HomeMy WebLinkAboutBLD2025-00115 - BLD CD Environmental Health Review - 3/5/2025 MASON COUNTY ParmHNe: a, O2o)S-ooug
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Bullding,Planning
BUILDING PERMIT APPLICATION N 2025
PROPERTY OWNER INFORMATION, CONTRACTOR INFGRNIATION:
NAME:Rem'wef+u•amaa.aa: NAME.I n .sN.
MAILINGADDRESS:ey'E°a^elW - MAILING ADDRESS:--'e '-- �t
CITY:� STATE:— ZIP:— CITY:°' STATE:w ZIP:WU
PHONENI: PIIGNE:Oaal Nl— CELL:
PHONE h2: EMAIL:eanw=eeasyymm -
EMAM:a.emee8ww.wa LAI HEO 41aYp L— EXP.
PRIMARY CONTACT: OIANER13 CONTRACTOR❑ OTHERQ
NAMH wauv P.MAIL^e^^^O...e. ✓
MAILINGADORM
ADORM wa.r. ft STATE"^ ZIP°"=_ 9?.
' CHLL iwiralm
PARC O EL INFORMATION• CO �
LEGAL DESCRIPTION
DigbN mhrrl y 2w$i v ZONING N'a
LEGAL DESCRIPTION IAbbre leJl mE°yerNBww°s RM' FIREDISTRICTa f
SITE ADDRESS a°'E w`u^e.wmw CITY aeleaew
DIRECTIONS TO SITE ADDRESS E'°'a Rrwk^e'4 W'awR.ere Aaas..e x enw TwM w.mx'ewfe
*VIM Ees.w Ammxawk.EMw.awem M,taameavwrmeeeA
IS THE PROJECTW'ITHIN 300 FTOFSLOPFASICREATF.R THAN 14%: YF.SD NOG. SNOWIAAD:a Pal
IS PROPERTYMITHIN 200 FT OF THE FOLLOWING: tt'+.rs enumaryry/.
SALTWATER❑ LAKE❑ RIVER/CREEKD POND❑ WETLAND❑ SEASONALRUNOFFO STREAMD
TYPE OF WORK: NEW❑ ADDITION O ALTERATION O REPAIR O OTHER FIwm+w
USE OF STRUCTURE lRmd,we.Gor p.Cmemmwt el4c£a I we'w°O1W N
ISU9E PRIMARY❑ SEASONAL[] NUMBER OF BEDROOMS NUMBEROFBATHROOMSO
HEATEDSTRUCIURE: YESrxaa.df¢IO VES(P tJ 9*)E3 Noe
DESCRIBE WORK'e°4'�^^+mw.p.aagyppyaa.,imapeaiam lwafww.
SOUARE FOOTAC •
1ST FLOOR_Eq.A. ZND FLOORsq.A. 3RD FLOOR_
sq.ft. BASEMENT_N.fl,
DECK__sq.fl. COVERED DECK_fq,A. STORAGE sq.a. OTHER_fq.ft
GARAGE_
Am4rhad0 Delarh¢d❑ CARPORT fq.fl. Arcarhd❑ OdarhN❑
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE—MODEL YEAR LENGTH--
MIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HRAI TM• sfff....
SEWAGESEWERSOURCE. SEPTly SEWERS / NEW EXISTING
PLUMBING M STRUCTURE? YES❑ NO 0 if a,aaa h mmplesM Waier Adepaary
PERIMETER/FOUNDATION DRAINS PROPOSED? YES[3 Noe EXISTINGSQ.FT.
EICISTMG BEDROOMS PROPOSEDBEDROOMS TOTAL BEDROOMS
OWNER adnoiaeEvea IM wbnievn d irumaaa NIm:Wldl mry naux m a aiop work order or cermll revouem.MboMMppmantot sucn:a ty
agreCue Edcw.l aedare Pal I am Ne purer antl I1uUgrEKlYlpal l am enullee to�aceiva lnu pamei and a W Ne xpk as p:oPoatl.I Mve
i. advroe G•mwem hwn Vtle PoreHaD'Podpa.indvd6p anyabenml ndtler or yams dlntcreu repaNirg tlev prged. Tna weer or legal
' relaeaen� uw,apesm¢Wltle Nbm�etion povMetl 4 exvYwtl penp emdeye®M Meam Caunry e®ab W eUme 4aealpetl yrnpe�ty
a:tl pruciue(a)tar mnew W Nfyediwk Tnia Pom:illfppYralNn bevmis nW d w4 RweM ar aul�onxed dwW cean b rot wmmexed..tnin:xg
dfyb aa¢mWtlirn wohe vopnded bra penytl d 1F0 drys
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
� ' �� ' °"` COUNTY CODE 14.08.42)
X 51g - ---- cap I Ito • 25
igreWre dOWNER(Must be alone by the OWNER) Oata
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDINGDEPARTMENT
PLANNING DEPARTMENT
FIRE L
BLIC HEALTH 'Tj
Him
W E 5115 q� ��p8 9€4g g F
M ma oaf w
gg ryHr! G0g
6 A o 0- N 8
nm
OC
RI
»a \
` pgpgpq��
0 1N �
z> N 4
�+ ) ®
yom
�
iBill
@�
^ � IP/.RO]IAIICfIIE WAiR]IGMGffACM N•C]f]]�]
6 wtuAy
tl1 EVtMVGNalA •GAC
9i•F{n xWmf nut LL w-.'
GIIAPAI[N WA9W!
ICI d6 SITE PLAN j