HomeMy WebLinkAboutBLD2025-00072 - BLD CD Environmental Health Review - 1/23/2025 Permit NO: & n2.a24;-OGOl2.
MASON COUNTY
COMMUNITY DEVELOPMENT RECEIVED
PennA AWsdlce tents,Building,Manning
BUILDING PERMIT APPLICATION JAN L 1 2025
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Peb FltlE aikgW T%^M NAME:F.IMH CmsbucYm W.Alder St vat
MAR.INGADDRESS:MtIGladed.NE MAILINGADDRESSONISEas Rtl
CITY:OMwIa STATRWA ZIP: Mle CITY:S�n STATE:WA ZIP:MM°
PHONE#1:3M—t7 PHONE:MOeyatasv CELL:
PHONE#1 EMAIL;rIayiEQro.nasdmndon ..
EMAMonfiskiQFlmd.mm L&I REG NFOAREHCM311i EXP.05/21/
PRIMARY CONTACT: OWNERD C0IPfRACr0R❑ OTHER `y
NAME— EMAIL z r1
MAILINGADDRESS CITY STATE_ZIP_ r
PHONE CHU W
PARCEL INFORMATION: G
PARCEL NUMBER(12 Digit Nards N)?PI9a5a000t0 ZDNINORRB tr
LEGALDESCMMON(Abbrtyi )'®°'"^r"^^"`^—...-,°" FIREDISfRICT3
SITEADDRESSIut ECarvmnny auh Rd CITYsmINn
DIREL'1'IONSTOSITEADDRESSNw pnM 3,E mE% dm Rd.Esslm ECpmmunihau0Rd.Ende1101Eaanrial W
ISTHFPROJELTWI 300FTOFSLOPE(S)GREATERTB 14%: YESE] NO[] SNOWLOAI)i
ISPROPERTYWITIDNZWFTOFTREFOLLOWING: (CkckWdmEyMyJ:
SALTWATER() LAKE[] RIVERACREEK[] POND❑ WETLAND❑ SEASONALRUNC)i STREAM[]
TYPE OF WORK: NEW[]E ADDITION❑ AUEFATFON❑ REPADL 0 OTHER 0
USE OF STRUCTURE(aqua:.woke Cardamom,kuk.a,)Sli Furey RmBnm
IS USE: PRIMARYD SEASONAL❑ NUMBER OF BEDROOMS. NUMBEROFBATRROOMSM
HEATED STRUCTURE? YES(Pxatirl i 0 YES(Puri.)ykkty❑ NO❑
DESCMEWORKNNycanN maa W=MriIBN 4yrai e.
SQUARE FOOTAGE:tarwa,aq
ISTFLUORI430 aq.R. INDFLOOR 89ft 3RD FLOOR aq.a BMEMENrli Eq.ft
DECKM aq.ft COVERED DECKM Eq.R STORAGE q.ft OTHER_kq.ft
GARAGE ul.B. Attached❑ Deracal CARPORT N.It Attached[] Dayaehed❑
MANUFACTURED HOME INFORMATION: '4 COPIES OF THE FLOORPLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WB)TH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
SEWAGFISEWER SOURCE: SEPTIC SEWER❑ / NEW RI EXISTING
PLUMBINGINSTRUCTURET YESD NO[I oor, ,arlach plered Water Admisi From
PERBNEfER/FOUNDATIONDRAOJSPROPOSED? YES[] NOD EXISTING SQ.FT.Its
RUSTING BEDROOMS a PROPOSED BEDROOMS 3 TOTAL BEDROOMSsi
OWNER xMaAed9es a that l Msnde NlneccwNe In(wmtllm msy reamt in s Yd s,der paths permit reuuetlm.ACMMetlkemtMNingave
slgnand ominainfinni an l re Mevun wend IfuMergedere Net nt entHleaNrms,o tMsret reendto tlo tM1evahm gppved.l Mue
OEtaintdpermis,wmsmell Nenerems ion warded.including alaganyeasemerats drohpadiesol interest]eNlnB rnh gvlecL iLew.nvakpd
.sad cia rgresenra Ne10einbimetion pmnaetlkacmmN and grants employee of Masm Cwnry actintp Ne e0predwGOM prt9dly
ana ahutlwe(a)(or nNew eN insptttion. This permil/eppllcation Gecdnes null8 uaa Ilwwk w auNmzad cOnsputtlm a rntmnmerced WNM 1E0
mya a acoaaNaam.ran u aatpmdm rape peaoa a Iw aaya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERANIT'llifIRPLICATION OF 180 DAY OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNW CODE 14.08.42)
- IgruWre of WNER) I ON4r
P APPROVED EA—W I DENIED yDATE ,J,V
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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