HomeMy WebLinkAboutBLD2025-00477 - BLD CD Environmental Health Review - 5/8/2025 Permit No: Of44 -I%.'y' •'.11f 4-74
MASON COUNTY v
COMMUNITY DEVELOPMENT APR 2 2 2025
- ` `1' Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER,,// INFORMATION: CONTRACTOR INFORMATION:
NAME:A/eA ' er '54YlGh NAME:
MAILING ADDRESS: 3170 6 y 7 ' 'C%S MAILING ADDRESS: 9,0
CITY:i41t&IIM/J STATE:W.4- ZIP: eV,/ CITY: STATE: ZIP: 1)
PHONE#1_ t j its:-2f?<0 PHONE: CELL: v.
PHONE#2. EMAIL' 1 N �,
Gt
EMAIL: ' e. ?l'11 L&I REG# EXP. /_/_
PRIMAR CONTACT:� Iy s J OWNERX CONTRACTOR 0 OTHER❑
0 J'
NAME 4f e.ka.t Oer-Bi I'"C.q EMAIL X bci co/t ye, coot p
MAILING ADDRESS 3I7O /7 - e i S CITY ./r STATE 1st_ ZIP (WAN
PHONE CELL (?mil 115,1—2 D
PARCEL INFORMATION:PARCEL NUMBER(12 Digit Number) 572 Oa/ 7 L 99O33 ZONING
LEGAL DESCRIPTION(Abbreviated) / 0 FIRE DJSTRICT
SITE ADDRES f' y/ CITY Shell Or,
/ !l��e
DIRECTIO S TO SITE ADDRESS d�, e i V JZ5t r 0� / A ? •riCnn1 4e i "
/' Ah w'/ham',., t be r, 'r//'-47 r i s e,.1 LP_ , " �t
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO'Y SNOW LOAD:pt, psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEWyk ADDITION 0 ALTEnRATION 0 REPAIR❑ OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg.Etc.) >Q.es,ett
IS USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS aZ
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Rarr_is]]of etd NO 0
DESCRIBE WORK nEto SCr2. u/74 .ecI
SOUARE FOOTAGE:(proposed)
1ST FLOOR I/3/1 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK fig
ft. COVERED DECK LAO sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE,7 ig sq.ft. Attached's, Detached❑ CARPORT sq.ft. Attached 0 Detached 0
MANUFAC'f ME INFOR *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAK MODEL EAR _LENGTH
TH BEDROOMS BATHS SERIAL NU
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER 0 / NEW ill, EXISTING❑
PLUMBING IN STRUCTURE? YESg, NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES NOD EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
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&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 D YS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) •
X
.3 Zo/S
ignature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT .
PLANNING DEPARTMENT
FIRE MARSHAL _ Weis` ,,' 1�\ L^� J� _ ,
PUBLIC HEALTH fói � -W 11 J •ALi2
smgovpmp
R; l5sga-
T':''' ''''''''''''''•"4,
_.mm O maeclWimt V•
b /y
3momsd ?Is (n ``A - di
i*3�YS' HaQ i 4 •� Li
rail
od4 &a A �l
N '.......
U liii
'
SS ••�
�
4�g I
N
s IW
....„ , ii.....
E Z
co o ! N I
a
cnz Qm �A'�
2 O ' ,.N c ( s (7 2p^om � o
I
co .13 N
-.-
13 N � V
n ' '; :Dave . N I
t
w m f I_ ----}----- _ (4 ro Z t I
DT N ' u' % 3
Z I •
� I arc_ I �' '
• i' A
1 W NN N n
O :7- iOcl
V 6 w 28,6,r CAII Vs
V+
-0I
1
. .1.- I si i-I
A IC.
r.
r.p W
I I
o
I. Z •I w
o '1` ` 11