HomeMy WebLinkAboutBLD2021-00720 - BLD CD Environmental Health Review - 5/12/2021 •
415 N 6TH STREET,SHELTON,WA 98584
q... MASON COUNTYw SHELTON: 360-427-9670,EXT 400
COMMUNITY SERVICES SELFAIR.360-276-4467,EXT 400
ELMA. 360-082-5269,EXT 400
pull".Mown].Emir amelul llwlh Comm nay Health
kyr,-st FAX:360-027-7787
ENVIRONMENTAL HEALTH REVIEW OF BUILDING PERMIT
Teresa Fortino 06/10/2021
4001 35th AVE NW
GIG HARBOR, WA 98335
Applicant: PRATT ET AL JEREMY J
Parcel Owner: PRATT ET AL JEREMY J
Site Address: 21 E ZEPHYR LN
Primary Parcel Number: 2 21 0411 50 08 0
Permit Number: BLD2021-00720
Permit Description: New SFR
Permit Submitted Date: 05/12/2021
Permit Review Date: 06/10/2021
The above mentioned building permit has been reviewed by Environmental Health and found more information is
required.
Environmental Health will require a satisfactory b eriology test on well and a completed Water Resource Inventory Area
(WRIA)form. Please see attached, have notarize and recorded with Auditors office. Once recorded, please provide us
a stamped copy. Thank you.
If you have any questions or concerns let us know.
Sincere ,
Rhonda Thompson, EH
pecialist
360-427-9670, Extension 581
rthompson@co.mason.wa.us
[ ]Jeff Wilmoth, EH Specialist
360-427-9670, Extension 543
jwilmoth@co.mason.wa.us
[ ] Luke Cencula, EH Specialist
360-427-9670, Extension 584
Icencula@co.mason.wa.us
I
t. MASON COUNTY COMMUNITY SERVICES PermitN 1 na1-002:20
PEUIWIN .PLANNIN.puaucN sA
DD,D, .P N,NG.PVRDN L .FIRE MS .` ENVIRON1ieNTa, I,
�y 11 6:5w eborStreet,5 Shelton.WA986N c
PM1mto Shelton.IRtlq,.glAb7q �:�..IMa„z>_„pEPhone.P111Y I t ce-i HEALTH
BUILDING PERMITT APPhI �1v Ali-',,T C>n..ci E-
PROPERTY OWNER INFORMATION J L.L)NIRACTOR INFORMATION.
I A1\9'
NAME aLG J Y' Ike srt— 7 ifiji7'N�l di._ en_ L 1IF'Y+'✓L—I- ,y�( Pi
MAILING AID��rS$. 0 k'Rf' ��J4ut- MAAIIdLIINN_Q RESS s E, v,k., 1`Ft-
CITY: tQ!1M42n STATE V ZIPc1?"• c7ix<.CITY }A
PHONE#1 I fir. 0''rf 3 PRONEzzIr4'VLh'I``JTLCELL
PHONE#2 fP.WET`JI/r 3`)'-7 EMAIL L>1u}9ttt4,11 ri/t�. C-C,i Gi?1 M4,✓ 7Y1
EMAIL/V0)r,7Te/.(h'D IM1i1 S/ ✓) Nb.M1?)L&I REG#I OIALeiL p7 HY EXT.it )FIN/ 91
OTHER
PRIMARYGONTACS TNNER❑ . CONTRACTOR e Le' De L-LzL. IIyA t r1/u`C. tsN'T''
NAMETCYGO.' .1 'V f3110 'a P:heee6l'LL iy-xxe-EmA1L
MAILING ADORERS uoCf iYE; GUY.As/V CITY 'I T STATE' r ZIP .
PHONE CELL F53' 3)K" 70 T
PARCEL INFORMATION _ .
PARCEL NUMBER(12DS N Number)
ft OIO.�iI- 5GN 'SO ZONING 1 ] 5 .) 3 �^.�.1/i
LEGAL DESCRIPTION(Abbrev_ia1HF I TfiI"I/}PI'�1 NE r�:}FEtEMI]OCT vILLG's'"" ��' )e lr
SITE ADDRESS Al /i,<'ltd 't4'T V _ ...CITY A PR- / `
DIRECTIONS TO SITE ADDRESS .1 '1 dii. 3i 7 'LT e • g 5 JI�r )
.; , 1. (I ) s ..�r—i 1 —hCtl 7—... et) Z[w^r,� 1
IS THE PROJECT WIMIN 300 F1 OF SLOPE(3)GREATER T THAN TOY.: YESO NO Ia`SNOW LOAD:_pH
LS PROPERTYWITRW 200 FT DETRE FOLLOWING: (C.c*ni,mmIPPPR SEASONAL RUNOFF❑ STREAM❑
SALTWATER❑ LAKE RIVEER/CREEK❑ POND O WETLAND
TYPE OF WORK: NEW rJ ADDITION 0 ALTERATIONEI REPAIR OTHER 9—_ I
USE OF STRUCTURE Oesid ce.Ong...Cunmmereial Bldk.Fc) 1t.PC4&c_nt 4-'. .1
IS USE: PRIMARY' SEASONAL NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE^ YHS Omarswop YES(Fever,.iglilddlyJ 1 NO❑ 1,;,:✓tu'LL,L.:
r /9't1 LOEC. /al CLs
DESCIUBE WORK L.h <. rd:(! r �9:�c% 1 I �
ILA FOOTAGE:(peening
1 ST FLOOR ly sq:ft. 2NDy�'LZO0OOt sq.R. 3RDFLOOR sq.R. BASEMENT sq.R.
1DECK sq.R. COVEREDDEW,I IJ� nq.R. STORAGE sgft OTHER `A.It
GARAGE FiL:li sq.ft A,mched gi➢etched❑ CARPORT_ sq R.Attached El Detached
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN.REQUIRED`
MAKE MODEL YEAR_ .LENGTH
WIDTH BEDROOMS _ BATHS ,SERVAL NUMBER
ENVIRONMENTAL HEALTH: /
SEWAOEJSLWEB SOURCE SEPTIC SEWER i NE\4'Y� EXISTING
PLUMBM4 IN STRUCTURE?. YES OI NO If yes,allach completed Water Adequacy Form I
PDRIMETERNOUNDATLON DRAINS PROPOSED? YES NOV EXISTING SQ.FT. I
EXISTING BEDROOMS. PROPOSED BEDROOMS—) TOTAL BEDROOMS�_ _ I
OWNER acknowledges that submission of Inaccurate infonnetlon may result in S stop work orderer pemtt macaw.MiwrovOclgement of suck Is by I
N `horn IWa - P tll He work as ar osad I have
r SoMgni pId r .Assert 6 n^ P Nn3 piped Twormerm Ma reM
npM roAdM wantsemployes:et Coss y 011ie above tlemr`Torned M1ent
D view d l Inspection.TI( 'emit/application beWnn null&void ftwork or utM1 rr eE ao Is a `shct p
aaysm.i construction wakw scow deO tor a penal of 18D Gaya.
PROOF OF CONTI OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
i PERMIT AP ATI OF ISO DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
14.00.42)
ix( " .SI /D 1
/
Euro cif OWNER IMUat Le signed by the OWNER)
Data
t D ARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSNO TES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIREMARSIHAL
PUBLIC HEAL IH