HomeMy WebLinkAboutBLD2025-00368 - BLD CD Environmental Health Review - 3/27/2025 Permit No:-&CUAA '())- 116
7 .._. . .. MASON COUNTY
4 COMMUNITY DEVELOPMENT
,`',. ...„._ Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: R,y . �e,riVasu, t����k.5 NAME:
MAILING ADDRESS: ai .. 5 t,per ).-1f, MAILING ADDRESS:
CITY: Vtai- tb. STATE:LA) c$`51f CITY: STATE: ZIP:
PHONE#1: - '� . PHONE: CELL:
PHONE#2: - ' EMAIL:
EMAIL: L&I REG# EXP. / /_
PRIMARY CONTACT: OWNERS CONTRACTOR 0 OTHER❑ 0
NAME�.� ' EMAIL r,c (73 ► r �
MAILING ADD I FSS to W1 Dt r�r CITY STATE A ZIP iir5'84
PHONE CELL ef1'7 - 775 t7
r.J%
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number)31 OO ibO 0.1000 ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT 5
SITE ADDRESS .23 ':per InNI CITY SWt�`A-inn
DIRECTIONS TO SITE ADDRESS _1;(eetN.- cow.- 5 to {� 'PccI �jlc.W '1u -% 'l4F t-
cilat) r Jo #&T mrr► 1�'Ilko .Kap:p+ r l-h Ah� “ c`1L 'leFt-
IS THE PROJECT WITHIN 300 FT OF SLO E(S)GREATER THAN 14%: YESD NOZ SNOW LOADx /psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
' SALTWATER LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION% ALTERATION❑ REPAIR 0 OTHER El4 USE OF STRUCTUR (Residence,Garage.Commercial Bldg,Etc.) L►y/ in 1
IS USE: PRIMARY SEASONAL 0 NUMBER OF BEDROOMS I NUMBER OF BATHROOMS .
HEATED STRUCTURE?/� YES(Whole Bidg)0 YES(Parr(:)ofBldg)� NO :I
DESCRIBE WORK 4(.1a(111 a in 6+1(l 54—
SOUARE FOOTAGE:(proposed) U�"
1ST FLOOR I56 sq.ft. 2ND FLOOR 1P'ra sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK4 sq.ft. COVERED DECK 1 'I L.Gsq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGElit,).sq.ft. Attached Detached❑ CARPORT sq.ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 C F THE FLOOR PLA: UIRED*
AKE MODEL YEAR LENGTH
W H BEDROO BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC,' SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YEIL NO❑ If yes.attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES'Vt NOD EXISTING SQ.FT.
EXISTING BEDROOMS I PROPOSED BEDROOMS a TOTAL BEDROOMS I
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 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
_g/ / , 2_,I;.
Sign a OWNER(Must be signed by the OWNER) Dat
DEPAR . \TAL REVIEW APPROVED DATE DENIED DATE AGS/NOTES/CO\DITIONS
BUILDI DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH 0 A 7I 71(z CCaitlincida,
i
Q
1 w Q °' ..l
rn ov � o D o
m• rW N _cn0 a' 0
o r* E Sandpiper Ln * = �,
Z
=' > CO 5' � = go Cna) 0D
O r. cn 3•7 m vi cn �' o �w0
1 QN i Q fl1 -.• one cr U) N7-1
a) 73ta go ail a)
T Ark
-- — 1111 M ID ~6 i a
NCI W I ¢� O —1 Q O (D
Q
• nonicv 11 I / N
al
IIloft tt IIj F yam „ to
-I lio
v.
(tn {7 ao / ccnn H I CO
t oDcn -* oE cn m 0
-a tC r J -0 cv =. v. - 3 ET-
SD r
(1 �, N c co v
rn co r3 I � � � CDDS oco z cn
SD C c w M
�. # c3DN 1 1I Q (n 00
o w o D
NN cr 0 4 Q c� Z -<
O �' cn 0 v 5. t
Dii r r =
y
� � � cn
N cn
lil 3 POp to , I cn
torn 0 O7 I CO
—
a• (51 nm mQp ,7 nw D r I r
2 � ll1LJB
, Q
0`G `D , A -- _ N
o N A 1
kV! .1 r n CD o o D 7 v ° (11 lP O/ 3
cQ r 6 F 4 a 7- �� 2 CO to t0
.p3 �• a � m � ccD r I- _
� �o _- v, ( _ - co
N v, 0 3 cu Q ro
� �CDa yo (/)
CD d o- N' n m 1
rt O -, m rD vi A- r^
d � o, R, o
0 .0.. 0 - � v D sB/L.---J
- A o - on0
-1 ono A. Qo3 ]C
N Q o o k,i 4 1 m o rD f o o
3_ n ..
N 7 .4- rDD 1, 0 3
0 Q Oakland Bay
(J c v, �•Q o \
•A � m� ?
°c -n� ci �
Q
ELqgtrzi
o 55
a 8 D mN
N
3 ON
e ati; " jib i ;19 g do
. !PIi VP.......„14,_.s.v_ ,..! I r
071
Ni1 ph
s Irs
„S��
cs
"C
isu
, •M _ ■
•
mor, . .,_ s",,,,. 4,
♦ PI •
a N.
�40.14'•`Y / . 4 r
1 i a n
'�• I •
t
le
ig
aN_ • . N*o
''%;' 4..itc114 ../..
13 41/4 ih..._4 1
C.".°14 ,
__________,X; 0 -- , ,,,**44'. ii
sN• Wt •INOW-- Ns
.I „ .. it ' -\,
N' , 1/41.0" sir
., :,,..... itri640, ,
•4 z_ ".. ;LIPINSIM ' 1
i
s. f \
441. s;\ %. • 1: / a` III
• i
s s ; ataat=:= :;q:seR ``\/ ♦
N lit!!
I!!
Ipt10411000140k k.)1kkkk0NWI _ E
@i„kkea4kkisttilmtPFRtotv!tijj��mesiiaikmak eat � •F;r_'. ,
R.aaseM1955943394sRYiY33i342i 111111111 III
�' \\ ,�`'
?sasasaaa{te>lea:e;t;:psaq�sasca=:: � :., .
^*cwig_ :!:!::!:!!a>i^!:!:::;ea:liw b IdW.ii <
3
�as*RRRigat;asat aaaa aaaSt*IV!R�i
i:�kiei�Aa�6ReiR�iskieiesciiia4a6cR s �
1 ya1!t=a3sa3gs11liil4iiiimga==2saeoe: >+r
=tttAa■ t t iRERRa�ttetRRCQ�tttaR
li i=�AR2•atRa^^t==�-tt'� ttA"R==�" X I
`
AhA INWINNW1010004)041}41400 I:
filtRii i:si Rgt t Ai70tNitt: II 1
9;IIMIE33i3lS11 :erxeeaeel511$43! it
a
tt
19A fi Lb6 l gdd
0
• . 41....„,0 . .
•• , ' , IN.. . • • •
-.. MIN VITU LIIIE
.. •
. . .
: • — .- — S. —
. . . i
. ,
.., OEM • DEM I 1 -
•11. • , • "° ' , •
,
Z. • .
' I I
dt 6P• '
........ . .. OHM U • CAM U 1 • MOIRE mow I
cum t ' ya la , . . ,, 14%
sf
la 0 1 LOT O4 1r2 8P 1.
. _
: .
i Hex.) .
0 ' ,,,
I '. ttA,.....r
sAt• 1/20.
. kp„0.00
... .71 : 1'1%01'
t 24414Z • '''
- /GC I I I
STOWE
s ?."
; 7RAINSPogr I 1 — — -- .. ... I
CMNIT
I
f • ,
,,, i 4 4,4 4)1 P t•P a-it ''...L/#1..,F
illft"S""#11111111--< - - - . •Oilir -'
- -; . . ---16, *,:.- '
y___ I I ----
/0
imill E."ir', 4
s ' . .. SE.PAR tt-PoN p,Es VE
misi
L.< • •
At:•.51.f.At oi.4.3..:;-, • ' . AREA\
• •,. • . I /0)(Se) /0)(SG
• c 1
SO 3- .
. , \
,
i 4C. 3-A--R2 7 67akt 6.
1
1 cu.iciedt4 .
etv4k .,effz.;_si. 1 cm
- \-- Clicratk Ci .iv,e.
"' 'ea i I •
• •