HomeMy WebLinkAboutBLD2025-00019 - BLD CD Environmental Health Review - 1/9/2025 MASON COUNTY IeT.Hw:RI nanas-000ia
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Building,Planning JAN D 8 M5
BUILDING PERMIT APPLICATION 61E W.Adw Si
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PROPERTY OWNER INFOADIATION: CONTRACTOR INFORMATION: z/
NAME:Spau'aad Pap 8lWaa NAME:SUPREWH 8
MAAINOADDR&SS: —7 MAHANG ADDRESE:tS9185oTN AVEE
CITY:MANrele STAT&WA ZB:aai l CA'Y:TALUMN STATE:WA ZIP MLNS m O
PHONE#1:N'dMT.TW PHONE:PWW'IN CELL'
PHONE#2: EJIAH,:C IICn2`68u�WM > Z
HMAII.:MPBYEWIBVPMLCCM�/W�WWAW(lVl 1&I SEO# E" 9
PRR1fAAY CONTACT• OWNap cowrIl ap nizz M
NAME dJIRATNQ El NWMIOALVRWIDLLTNG Zcw Z
MAITNGADDRHS$YIH/MTNAYEE cAYWWWI WATB—WA ZIP WIN
PNONE..'No CELL ✓
PARCEL RNFORMATION: nA� ��Q/�
PAACELNUMBER(12 DigR Numbs) 92103Na00'N ZONINGPAS •LA(C v1p
IEOAL DESCRO'f10N(Abbmviamd) LOf:DOFaPi1956 P1NTHs86PA9FeanN8lYM gDRgDMRICf
SITE ADDRESS 100EGIGNMOGD OB QPYUMDN (CO
DIRECTIONS TO SAE ADDRESS
ISTBEPROI6CTWlTIDNSMFFOFSLOPE(S)GRRAT61tT 14%: YESp NO® SNOW[UAD',?§,-�
IB PROPERTY WITHDn 1p FT OF]1D2 FOL.L/OWING: 1c.W#rlamaPNf
SALTWATER[] LAREp RIVER/CRFSK PI Porn❑ WETLAND❑ SEASONALAUNOFFp STREAM❑
TYPE OF WORK: NEWS ADDITION[I ALTERATION13 REPAEtp OTHER ❑
USE OF STRUCTURE(xwLLva Gwga c*.+n.'IW W.BeJ RESIDDICE
ISUSE: PRAtARYO SEASONAL[] NUMBEROFBEDROOMS 0 NUMBEROF BATHROOMS Y
HEATED STRUCTURET VESfMa.aLW❑ YFS(Pwr4J4»1410 NO❑
DESCRIBE WORK BWO NEW HDIEON PAP.C6
OTAGIll
ISTFIMR 1.= R.R. 2NDF I q.e. 3ED FLOOR y.R BASENEM'_N.1L
DEI ( K.A. COVEREDDECKM q.R SI)RAGE K& OINBR_q.R
OARAOESIT p,R AFb o D 13 G1WRT q.R Aa 13 DOWWO
MANRRACFLRED HOME INFORMATION: •a COPIES OF THE FLOOR PLAN REQUIRED'
MABE MODEL YP.AIL LENOTH
WWTE BEDROOMS eA115 SERW.NUMBIDL
FNS^.RONMENTAL RFAF.TH:
SEWA�SOOxCE: SEPTIC® 9EWERp I New® EXISI'DIO❑
PLUMBINCNMUCTURER YESIr] NO JfMs.aaod cProbeed O'ro Adaguuy Porn
PERD4TERIPOUNDATION DRAINS PROPOSED4 YES13 EIDSTIIGS(I.PT.a
EXISIINO BEDROOMS 0 PROPOSEDB®ADONB a TOTALB®ROOMS 3
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PROOF OF CONTINUATION OF WORK ON THIS PERM'IS BY MEANS OF INSPECTION. INACTMTY OF THIS
PERNR APPLICATION OF IN DAYS OF NONE WILL CAUSE THE APPLICATION TO BE E%PIRED.(MMON
COUNTY CODE ICWA2)
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DEPARTMENTAL REYRW APPROVED DATE MN® DATE TAGM40117SICONDATONS
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