HomeMy WebLinkAboutBLD2024-01196 - BLD CD Environmental Health Review - 11/14/2024 Pe.ft N.•" V I (CI`i"
MASON COUNTY
COMMUNITYDEVELOPMENT L��3 Perrbk sslaanee Grata,BulldiN.Plannln8
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CnNTRACFOR INFORMATION:
NAME:un NLMES NARffi:t^TcoxBtRurn°"
MAILING ADDRESS:
IPYA CM°Nxn wsM lM MAKING ADDRESS:IMMDMI°M^°°n xasn lM
CRY:^^w^L` STATE:wA ZdP:else CRY:WMwu STATE:WA ZIP:w+W
PHONEWI.zneo.mee I PHONE:m.eW zlM CELL:
PHONE A2: EMAIL
EMAK.:XdsNDMrI1MNMe.CM1 Lit, REG AMTTc�^MNr EXP._/3 /
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER OO
KAMH EMAIL AMMRXxPM.m.—
MAILINGADDRESS IPai"olt"itt CITY Wu STATE MPMIM
PHONE Meal CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 1'1a650d10M ZONMGg1 GRITvm ARFA
LEGALDESCRIPHON(AbbrcviaW) AL IRX:61LM$ FIRE DISTRICT
SITEADDRESS"Eca -'- CITY�-
DIRECIONSTOSITEADDRESS yeeem°xv reel
N ISTBEPRO CTWRHDi300FTOFSLOPE(S)GREATERTN 14%: YESO NOD SNOWLOAD:_Paf
ISPROPERTYWI'ENIN200FPOFTHEFOLLOWING: fit/ afil oplyl:
O SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND D WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
NTYPE OF WORK: NEW O ADDITION❑ ALTERATION❑ REPAIR O OTHER 0
USEOFSTRUCTURE(Bmmxv.Cmngr,Coaaaa IN4Bic/REd2--r
IS USE: PRIMARY21 SEASONAL NUMBER OF BEDROOMS s NUMBER OF BATHROOMSe
HFATED STRUCTURBV YES ry BW O YES WmIN)JBW❑ NO❑
DESCR[13E WORKNEwePR
0_ SQUARE FOOTAGE:4
I IT FLOOR 1212 sq.ft IND FLOOR"" sq.ft IRDFLOOR_aq.R BASEMENT_aq.R
DECK_W.ft COVEREDDECK> y.R STORAGE R.ft OTHER bq.R
GARAGE'M aq.ft Aoou Aad0 Detached❑ CARPORT aq.1t Aemehed❑ Detached❑
MANUFACTURED HOME INFORMATION: '0 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SRRIAL NOMBER
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC SEWER O+ / NEW O' EXISTING❑
PLUMBINGINSTRUCTURET YOE] r NO❑ Ify ,attach completed Wmer Adequacy Form
PRONETER/FOUNDATION DRAINS PROPOSED? YES NOO EXISTNG SQ.FT.
EXISTING BEDROOMS - PROPOSED BEDROOMS TOTAL BEDROOMS'
OTNER edwMekea mM sudnleNm Nlnem�mle iMolmNon mry reauE in°aWp xoM1 oNerorpxmX rewutbn.MknvMeM1iamanl W euN-Iv Ly
vYeMMre Eebw.l OBy°n IXet I em Na WmereM I Neer Eedare Pel l em mlllletl b reCBNe IMe pBlmll eM to tl0 Ne xwk as popasep.l AM
oElm pMMs°imwroall Nseibfom onproindutllp0 eny easement�okworpaNm,oleerednlya n0Niatha&b. IDet-twmlapel
IBpresenlBYart repreaenM Na1Ne inlom.MOR pmNEe01e amuale anE p2Ms ampltlyeas a Mawn Cwnly aUaai b Ne eEove OeacnEetl pmpery
xp atru'JNalb)Mt rewm'eM mapetlbn. ilAe p¢m.IVapPll[elion Eemmee MI d Wltl Mwv�k o!Bultanxe0 CMSW[lion is nM mmmeroe0 rNVN 180
aryB mXonseu lOn voM1 iB euape�Mee IOr a penoE N 1B0 tleys.
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 I4.08A2)
X D.M
HlOreMro vtOWNER(M al be Ivne.by fba OWNER)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSMOTES/CDNDITTONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUEWCHEALTH ZI R
q^. %
A O
ig
$St E i
SIX
E COMPASS LNt P _S $-
69
a�
�� 4� � �I I •-1 I8 rJ
R `�" SC4' del "f0 I'EL
I8 x
7.W
Aw
zA I I LR �Er �
mma
a r $
1 pp y S
� Nt)oo'oo'E a000
a W n
E SULLIVAN ST
p � �•w.u.- -66"-
j$j [}Y � SD----SD —S
MOP,
ALLYN 10
MASON COUNTY • ALLYN, WA C"Aw
i LOT 90
` cw.. IffT XOIEB XORTXWEBT '°"'^��A
:u-
Ho
11t38 SE erx ST. smE 1a wn 06001 nm I......