HomeMy WebLinkAboutBLD2024-00352 - BLD CD Environmental Health Review - 3/13/2024 MASON COUNTY Pernik ND: _0035 •-
COMMUNITYDEVELOPMENT RECEIVED
PermkAUlsGna trn r,Buildll Pl.rW, MAR 13 2,024
rn
BUILDING PERMIT APPLICATION 615 W Alder Z
PROPERTY OWNER INFORMATION: CONTRACTORINFORMAT[ON: Street <
NAME:A&Mea M*aY NAME: sia+� D O
MAILING ADDRESS: 2IJN
IK4 S 0 MARLING ADDRESS:MO0 W 8NNM wryW
CO'Y:Kant STATE:WA 23?:s COslwm
Y: m STATE:WA ZIP:RON,
PHONE#1x "1-21W PRONE: CELL: 3
PHONE N2: EMA¢:w -Qpal— = M
EMAIL:IImak"80 mvRml L&I REG#WO2 EXP. I I z
PRIMARYCONTACT: OWNER, CONTRACTOR, OTwmE)
NAME—ate EMAIL aRmn D
MMLING ADDRESS 2000 W BNeom ViW R! CRYRad STATE WA Hp8 r
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Dt Number)22D881WOB0 EONR.IG raalAdM
LEGAL DESCRBT[ON(Abbeevieled)MADWDBBUNNYSX EADDRV FRREDIsTR2CI0
SITEADDRESSMMEMasanl *OrWGrap M CFFYglypl
DIRECTIONS TO SIZE ADDRESS°^S's NE atl.dMwl Wa
MTHEPROJF.GTWITIDN300FTOFSLOPE(s)GREATRRTBANI4Y.: YESQ NOD 6NOW LOAD•,_pzY
L4 PROPERTY WITHIN 200 FT OF TBE FOLIAWINC: laaLes Adalloi:
SALTWATER❑ LAKE[] RIVER/CREEK❑ FORDO WETLAND❑ SEASONALRUNOFFO STREAM❑
TYPE OF WORK: NEW, ADDITION❑ ALTERATION[] EEPAIRO OT!lCR pINea PXnsl OaeRn
USEOFSTRUCWREMani,•Gm �lehkad)Ra4tln41alafiwiva.
ISUSE: PRIMARYQ SEASONAL❑ NUMBEROFBEDROOMS__;� NUMBER OF BATHRODMS_'�
HEATEDSTRUCIIIRE7 YGq(wede [] YES OW.] NO[I
DESCRIDE WORK eZ-
SOUARE FOOTAGE:1�vAara)
1ST PLOOR aq.ft 2NDFLDORI" p.ft 3RDFL00R_,& BASEMENT_,&
DECK eq.& COVEREDDECK_K.ft STORAGE ml.ft OTHER eq.ft
GARAGE_q.ft Av had[3 Drip[3 CARPORT I&Attaa�O Daw 13
MANUFACTURED ROME INFORMATION: ae COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WWn BEDROOMS BATHS SERIALNUMBEK
ENVIRONMENTAL HEALTPL•
SEWAGEISEWERSOMM: SEPTIC El SEWER, I NEWS EXISTING,
PLUMBINGINSTRUCI'tIR%f YESD NO❑ lfy lattod e.,k d*dwAdequary Fame
PERM(FTER/FOUNDATION DRAINS PROPOSED? YES❑ NOB EXISTING SO,FT.
EXISTING BEDROOMS_ PROPOSED BEDROOMS TOTAL BEDROOMS_
.ER BGnwletly MatslYenblon allry0.y2blMgmaEon may revuX'maatopwkmtlsrm PennX RWCeIbrt Pbnw.leEgememde1N119W
slgnamm balm,.Id,dam tlu11 am me—am l NMer netlmm Mal l am mwW W U uva Pi¢pmmd and m tlO In,wak as pminmi l new
madame,pe-fission hom afl me nerema,paM .'lutling any easement NYtla w p Tm ofmd t RgaNiea mk lanletl. Tne anervlpsl
RPIBsemtts
� m Xaltle intwmatiOn gmNee Is avL2ta.M g�enb BmplpyW9 m Mzam CmumtY amass W tM ygVe ERWI»]gcFa,y
u in n. ,a018sams sls/per a,lorepalWdlBYMa TI N OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
OF 180 DAYS 0 MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
DUND CODE 14.08.42)
X3) Z >ER Dave
DEPARTMENTALR W APPROVED DATE DENIED DATE: TAGS OTESACONDMDNS
BUDDING DEPARTMENT
PLANNING DEPARTMENT
FIXEMARSHAL
PUBWCHEALTB
`bWNG 5EPTC g:PUMP
TANKS.VSEP. IF RESERVE
' D/F IS NEEDED NEW TANKS
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