HomeMy WebLinkAboutBLD2024-00310 - BLD CD Environmental Health Review - 4/12/2024 / MASON COUNTY COMMUNTIY SERVICES RI� ~tl��OO
PERMIT ASSISTANCE CENTER:
•BI/ILpNG.RANNING•PUBLIC HEALTH.FIFE W4 AL n
616W.Aem Baaa.S*w WAM586 MAR - 7 2024 ti!.
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BUILDING PERMIT APPUC�.TIO - Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR RNFORMATION.
NAME: G I A oP NAME: �(+mcc •J
MAMING ADDRESS:
CITY: STATE ZIP CrrY: STATE: ZIP:
PHO #I: PHONE: CELL:
PHONE
EMA L: L&I REG# EXP._/ /_
PRihL1RY Lb ACT: OWNER' CONTRACTOR❑ OMER❑ vo
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EMAIL ptt—AL1�WJ
MAIUNGADDRESS CITY S'1'ATE_ZIP_ m 7y
PHDNE CELL
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PARCEL WF'ORMATION: /te 10
PARCEL�(12Di®tNm ) C�O` QOO OA ZONINGO(-(
LEGAL DESC fI (Amre mq FIREDISDUCT IAA 144 (G
SITE ADDRESS 0 CrrY �1+-Ah _
DIXECfIONSTOSITE,[w�DDRESS YC(*per fa4quo4M �.AAo a
Af-
_6My.A"&jWo 19 l�he fi/
MTHEPROJ WfTBA'300FTOFROPE(S)GREATERTHANI<X: YESE] too SNOWwOD—Vpsf
ISPROPERTYWrDONNIDFTOFTBEFOLLOWING: �VW:
SALTWATER❑ LAKE[] RIVERERSEED FONT[] WETLAND[] SEASONALRUNOFF❑ STREAM[]
TYPE OF WORK: NEW Ld ADDITION❑ ALTEERAAUON❑ REPA]R❑ OTHER
USE OF STRUCNRE(hanea.n.Gw ..Ca BN; �Is E.0G
ISUSE: PRAIARYql SEASONAL❑ NUMBEROFBEDROOMS_Z—NUMBEROF BATHROOMS_
HEATEDSTRUCNRE? YESO9M ja YFs(van(alelBUN[I NO[]
DESCR®E WORK
SQUARE FOOTAGE:&.P..✓
ISTFLOORISS, sq.R. 2NDFLOOR sq.ft 3RDFLOOR sq.ft BASENONT Sq.ft
DECK N.ft COVERED DEC]C—YXK ft STORAGE K.ft OTMMK ft
��� GARAGE 9q.ft AaOcheA❑ tktachad❑ CARPORT K.& Ae W[I Da M[3
MANUFACTURED HOME INFORMATION: a/COPIES OF THE FLOOR PLAN REQUB"'
MAKE MODQ YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL
NUMBER—MENTAL HEALTH:
SEWAGESEWPA SOURCE: SEPTIC11 SEWER❑ / NEw'DI EX[RTING❑
PLUMBDIGw STRUCTURE? YFS(4 NO❑ tfy ..aurch Water A&qu F.—
PERD./ErERROUNDATION DRABiS PROPOSED? YES❑ NOD WMNGSQFT.
EKISTING BEDROOMS PROPOSEDBEDROOhfS TOTALBEDROOMS
OWNE11 a1no.nm9.s vAt wdnudm muamam immaaauona irtmina Na9xm am or 9rnNl reromaon.Aaawf.alemaeaae�Hp
abnea.e Brow.i aaaara um i am x owaar.aa i mnnar aaaae ua i.n mlm s m rea�.a m's 9em,n am m ao ue swA ea pwasee.i ree
oaaaee waa'gs�oo nom ao Ine mmewn 9aNas,moioa�ro aar a.samem naaaral�nes a imerest re9a,ea9 wa 9miea_me aaaa m�
�.Pmemana,re9�esems ma ue nm�malaa ereAeea is.m�me ena erems enpgeea a Nason coumy access m ue moue aewleaa mwrb
am veucmMs)mrreNew ene rtnspe3an. llvs pennNeppnmaon 4u-niee rvAl B wle n waA orauwnzee mnsm+abn is na mmmervxe wmn 1BJ
eys a rcmaa�mn.m'.wsoemeerme 9enoa a'w aa/s.
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 14.0EQ2)
preWla ER W.1 n tM1 ER Q Data
DEPAR LREVIEW APPROVED DATE DENUM DATE TAGS/NOTFStCONDTTIONS
BII ING DEPARTMENT
PLANNBJG DEPARTMENT
FORE MARSHAL
PIIBIIC HEALTH S
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