HomeMy WebLinkAboutBLD2024-01181 - BLD CD Environmental Health Review - 10/4/2024 MASON COUNTY Permit NM: 1 491VED
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COMMUNITY DEVELOPMENT OCT 0 3 2024
Permit AralatlMe ren[ee buildIMPlannin{
BUILDING PERMIT APPLICATION LO} A-W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:MR H(RCS NAME:Mi C01I81 UMION
MABdNGADDRESS:ImNq arra a-BIN IN MAILMGADDRESS:arraaa —R°51s1ra
Q CITY:^s"'Ou STATE:wA ZIP;"IN CITY:suNmu STATE:WA ZIP:PMM J
Q PHONE#1:Na0Yas% PHONE:Nss.essN CELL: Q
(J PHONE42: EMAIL
Ts EMAI),:IwN®Nmwtowcsew L&I REG#�0e1°N"T EXP.8 /_/2f z
•1 PRIMARY CONTACT: OwNERO WWRACTOR❑ OTHERS
CAI NAME OxswFa nu x uaeuuwu EMAIL c1wP0Nay-l—
Q MMUNGADDRESS 18NBN"n"W CITY eu.eN STATE WA 21P--
` PARCEL INFORMATION: TZ
PARCEL NUMBER(12 Digit Number) IlOrM"61-1 2ANMG ueews o3aynwaPR+
LEGAL DESCRIPTION(AbbrcvutM) "`""`^'°" •'°""'"""°""�"^�""'�•�"•�" FIREDISTRICT
dSITE ADDRF3S sm 8eaMvasgsx CQYu�vx
�] DIRECTIONS
I— TO SITE ADDRESS O
THE PROBECF WITHIN 3W FT OF SLOPE(S)GRRATERTHAN 14%: YES[] NO[a SNOW LOAD,. a F "a",
"T ISPROPERTYWITHIN201)"OFTHEFOLLOWNG: A'e.tmteSmggH: Q
`n SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WEH.AND❑ SEASONALRIMOFF❑ STREAM❑
V J TYPE OF WORK: NEW 2. ADDITION❑ ALTERATION❑ REPAIR❑ OTHER n
USE OF STRUCTURE(n+a.e.Gomma coaralaroor N4..De)
IS USE: PRIMARYE SEASONAL[] NUMBER OF BEDROOMSs NUMBER OF BATHROOMS
HEATED STRUCTURE? YES Imw B),10[]O YES RO"/a/e'mW❑ NO O
DESCRIBE WORK" +
SQUARE FOOTAGE:li ya..p
ISTFLOORIetl q.R 2NDFLOOR_p.R 3RDFLOOR_N.R BASEMENT_eq.R
DECK_sq.R COVEREDDECKIN q.R STORAGE q.R OTHER N.R
DAFAGHwe sq.R. Attached+I Demchad❑ CARPORT q.RANaehed[] Desaehed[]
MANUFACTURED HOME INFORMATION: 'd COPIES OF THE FLOOR PLAN REQUIRED•
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERLIL NUMBER
ENVIRONMENTAL NEALTH;
SEWAGFESEWER SOURCE: SHPTC❑ SBWERQ / NEWT EXISTING El
PLUMBINGNSTRUCTURE? NO[I (ryes.Ntarh.'oMdewd WNer Adequacy FOM
PERIMETER/FOUNDATION DRAINS PROPOSED? YBSO NO[] EXISTINGSQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS s TOTALBEDROONS-
gVHER kigMed{ee mMeWnbtl.n dlneccumle iMamelb�mayrewnlna uoP daddPen�It�ewa�:°:I°n.Odnd^I......awtlibEy
z'gneNe ttivx.I btla.Hu11 am thy,—,and I tunny. unNua m.:..m enuuea m remlw lnls pe�mX a�q 10 ao uO vnM1..Pmpo:ea.I Ivro
C ta. P.ml.Nmn eNtwn sa P. es,nduaino anyeaaem.l MIa..oaniesdnleresl reo..ame mill'Lied Tnemun...leyl
andoro :efiM.Rr pa.M met m.Id.nn. ,,is
I.amlmleanaomnl..moloyeI dM.sonyounN..¢ss:uNvs nor mouneaP aronI
day BNtlurt(al I"oaul.a'.na'ugarden. ral rud,f 10darry�smee null8.vtia nwnM o�eulMrlmtic.nslruvironb nor c.mmmxE MNvn 180
days.rHxns:nmLon vclk le wspenaea ba pwetl o1180 Gaye.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE N,08.02)
SIOreesm d OWNER EI tbaslgnatlbLEMM NER) Darn,
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSNOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLICHEALIN
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