/❑ NOD
DESCRIBE WORK
SOUARE FOOTAGE:uenmaM
ISTFLOORIN 9q.R 2NDFLOOK aq.R 3RDFLOOR K.R BASENICNT_9q.R
DECK_p.R COVEREDDEM p.ft STORAGE R.R OTHER ail
GARAGE_K,R AR dd ❑ere 13 CARPORT ,.& AuadMD DeraeAeal
MANUFACTURED HOME INFORMATION: P_G/`JCOPIES OF THE FLOOR PLAN REQUIRED•
MAKE l9Yo 42-TINWD MODEL P"P/ML f"V YEAR 1 IS- LENGTH Z
WD)TH2_BEDROOMS BATHS 2 SERW.NuMUER taW S cd Sr
ENVIRONMENTAL HEALTH:
SEWAGF/SEWERSOURCE: SEPDC sEWER EXISTING❑
PLUMBINGINSTRUCTURE? YES{]/ NOD Y,p mm/Aromplettd Waam Adlgnl Form
PERTNETERIFOUNDATION DRAINS PROPOSED? YES❑ Noor EDSGNGSQ.FT, 13Y'F
EXISTING BEDROOMS PROPOSED BEDROOMS�(_/TOTAL BEDROOMS
OYINER w*mMMOes N subnlWm dlnamvab Me�metlm mN muX In a NW wb bdmu pemitreswLM�.MfaMeyemeM W suN b py
.,.al l=m%.I am me—el I N.Eetlere.I am m.ro--Nls pe-m end 1.a.me—.as p,...I.
s inM pema'san"mall me r—,peNM.Ftludln0 eny easement aol padiOa Iintere9 re0asdlnA meat TheaMYorlel
repnemb0w,rOp2^eMemel me Mamsuon pmNdeOls Kalb eM praMa employees W Mason County emess b me aGow desviEetl peopeM
eM aNtlurels)MbNewaM in.pecti0n.11Yi pe�mNeppGutien taceme9 nYll d wid XvoM1 orautlwAzad wnseucAan is nd amnairsd vAmin I80
aaye m XmnNmmm vnb b ai¢emeerma pedpd a+m say..
PROOF OF CONTINUATION OF RK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
MR PER APPLI ATION OF AVS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY 0011E 14.0EA3) ,a
X r l0-/l�'e'7
SlaraMrt MONNER(Musta9ll bvmetafill DMO
DEPARTMENTAL Rl .APPROVED DATE DENTED . DATE TAGSINOTESICONDITIONS
BUILDING DEPARTMENT
PLANNINGDEPARTMENT
FINE MARSHAL
PUBLICHEALTH LI
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