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HomeMy WebLinkAboutBLD2024-01261 - BLD CD Environmental Health Review - 10/14/2024 ate MASON COUNTY Permit No[e2I ttf-vii>=d COMMUNITY DEVELOPMENT OCT 2 3 2024 1," n" Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAMEC-. '?`' \ Ck.(v1K04 b NAME: /�/f- MAILING ADDRESS:, )7 4d,4)s O S- MAILING ADDRESS: J - . CITY: 7ir`�- STATE ,6 ZIP:/4 CITY: STATE: ZIP: Q PHO #1: Z. 6 f- 6'7 ^ ©?git PHONE: CELL: F— PHONE#2: EMAIL: Z EMAIL.Q.... .t r—y I,.��,i,Ctnrt� L&I REG# EXP. /_/ w = PRIMARY CONTACT: 1 OWNERti CONTRACTOR❑ OTHER❑ F- NAME ' EMAIL Q MAILING ADDRESS CITY STATE ' ZIP PHONE CELL w PARCEL INFORMATION: ``vv PARCEL NUMBER(I2 Digit Number) (e-1q oaa)c� ZONING 2-2-0 >>:` _ LEGAL DESCRIPTION(Abbreviated) 1 `� L _ 1= f 1 C.: FIRE DISTRICT i NtT ' SITE ADDRESS v CITY — &Li DAECTIONS TO SITE AQD SS O - % r KGfrr / M I ct) 19ht IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NON) SNOW LOAD psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM 0 TYPE OF WORK: NEW 0 ADDITION la ALTERATION❑ REPAIR 0 OTHER 0 USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) 3 1 L^�I tL.."‹....c. IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)0 YES(Perils]of ❑ NO l.. DESCRIBE WORKOZ1 U p I Cl ei(.) nil i t r�tt^I�L \Q-14VAL12.-krtitict) SOUARE FOOTAGE:(proposed) 1ST FLOOR 17Q.<1.ft. 2ND FLOOR �q.ft. 3RD FLOOR �. BASEMENT , sq.ft. 'DECK f1 so.ft. COVERED DECK sq.ft. STORAGE -l'sq.ft. OTHER �q.ft. LXIS I YlI` GARAGE_� `sq.ft. Attached❑ Detached CARPORT_ *7sq.ft. Attached❑ Detached❑ 4-MAN-UfACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE__ 1,]L MODEL .70 ('�- YEAR (Q qq LENGTH Y f � WIDTH V.7 t BEDROOMS g BATHS 3 SERIAL JJIIU,M,BER� 9D}(` ., ENVIRONMENTAL HEALTH: J1t N SEWAGE/SEWER SOURCE: SEPTIC SEWER 0 / NEW VI EXISTING 0 PLUMBING IN STRUCTURE? YES NO 0 If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 N92( EXISTING SQ.FT. EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS t, OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null 8 void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. 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) / ' ` akc,•\\A\ _� x t Signature of OWNER(Must be sinned bi he OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL I _ PUBLIC HEALTH cl 11"ti Il i (,(,), .- 3Z`"1-(tat? CAS bCu. IALL yob /710P~ e•-). / 0 m Ill U100nQ7 D w O v p -ig t0 y 0.O V O m 1 � V V O m O m O 4� =.Vl. * C a 0 () 3 5 cjv� co7'E.us umi =•a su w 0 w R- co ai c.ma) O rn fD �t3 ••vm 2"71 co m st fliruI m .c T ompm3 Ovum Al m3.»N A� 1 \ v Al O 3 %= N W O ,✓ ` \\ m o rrt N N 0 , 3 g.-m AC \\ \ col m 7 m C f 3 w 0 —�� \ -o 9+.0 a) < 03 go x 0 �. m c� is o cn a o 3 (n . . • I �\ \ ova \m cp m CO ce o = 1'�\ m O. mm -' ccfl L• V �, �C3 Z ti �7 o oa Al `a) o 5 cn .. ) O co v \i 0 m r i 1 . a = 0 1 r `f 3oN D rss- I` I I • L! I1JLtT \ rS • un J � t N t_ I I) 1 !' N i1 i t io g IV (,sic i r, 1 A7 y A Zri 1 - gal o Q z r !mi. 4 4 ,, S. i 1 a d > $Z I ^j� ga iC 1 1. E