HomeMy WebLinkAboutBLD2024-00295 - BLD CD Environmental Health Review - 1/30/2025 yn —' —'-A46vt)G Permit No D
MASON COUNTY r[t
COMMUNITY DEVELOPMENT MAR 06 2024
P«mR Aulsume Center.Baum Ponning
\ BUILDING PERMIT APPLICATION 615 W.Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:�cmus &REoE NAME:
MAILING ADDRESS:413 BFAIRC MArM So MAILING ADDRESS: /\
CTCY:3E0GM STATE:-ZIP:MY2 CITY: STATE: ZIP: 9,y
0 PHONE#1:1ntMaMs -- PHONE: CELL: vv
PHONE#2:eMaxmM EMAIL:
C�(d EMAI.:a^a'angP�m.ms xy»mBma L&I REG# EXP'—/—)— tC2 �Oj
\Fr- PRIMARY CONTACT: OWNERD CONTRACTOR[] OTHER❑ FO s
NAME w^%+e^^ EMAIL—141 '
MAILINGADDRES M3 B OREEKMAIEaW CITY Bmw STATE w" ZIPS
fC1 PHONE ax.ap.aop CELL
_M PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Nxmb«) 3]3M.IS-0B1M ZONING RRS
LEGALDESCRIPTION(AbbrevieW)Lae aewteu NWOPIBORWI TR&B FIRE DISTRICT 017
S)TEADDRFSS413Nx RNGEOR CITY uuMmP
DffE IONS TO SITE ADDRESS G°"e'min rt0+nmsDMTaasm.Rblpmx.x.rma Rbeaom..l.nn�tsx.x.�mawya Gyre.
;V'7SJ1 ISTHEPROIECTWIT 3M"OFSLOPECS)GRRATERT 14%: YESO N00 SNOWIAAD:_Pd
ISPROPRRTYWrrMN•200FTOFTBEFOLLOWING: fchactoab ww:
SALTF'ATERO LAKE❑ RIVER/CREEKO POND❑ WETLAND❑ SEAEONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR,❑ OTHER 0
USE OF STRUCNURE(AOMw«,D ,camas N4 Fm)REMyENCE
MUSE: PRU3ARY0 SFASONALO NUMBER OF BEDROOMS a NUMBEROFBATHROOMS3
HEATED STRUCTURE? YES~BMW EI YES fPR4,)leuy❑ NO 0
DESCRIBE
SOUARE FOOTAGE:S,poara)
ISTFLDOR t0M p.ft 2NDFLOOR 1031 p.ft 3RDFLOOR WA p.ft BASEMENT WA p.ft
DECK 3M p.ft COVEREDDECK 740 p.R STORAGE p.ft OTHER_p.R
GARAGE p.& Afw W D Deuw W❑ CARPORT sq.ft Aw [I DeMchol0
MANUFACTURED HOME INFORMATION: 'ACOPIESOF THE FLOORPLANREQUIRED-
MARE WA MODEL YEAR LENGTH
WICTH BEDROOMS RATES SERIAL NUMBER
NVIRONMENTAL REALT'H•
SEWAGFISEWER SOURCE: SEPTICD SEWERD 1 NEWO EXISTING
PLUMBINGINSTRUCTURE? YESa NO0 Ilya+,ouad co kP W.w,fdwuary Porn)
PER MoE1T3/FOUNDATION DRAINS PROPOSED? mg NOO E)DSTING SQ Fr.
EXISTING BEDROOMS PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
OWNER tl«.vtayestlut aulwniszlm IN IMmurzh InMmetian may Mutl In a ebpwaM wtlarorparmil revaution.MmmNeEpemenl W auto b Ey
eIpMWA BeM✓x.l OMn Nal l em Me Owner m011uMer Cecbra Nal l am anWM b rettWB xik parmil enE to Eo Ine wOM1 ea pmmeM.l Mw
a+eirctl pnxzaknfmm all Vle rewuary panim,ircluYng a�ly amemenl Mltler or peNm al IineM+�epaNlg Inlz pmlacl. Tta owls or Ipel
rapRNnlatlw.MMema Na11M In(omalun pONEM u Mumb mtl pRntl empYryNe aMawn LOunty u'a'uub Ine eCoue CeaTh 1 pmpMY
mtl MUW2(a1M MicweM mapeCbn.ll�b permM1leyllwtion�«mea nu116wM ilxak«auYmzM mnaW cticn b nd ammma0 wMln 1BB
tlara«Rms.wmm.olx b.uaP.mstl t«e palloa a tao says.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTMW OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE I6.08A2)
Sienawre a OWNER(Moet to wo.Wtha OWNERI Date
DEPARTMEYT'AL REVIEW' APPROVED -DATE DEMED DATE TAGSINOTESICONDITIONS
BUDDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSKAL
PUBLIC HEALTH
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