HomeMy WebLinkAboutBLD2024-01350 - BLD CD Environmental Health Review - 11/14/2024 Permit No:FJLY a1.J P2lr.Q{-65c)
MASON COUNTY RECEIVED
COMMUNITY DEVELOPMENT(410
Permitmslscaoctunter.Bonaln,PiznnlnE NOV 12 2024 m
BUILDING PERMIT APPLICATI M G
PROPERTY OWNE1R�INFO��R�M�ATION: CONTRACTOR INFORMATION: �,
NAME:3�M� [1rr+A++aB"-' NAME: (�
MAR.ING ADDRESS' MAILINGADDRESS: +L
CITY: /��yy� �STATE:a.aA ZIP: CITY: STATE:_ZIP:
PHONEp -Ft0\ -A460 PHONE: CELL:
PHONE N2: EMAIL. rn
EMAI.:6l , . aM L&I REGx EXP.ll ?. Z
PRIMAM CONTACT: OWNER❑ CONTRACTOR❑ OTHrPKh
NAME l 01P3TMAA) EMAIL
MAILING ADDRESS$ L RUT ST CITY\TNr (]QiytlI18FATE Ill ZIP r
PHONE ShO e 8 6 CELL '2
PARCEL INFORMATION: nnnn L\
PARCELNUMBER(li Digit Nrwba)�OoD-So-39oD� zoNINC IILA. R.Z
LEGALDESCRIPTION(Abbreviatdd ALLYA) Pj 4 FIRE DISTRIcT v �J
SITE ADDRESS - CITY
DIRECTIONS TO SITE ADDRESS LLlll] o" BP —
4w1 • •,J Al N+h �. olpi LeF9'
IS THE PROJECT WITHIN 300 PT OF SLOPES)GREATER THAN 14%: YES[] Ii SNOW LOAD:3QPsf
ISPROPERTYWITIM200FTOFTHEFOLLOW G: (ae•R all nwr.Ah):
SALTWATER❑ LAKE❑ RIVER/CREEIC Q POND Q WEDGAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NENX ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(waldrand Gomm.Crmrrn'm euy—)
ISUSE: PR5l SEASONAL❑���...111TTI NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRU 1 YESIOaal dr, YESIPanRj,,Bhi Ii
DESCIUMEWORKO'l P Z.- M SPtL
SOUARE FOOTAGE:Fad a d)
ISTFLOORj,-4_l,l MDFLOOR%,45�p.B. 3RD FLOOR_K.ft BAEEMENT_R.ft
DECK_rl COVEREDDECK—Al STORAGE w.ft OTEIER_`l
GARAGEl I ft AdachedKD W[I CARPORT ft. Almchmal Diddel ❑
MANUFACTURED HOME INFORMATION: a0 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATES SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER < I NEWT EXISTMO[I
PLUMBBiGni STRDLTUREY YBS� NO❑ �1 ijyve,attachwmplelMWatn Adequacy Form
PESUMETER/FOUNDATION DRAINS PROPOSPDT YES NOQ EXISDNGSQ.FT, —
EXISTING BEDROOMS PROPOSEDBEDROOMS A, TOTAL BEDROOMS
PNNEBadTa^1eBPee tlul cudnisabn Nlrrasrnb MbrmNon may reeuAin dalop and.w Pal reroulbn.AcknaaeAjmunlo/wM leW
aianawle Eebw.l a.a.remaumIbe wmx ane wMer a.dare I�flem.n4a.aarxeive Nla permu matoWIM wkx Pppaea.rhal
oosmard pmmffiabn from all Na necasaery peNds,Including any eaaemanr ho l random ollnvoi rga mou Nla"am TM dmTa bgel
aanedn a�humrrman�,w6,)r meppre oraanv mwiepwn etrhMaata NIanaaapommon.Wn gppmHmaetlisar manda Edcommeee null
&voolytlz JeawWpaMaeseounl nCoaruznary]dmagnucbEor la no dMmamcAnEmeaa puvernalpiary
m
pmaealor.peneaullMdaa PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION 9F 180 DAYS OF MORE Will CAUSE THE APPLICATION TO BE EXPIRED.(MASON
�yJ COUNTY CODE 14.00.42)
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Stoll vivi(Mrnl baelarfed b,lM OWNER)
DEPARTMENTAL REVIEW APPROVED DATE DEN= DATE TAGSINDTESCONDITRINS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
EH APPROVED
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u.m.� oansrmzs
$ V ,
/ WATER LINE NEW SFR -
//\ 3-BED, 3.5 BATH
WELL
-\, - DIRVEKAr
OVERHANG
SEWER LINE \
W
�00•/ GRINDER PUMP
s- 1
f :.SOUIN'.
I.
51 TE PLAN
I" = 20'-0"
J N HERMAN
19680 EAST H 5
ALL",WA 48524AT49
PAWAL HM M
12220-50-54004
THIS SITE PLAN IS DRAWN BASED ON
DATA SUPPLIED BY CLIENT AND WITHOUT
BENEFIT OF SURVEY OR TOPOGRAPHY
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