HomeMy WebLinkAboutBLD2025-00166 - BLD CD Environmental Health Review - 3/10/2025 MASON COUNTY
_ COMMUNITY DEVELOPMENT
Permit Assistance Cents,Building Pbndin
BUILDING PERMIT APPLICATION F�N�
71-0 PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: /
NAME: Kn
NAME: �CFjG 9�O1J
MARINO DRESS: MAILING ADDRESS:
CITY: STATE: ZIP: CITY: STATE: ZIP:
PHONE#1: PHONE: CELL:
�` aI PHONE#Z: EMAIL:
Ell Ambol Ill L&I REG# EXP.
(� PRIMARY CONTACT: OWN��t❑ CONTRACTOR❑ OTHER❑
NAME E AeS{1�'NPi EMAIL
MAILINGADDRESS CITY STATE_ZIP_
PHONE CELL —
3a PARCEL INFORMATION: �L�4 Z6Z'-� — DOO I � /m
ARCEL NUMBER(12 Digit Natatbol— ZONMG FTR-
LEGALDESCRIPTI N(AbbseviMed FIRE DInmcT
SITE ADDREssWSE r/JI)j—y— CfTY
DIRECTIONS TO SITE ADDRESS }�
MTHEPROfEC'1'WITHMMff OFSLOPE(S)GREATERTHANIYA: YES❑ NOR(SNOWLOAD:�+l
ESPROPERTYWIT BN2N"OFTHEFOLLOWMG: (aneairheal l:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NE ADDITION❑ ALTERATION❑ nnREPAIR❑ OTHER Il
USE OF STRUCTURE(x .c;eheI catmer.Ea,) SFL IS USE: PRIMARY SEASONAL❑ NUMBEROFBEDROOMSl NUMBEROFBATHROOl
HEATED STRUCTURE? YES M.Ih j YEs r.,a(�ye ❑ NO❑
DESCRIBE WORK
SOIJARE F OTAGE:(P.aPaaml
1STFLOORLB Ill. ZND Ill 3RDFLOOR_ad.ft. BASEMENT_I,R
DE IK q.R s COVEREDIDEaS.R STORAGE l OTHER K.ft.
GARAGE lft. Af CARPORT N.ft Attached❑ Doleal❑
MAN F ED HOME INFORMATION: ed OF THE FLOOR PLAN REQUIRED'
MODEL YEAS.
TH BEDROOMS BATHS SMAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGPISEWER SOURCE: SEPTIC SEWER NEWO EXISTING❑
PLUMBING IN STRUCTURE? YESK NO❑ If,.,eal coetekdr dW wAdegN,Form
PERIMETER/FOUNDATIONDRANSPROPOSED? YESX NO❑ EXISTINGSQ.FT.
S FUSING BEDROOM PROPOSED BEDROOl TOTALBEDROOMS-6—
ONNER;all— ]ea lnel auEmisvbn al lnaoz:ale iMo:metion mey nzMlnaMpxwk ceder«PaimB nveeallon.P6iwMeflgemenl Uhe-bby
obained Celcw. eem mal neesarnerene Nnnar,-yel el enoerorearn. deualree ato cep Ne wo:k es Gmpovee.lnaw
ohmies"al'uspa,om all the van'rea.lrclumag ereaaaa'nam Mwa.vpaNw m lmorcsl nt,1 reel thus pn,Ion-
Tnewme,dr loeal
aaraaaenblira,ra rnaal um themm this mein IStualoMeraanull&nadeeaaNsedahozed—eeemIn e;no,caexaeoa polI
depotat
IlureUlrotern aorl Ideape=uon. raNOW a180NeaEemmg awl6 mla nvvMrvauPoaaea=oaawcuoa�:aol cmmm¢ama wiNN tBO
dam«nwnawcdpn wn b susPeaaed wr;peso;a taB says.
PROOF O TINUATI ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS.
PER APPII I OF/80 OAVE ORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
)
nature MOWNER E USE Dale
D"AlkTISENTAL UYXV APPROVED ATE DENIED I DATE TAGSNOTE41CONDRIONS '
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FINE MARSHAL to
PUBUCHEALTN
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