HomeMy WebLinkAboutBLD2025-00256 - BLD CD Environmental Health Review - 3/10/2025 e 73a{ ,BcOtN�[1 NTALPermii
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Permit Assistance Center,Building.Planning MAR - 5 2025
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTORINFORMASA& Alder tweet
NAME:JOMI MMIKE FAMILY LLL ET AL NAME C.P.C.Landaaca.LLC
MAILING ADDRESS:826 FAIRMOUNTAVENVE MAILING-ADDRESS:41m10mem Aea NW
CITY_SHUTON STATE:WA ZIP:Ml CRY:CMMa STATE:WA ZIP:
PHONE#l:wm ws-aMap PHONE: 1 CELL: 'ti
PHONE#2:(W)42M5536 EMAIL: Zlfd emneaa.mm
EMAIL.wilamuDmanxelamberram L&I REG#OPLI MMDJ EXP._/_1
PRIMARY CONTACT: OWNER CONTMLTOR❑ OTHEROi
NAME arl SMS81 EMAIL srilliamBMmmFNulNe,¢m G O
MAILINGADDRESS 828FAIRMOUNTAVENUE cm . STATE WA y(p Gal O
PHONE DmIa2M88 CELL Nul Tasaea
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Numial l2]OTE000021 ZONING RMeI ReeNemM SAaee
LEGAL DESCRIPTION(Abbreviared) LAIC CUSHMAN#2 THE 2T-280PC#80 M HRE DMTIUCT
SUE ADDRESS 271 N PpMW Or CRY NPatlspml
DIRECTIONS TO SUE ADDRESS Fdlm,US 101 N WN WA-119 N ro N MaNN CIVMM1 Drror20.1 mi.
Continue an N BbJm Ch h Dr.Drive to N PV1.l Or.
ESTHEPROOELTW W3WnOFSIAPE(S)GREATERTHAN14%: YES[] NOE] SNUWLOADl
IS PROPERTY WITHIN 2110 FT OF THE FOLLOWING: yarawva,,,
SALTWATER❑ LAKE 0 RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER Di R 0--
USE OF STRUCTURE/ne,re<m.,r,,cemmert,arB1,F,)Rwseral Form,Maur
IS USE: PRIMARY[] SEASONAL Di NUMBER OF BEDROOMS WA NI1,1BER OF BATHROOMS WA
HEATED STRUCTURE? YES iTrar Jamie l❑ NO Di
DESCRIBE WORK RaWnp ma agaom.nlmena,a..roryem mmgrno.nNmnry.ebb.amnama PUNr"Aml
SQUARE FOOTAGE,
1ST FLOOR ill 2ND FLOOR K.ft 3RD FLOOR aq.R BASEMENT a II&
DECK sl COVEREDDECK sq.ft. STORAGE it OTHERIM al ft.
GARAGE_sq.& Amached 0 Demched❑ CARPORT a1.ft Amal0 Dmal
MANUFACTURED HOME INFORMATION: a/COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
VVIDTH-BEDROOM BATHS SElUALNIMBER
ENVIRONMENTAL HEALTH:
SEWAGUSEWER SOURCE: SEPTIC$ SEWERO / NEW[] ERISTING 0-1�
PLUMBING IN STRUCTURE? YES❑ NO IU-07-- UJaa,anaa�h mmmnd W.1A&,taa Form
IM PERETERITOUNDATION DRAINS PROPOSED? YES❑ Nµ� EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSEDBEDROOl TOTALBEDROOMS
OWNER arhmnletlpes Nat sudnlsslm olinam,ab Inbm,alion mry result N e 96P aah IXCYWpamat ma JOp1.ArkMMetlpemNW Ntll leay
uanalure bNow.l tlNsa Nal l am Ne wneraM NMertleGsa Net Bm MWM b Iwivatlli91wmi18M Ia EO tlla Wnk 88 paryxa.l M.a
otlaineE permaslaaM1om all me necessary Fame;md,d,n9 am aosement Moll pal ainleaA Mal thispgecL learamaralpel
rai asenbtiux repeserils Nal Ne iirtamMon Pra.We]Is atwMe mC pmb enpbyeesMMaeon Lwnly x¢ae b Ne BMwUesvba gapxly
entl slnicwre(s)M reNexnE inspection.TNs PennlVappliretlen eeranea rutl18 uatl nxMaeulaoriretl mn54ucLon 6 M mmnersatl xtlM1F 10J
seas ornranxNaan warE a aaepenem rove pe6otl m+e9 aaas.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS -
PERMIT APPLICATION OF 180 DAYS OF MORE VALL CAUSE THE APPLICATION TO BE EXPIRED.IMASON
COUNTY CODE lat,o )
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pneWRoI OWNER gi a all bar Me CANEin Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS9OTENCONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH 1
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