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Home My WebLink AboutBLD2023-00643 - BLD CD Environmental Health Review - 6/8/2023 �,,r```''' ti\ MASON COUNTY COMMUNITY SERVICES Permit No:)L.1 O ` OOW —3 ri 1:\PERMIT ASSISTANCE CENTER: RECEIVE CI BUILDING••PLANNING••PUBLIC HEALTH••FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 ,l`. ' — ,, Phone Shelton:(360)427-9670 ext.352•Fax:((360)427-7798Phone UN -8 2023 Beffair. 360)275-4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATIO1\A/ Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR, INFORMATION: C n I` I O n C n I T^ L NAME: // T•?Ef / NAME: c�,TM� C i�l V I V +1 E i V /`1 MAILI q SSr S(�S/7 �S''��YE•elr6,MAILING ADDRESS: STATE: ZIP: HEALTH CITY: $ PHONE# : PHONE: CELL: PHONE#2: EMAIL: . EMAIL:Th jri II f Qi'{�y 0? 7Ah .elm L&I REG# EXP. / /_ PRIMARY CONTACT: + �/ OWNER CONTRACTOR 0 OTHER 0 NAME Sfi/nV EMAIL MAILING ADDRESS CITY STATE ZIP Z PHONE CELL 7. S PARCEL INFORMATION: {f i�. PARCEL NUMBER(12 Digit Number)�JO 3 4 v 12, • 0 003 / ZONING LEGAL DESCRIPTIO (Abbre/vv�iatejdj) ,`��.��T FIRE/� DISTRI SITE ADDRESS i • G.U' 0 rL'4 , CITYt7 . DIRECTIONS TO SITE ADDRESS I r r ' ( 0 ' 'SO 6 Cam.FO) , 2 mI t-Es IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO❑ SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER 0 LAKE" RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0 TYPE OF WORK: NEW*X. ADDITION 0 /1 ALTERATIONj� p /tREEPAIR 0 OTHER 0 USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) GS I r`O EN _ IS USE: PRIMARY 0 SEASONAL NUMBER OF BEDROOMS 2. - NUMBER OF BATHROOMS / 9iL HEATED STRUCTURE? (Whole A o1e Bldg) YES(Parr(sl a��/ NO [ DESCRIBE WORK 2— 1RM / 'u 1 , Del O SQUARE FOOTAGE: (proposed) 1ST FLOOR/O•51)sq.ft. 2ND FLOOR �f sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK 2 t O sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft_ Attached 0 Detached❑ CARPORT sq.ft. Attached 0 Detached 0 MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC, SEWER 0 / NEW EXISTING 0 PLUMBING IN STRUCTURE? YES)k NO If yes,attack completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOJ' EXISTING SQ.FT. EXISTING BEDROOMS __ PROPOSED BEDROOMS 2, TOTAL BEDROOMS 1 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 penmit/application becomes null&void if work or authorized construction is riot 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) )rl,�- 62 8 da� ignature of ust be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH di,/ 0VJ.,1 415 N 6TH STREET,SHELTON,WA 98584 r MASON COUNTY SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 ENVIRONMENTAL HEALTH REVIEW OF BUILDING PERMIT SPEARS DENISE &TIMOTHY 07/06/2023 16519 91ST AVE CT E PUYALLUP, WA 98375 Applicant: SPEARS DENISE &TIMOTHY Parcel Owner: SPEARS DENISE & TIMOTHY Site Address: 840 E Benson Lake Dr Primary Parcel Number: 221035200034 Permit Number: BLD2023-00643 Permit Description: NEW SFR Permit Submitted Date: 06/08/2023 Permit Review Date: 07/06/2023 The above mentioned building permit has been reviewed by Environmental Health and found more information is required. Environmental Health requires a satisfactory bacteriology sample on the well within the last year. Please submit to our office. Thank you. If you have any questions or concerns let us know. Sincerely, honda Thompson, EH pecialist 360-427-9670, Extension 581 Thompson@masoncountywa.gov [ ] Jeff Wilmoth, EH Specialist 360-427-9670, Extension 543 jwilmoth@masoncountywa.gov [ ] Dave Anderson, EH Specialist 360-427-9670, Extension 353 danderson@masoncountywa.gov