HomeMy WebLinkAboutBLD2024-01126 - BLD CD Environmental Health Review - 9/16/2024 Permit ND:ZInZfiEWVED
MASON COUNTY SEP i 6 2024
COMMUNITY DEVELOPMENT
PamilAwroRPe cemac EP""�.Pm^"'"° g1 Alder Street
BUILDING PERMIT APPLICATION.4p �01'
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
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NAME: tn000cHtmu..AdA>tm MAILING ADDRESS:teooq cnn.rm,>m,eras.tm
MAILING AD DRESS: aemY.rn STATE:WA ZIP:"'"
l` CrTY:�u STATE:t^'!ZIP:Penn_ CITY: as> ar� CELL:
PHONE#I:�aPe°1•n PHONE:
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PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ arXI:R O Z
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NAME x.xrxeasTraua.m-oaaErntxmux cm.�.ex SPATE m=_SIP wt� LIB
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LEGAL NUMBERON NEit Number) tL".M0°I
LEGAL DESCRIPTION(Abbrcviamd)wEm nuc et wr> FlRE DI511ULT 1i
SITE ADDRESS>t E cameras Tx
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DIRECTIONS TO SITE ADDRESS °u
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SALTWATER❑ Lm 0 RIV FF❑ STREAM
ERCREEK❑ PoND❑ W6PLAND❑ SEASONAL RUNO
TYPE OF W ORK: NEW O ADDITION❑ ALTERATION❑ REPAIR❑ OTHER Nl
USE OF STRUCTURE(R.nemn,Cmrrg..ctv ,`I'E D`'/aEsmENrBR
IS USE: PRIMARYO SEASONAL❑ NUMBEROFBEDROOMS?NUMBEROP BATHROOMS?
HEATED STRUCTURE? VES( kBFEI❑ YES ry.rtGlyeay0 NO
DRECRNE WORKNLW ST
SQUARE FOOTAGE:OmF•M
t-P .R. INDFLOOR_sq.R SRDFLOOR_P BASER-1 ft- .ft
IST FLOOR_nq
COVERED DECKns KR. SPORAG6 ''R Aaa W[l D--rc Id❑
GARAGEann n9.ft Aaach" D-d-d❑ CARPORT—W
p ANJFACTURED HOME INFORMATION:
•A COPIES OF THE FLOOR PLAN REQUIRED•
MAKE
MODEL YEAR LENGTH
W.IpTN BEDROOMS BATHS SERIAL NUMBER
NVI 0 ,NTAL HEALTH: EI t NM EI EXISTING❑
SEWAGE/SEWER SOURCE: SEPTIC SEWER
Ul•^Ptra h,lercd WmerAdegwq Form
PLUMBING IN STRUCTURE? YES Q NOD EXISTING SQ.FP.
PERIMEPFdUFOLMATION DRAMS PROPOSED? YES El n LBEDROOMS�
EXISTING BEDROOMS PROPo TOTA
SEDBEDROOMS re EDROOMyeq.mmnm rarer iaq
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PROOF orT IS By
PERMIT APPLICATION OF OF
DAYS OF MORE WRK ON THIS ILL CAUSE MEANS TO BE EXPIRE�OF THIS
MASON
COUNTY CODE I4AEA4
R Oem
Sipmmm of OWNER( ei e b M OWNERI
DEPARTMENTAL REVIEW APPROVED DATE DENR:D DATE TAGSMOTES/CONDITIONB
_ BUILDING DEPARTMENT
PLANNNO DEPARTMENT
ME MARSHAL I L
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