HomeMy WebLinkAboutBLD2024-01129 - BLD CD Environmental Health Review - 1/21/2025 1 Permit No:�LA
MASON COUNTY
COMMUNITY DEVELOPMENT
PermRNslmnm Ce^Ru,Building,Planning
BUILDING PERMIT APPLICATION W'
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:MTN""• NAME:NTTyddyag UC10N m
MAILING ADDRESS:Ivan^41eMesain assay IM MAILING ADDRESS:IMOChinderaen Rasolw Z
CITY:Tta'mla STATE:wA ZIP:MINT CRY:TMN 1 STATE:wA Zip x1M <
PHONE#l:ssw as PHONE:—Ise CELL:
PHONE#2: EMAIL:
EMAIL:w.sxf9MfIXOLLNgS.COM L&I REG gan"TO s' EXP._/3 / 3I m O
PRIMARY CONTACT: OWNER❑ CONTRACTOR[] OTHER O D Z
NAME N^a—TreRxiTiw.�cxsoBua EMAIL Cr Eyxvncorn
MMWNG ADDRESS rdxswlwarsr m CITY BURS M STATE WA up...
PHONE--a CELL = m
PARCEL INFORMATION: .--I
PARCELNUMBER(12Mg Number) 1-11- ZONING G VRNWORQMNd D
LEGALDESCRIpT10N(Abbre,,i .1YNL0T:an.NA walla] FINE DISTRICT r
SITE ADDRESS TI E COMPASS LN LTTYIILYN
DIRECTIONS TO SITE ADDRESS
MTREPRWJ WITIIBN000FTOFSLOPE(S)GREAT RTHANIB%: YES[] NOD SNOWLOAD:—paf
M MOPERTYWEIIIDV2W0 OFTH MUOWD . ICxv aadaapjay)
SALTWATER❑ LAKE❑ RItlER/CIl ❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR 0 OTHER 0
USE OF STRUCTURE(/M+DRme,forge.Canal W RESIOEMNL
IS USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS a NUMBER OF BATHROOMS 2
NEATBD STRUL'1'URB? YES/wl.+ Al 0 YES IPmrfaJPYeIAd❑ ND❑
DESCRIBE WORKNEw�+
SQUARE FOOTAGE:TPmyamel
IST FLO011 sq.R. 2ND FLCOR sS.R JRD FLOOR sq.B. BASEMENT sq.I
DECK_sq.R. COVEREDDECKIN p.ft STORAGE BS.R OTHER as.R
GARAGEem s fi, AMched[]+ Demchnd❑ CARPORT ml Ausi[] Demclred[]
MANUFACTURED HOME INFORMATION: ea COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERW.NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE(SEWER SOURCE: SEPTIC❑ SEWER[]. / NEWD EXISTING❑
PLUMBDNGINSTRUCNRE? YESE NO[] T/yee,addal mnPlessi Will Ahquecy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NO[] EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS a TOTALBEDROOMS d
GAINER SINbMed3sa NM sudnb%m W Nevurele inblmeWn mg re¢uX in a¢Np vark artlarm Pomylmocelbn.MknMetlpemenlol su A b Gy
Npna aeb.V.ldetl tnMIemn wmarend IMU herds amthMlamwtmwwR we IFhp daMw MNBNURaspropoaea.l^aw
eWinea Po^^b¢im ham all ire reressery parties,r6l ang any msemenl haserw paths•M hill warning NIe Emilia The wmer a l-gal
reprBeMlBtlw,wileuMs Ihas NainAm lion pmvbed I¢scam,and gR^Is employx¢of Meson Canty Bsdand N on above deambed ampaM
yk shutlure(s)lar nriaw and inspeNon.This Po^nNepWiuWn berwnes null d wid RNvrF ar MMdud¢ns4umm'u ml mmmerced NINE 1B]
tlrya a Mmnsducaan xwk b nuepended Iaa Podoa✓180 dryt.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE PALL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.0.42)
X
Sienewre MOWNER IMuM Be aigna#WIM1e dNNER1 Deie
DEPARTMENTAL"VOW APPROVED DATE DENIED I DATE TAGSRNOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH 1 K'L
• N � aaaga � � s
1 x1 a"x y � vCBtq8
1Tp i g fg *�i 9 y
if S�•p A R # tl�tl •a s i#>� R yaE Ar��3j Sj n y
$�p $ '
gg $ 5 I
tt; � FFF
m
p c 'o E!,9 PASS LN
— lFlCh
3
= < $ --- -'o-. --- gig $I Egg
y s 1 ARa R
FX @
1-4
I8 ^fat
$$
H
7407
tR
� $ m p
. s b
M # e'a
ITIXIOO z
E io oo m
o aIs
$ � 6 boo N
10.14-111011
ESULLIVANST Mac)D - .€
" _ ALLYN 10 /r�+�r
° a? MASON COUNTY . ALLYN, WA CYA.7.NWINC
i z LOT 4 mn eHaRmw♦KwnmHr
eG. Cry. WT HOMES NORTHWEST ��+ n•-•�10+=•w•
1 5mE 230 a wE.we 96004