HomeMy WebLinkAboutBLD2025-00067 - BLD CD Environmental Health Review - 1/21/2025 MASON COUNTY Permit No: R_( bg,( —10 if7
COMMUNITY DEVELOPMENT RECEIVED
_ Permit AulsranceCuvter,Building,Planning JAN 21 2025
BUILDING PERMIT APPLICATION 615 W. Alder Skeet
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:1 W T/✓ a S ✓OY W W; NAW:B,I1' (nAT�MAUJNGADDRESS7o2 SS: .$eK
CITY: STATE ZIP:gxr MC�AR J
STATE:}�. ZIP: Q
PHONE gl: PHONE3602(n)3b_CELL:%O 273C, 1—
PHONEk2: 7 9— to G f� Z
EMAIL:��j5k(yC"9 � : L&I R { 'T EXP. 1 /LL/� LCCL,I
PRIMARY CONTACT: OWNER❑ CONTRACfORQ I OTNRR❑ eTSLY L J
NAME EMAIL Z Q
MAILING ADDRESS CITY ) STATEu�ZIP Ltl
PHONE�RO '/ ZZf/_ CELL
PARCEL INFORMATION: � �1 >
PARCELNUMBER(13Die Number) a��_^ .•Z(,£('0W J ZONING IZ55 Z
LEGALDESCRIPDON(Abbreviated) FIRE DISTRICT LU
SO'HADDRESS `3" /ipD i IG7 CITY T6hvLTld
DIRECTIONS TO SITE ADDRESS A�.VOrd✓
SKe K6Ce T r . .G7nf iAx c'f
ISTHEPR=CTWTHM300FTOFSLOPE(s)GREATERTN 14%: VHS[] N0jj SNOWUTAD:�.a A Z
ISPROPERTYWI 200FTOFTIIEFOLLOWMG: (C'M4a/IMmW09: n r �j
SALTWATER❑ LAKE❑ RIVE I EEK[] POND[] WETLAND[] SEASONAL RUNOFF❑ STREAM[] T
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER A tU,
USE OF STRUCTURE(SaWain,fmrega,CnaaadedRUS loo) r e
ISUSE: PRIMARY[] SEASONAL[] NUMBER OF BEDROOMS NUMBEROFBATHROOMS
HEATED S'IRDCI'l1RE? YESl:raw.emN[] YES(eb,r(jr&ddl❑ NO[]
DESCRIBE WORK
SQUARE FOOTAGE:rP,oyo.m/
1ST FLOOR/Wsq.1L 2ND FLOOR sq.R 3RD FLOOR sq.R. BASEMENT_sq.R
DECK sq.it COVERED DECK sq.R STORAGE K.R OTHER sg.R
GARAGE e,R Attached[] DetaohM❑ CARPORT ,ft. daachad[] Damohad❑
MANUFACTURED HOME INFORMATION: *d COPIES OF THE
,,FFL� ED LOORPLAN REQUIIR *
MARE GIA-1110 MODEL SWEEDVL+MIA YEAR ''�_LBNOTH �6
WNTH� _.HEDAOOMS y BATHS y SERUM,NUMBER
ENVIRONMENTAL HEALTH: .✓ _/
SEWAGF/SEWER SOURCE: SEPTIC Ip SEWER❑ / NEW❑ EXISTING IR
PLUMBING M STRUCTURE? YES❑ NO[] lfyeu,artach awP(end Worth,Adequaq Foam
PERIMETER/FOUNDATION DRAMS PROPOSED? YTS❑ NO[] "'TIN""-
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
MVNE0.uknwMtlpeatM sudnuabn INlmcareb Inb�metim mey naJtln aelopxwk wtlarwpnmX nwmlbn.AckmnletlgemaMol auM N by
a,,ar re arrols l n from Mall em es owmr ane NMer tlecbn Met nt ender or
rviceiva Mie pmmileM b tlo e h d ch ea OrePmM.l brve
oblalnetl Poanbsion from all M8 necessary paMaa,IncNEing my eenemam bottler or peaiea olinlareat regeNing IFda papct The miner or IeaN
rapresanlard repreeeewand1ra iMarmatPnpoNtletl le accumleentlrresnull
em vold 4f ofMoron Wunry 6aess10on is now emvlbd patntoI
antl ellYvluKl9)m�RNBwepe InepeNon.TA4 pamNapPllu4on tedmes null8 vole II xvM or aulMvne�'aaeaumion w not co'nmercMwiNn IN
lays or tl more W ctM�xvM1 Y suepeMetl(u a penotl N 180 tlayt.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTMTY OF THIS
X LIGATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14Ae.I2)
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SignaWM of(AMBER(Mud be eland by the OWNERI Data
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSPIOTES/CONDITIONS
BUTAMG DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH Wr
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