HomeMy WebLinkAboutBLD2024-01226 - BLD CD Environmental Health Review - 10/22/2024 f MASON
SON C077�7TY PermltNo: d o - 1aaLP
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Permit Assistance Center, Building,Planning 5 I�C.{'�_ 7-02A 02"
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�� BUILDING PERMIT APPLICATION
(^6 PROPERTY OWNER RNFORMATION: CONTRACTOR DVFORMATION:
�a NAME:Ma H.LIC NAME," Homan u.c
V MAILING ADDRESS:NN Em Dr MAILINCADDRESS:m1EB Dr Q
O C1TY:U� STATRWA ZR:ww CITY:Uni. STATE:WA ZB:� _
1 PHONE#L3W aBBwssma PHONE:380890 OMs maa CELL: W N (�
PHONE EMAIL:ameee,®eBeblavlmmpmfie.ran \ o
N FINAL:mnd.@.Ieanmowpw.Beamm L&I REG#saEWDRmoe EXP. 1111?m
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Q PRNLIRY CONTACT: OwNERD CONI'MCIORD OTBERO Q
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MAILINGADDRESS871EBMMDr CITYLvee STATE WA ZIPBBSrt U
PHONE Mmm 5ws CELL
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PARCEL INFORMATION:
` , PARCELNUMBEI(12M&N� ) B21W aal ZONING OrT �J�^ to
LEGALDESCR ON(Ab &Ud)u RBROOKOIXFdCWNI =BLOTB:B1 gIRE 073fWCfB 'Z7
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DIREMONSTOSDBADDRP53 RIBMw Mmvams,Wmm111OmvA YPM Ln,BNMannm NrtnmM.B.. AC`p�O jQI�
i 1 M TBE PROJECT VVrrM 80 FT OF SLOPES)GREATER THAN IRY.: ME] NO[] ENOW LOAD:
"T MPROPERTY WIT®Y2NFT OF TBE FOLLOWING: IrAu[aunmmPryJ:
SALTWATER❑ LAKE❑ RIVER/CR (] POND❑ WETLAND❑ SEASONALRUNO"El STREAM O
TYPE OF WORK: NEW D ADDITION❑ ALTERATION O REPAIR O OTHER ❑ Q
USH OF STRUCTURE(RmWaua Gvepa OmuWcIaMASm)Re�la^a T
ISUSE: PRIMARYD SEASONAL[] NUMBER OF BEDROOMS B N ER OF BATHROOMSa Lu y
HEAT60 SiRUCI'URBx YESI jn4rjD ME gslofBWD NOO C J
DESCR®E WORKNW.'anWaf.IN1�^W°nea Gz �
SQUARE FOOTAGE:Ip,mma# Q IyJ
ISTFLOOR2� N.ft 2NDFLOOR nq.ft 3RD FLOOR q.ft BASEMBITI_p.ft T =
DECK K& COVEREDDECKE ea.ft STORAGE K.ft OTHER N.S.
OARAGE�.a.ft Aaachi Ej DelacJMA❑ CARPORT .S.ft AN W[3 DrbcArd❑
MANUFACTURED HOME INFORMATION: •4 COPIES OF THE FLOOR PLAN REQUBRED•
MAKE MODS. YEAR LENGTH
W TTI BEDROOMS BATHS SP.RIAI.NUMBHR
j ENVIRONMENTAL HEALTH:
SEWAGF/SEWERSOURCE: SEPTICD SEWER❑ I NEWS 8103TRNG❑
PLUMBINGINSTRUCTURE? PESO NO IfP ,amach wapld lPawAdrqu Form
PERIMETEWFOUNDATION DRAWS PROPOSED? YES❑ NOD EIUSTINGSQFT.
BXMTING BEDROOMS PROPOSED BEDROOMS J TOTALHEDROOMS3
� OWNER mtmwbaP,ama.vem®.Iea of Mcwmb nnwnamn wrmmnlneamawmmammpamR moWM.AtlmwAW.mma pt.ambq
.Mn.am Mbx.l aemm mm i am xm m..mr.w I mmeraaobmmal l em aouu.a w meal.o ub pe�n.oa nee Bmxak..Pysaa.I Mw
emelnea pmmwim M1an aumejnu AaNea.lmlumnv anyeeeememmmerwpaN&Msmcwnm tlY.Pa).e.Thdo . bwl
mp�ewnbnw ryMBBen6 MtliM Inldme4m pm�'IaM u mama aM pnnh employee N Aleaon cwnryeveeBb the sinus eumEetl popaTy
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aM n YwmWybn xoh 4 auapentletl Iwe wmtl at 1 W Oep.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. PUCTNUY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLK:ATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.Cn
X0.�"�"n 10/71/2024
Sianelure of OWNER INUN bvtM OWNERI Dab
DEPARTMENTAL REVIEW APPROVED DATE DIVIDED, DATE TAGSM1OTESICONDMONS
BUILDING DEPARTMENT
PLANNWODEPARITAPNT
FIRE MARSHAL
PUBLIC HEALTH .
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