HomeMy WebLinkAboutBLD2023-00846 - BLD CD Environmental Health Review - 7/26/2023 M.\\v"'G.11-4A:t.,,,;'
,t MASON COUNTY COMMUNITY SERVICES Permit No: 1 -{ 2D_ 7 .Q0eillp
�.
PERMIT ASSISTANCE CENTER: RE IV
'.� •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i
f
615 W.Alder Street,Shelton,WA 98584 �12n
'i Phone Shelton:(360)427-9670 ext. 352•Fax:(360)427-7798 Phone JUL 2 4 `i .3 `��ZLJ/
J`ii '4' Belfair:(360)275-4467•Phone Elma:(360)482-5269 1 jvL
�".)•1tri 615 W. Alder Str eta 6?023
BUILDING PERMIT APPLICATION ECEIV 0rn
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Janessa Omdahl NAME:T.B.D. = '1
MAILING ADDRESS:4350 E Agate Rd MAILING ADDRESS: m as
CITY:Shelton STA'I'E:WA ZIP:98584 CITY: SIIATE: ZIP: r
PHONE#1:360-338-5792 _ PHONE: CELL: —1
PHONE#2:360-490-0274 EMAIL : = -
EMAIL:dogsforever86@yahoo.com L&I REG# EXP. / / '
PRIMARY CONTACT: OWNER❑ CONTRACTOR 0 OTHER❑
NAME EMAIL
MAILING ADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32024-12-90061 ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS 100 E Emily Lane CITYShelton
DIRECTIONS TO SITE ADDRESS Hwy 3 to Agate Rd,Left at Agate Store,Right on Emily Lane
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO D SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK ❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW El ADDITION ❑ ALTERATION ❑ REPAIR 0 OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Eto Residence
IS USE: PRIMARY 0 SEASONAL ❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg) Q YES(Part[s]of Bldg) 0 NO ❑
DESCRIBE WORK
1 SQUARE FOOTAGE: (proposed)
1ST FLOOR 1239 sq.ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. fl.
DECK220 sq.ft. COVERED DECK592 sq.ft. STORAGE sq. ft. OTHER sq. ft.
GARAGE667 sq. ft. Attached 0 Detached❑ CARPORT sq.ft. Attached❑ Detached❑
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 0 SEWER 0 / NEW 0 EXISTING❑
PLUMBING IN STRUCTURE? YES ❑� NO 0 If es, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS V PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
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
e>,...____
COUNTY CODE 14.08.42)
X06-26-23
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL nn PUBLIC HEALTH 9 / f/ 2) CO, /•47-nS 1eatoe
•17 iX ( 71 _ ? zoz;o
cu
to
D ? n Dn
C O ° O.+
0 � a
a 5.°ic r'
0: O .n NN �a6 a
nn r j Q � U 13 »„ ;1) 0 I
2Z ° ] 0 gv
° � ° O a vr �v § Z
m - n < d m G.m
m �� = � 3 o M 21 3V,t
NN0N 0 (Dm = W 0 a� „�,. m
` O cn 4r � N2
c 3 �� o- c 0 7•(13 m a d 14.,
m 3 0 a m 2 = a ^ m
Q 2. 0 O N '- N 5 a N » --1
mK W `° CD d0 3 ,�^rD
O ' er C/ ° '"' " d /�
D � CD3 Cr - 0 , 1
< a1 3 "` 0 0 3 7C
a •O O Cl.i/ cD 0 ))6 �o 2 I ( / i 111
cD 1 r 1 £'
• •
d
3 & 1\ a .x \ a '�- I a 3,
\ ' :soar . / a
o
�. f• • • a to
til
. 'Oil r4. A I
x1' � IA� 01 '.•'1
JJ
1 .'J.lr' :::.an .x.• 1 1
IL u1w . i .
D
cA
? 1��1y
m V' '•� ' '1 lii
r
W •� • • O
y . . .I
•
. .. � _,
8 ,
1 0
1•
i 7E0.» l
E EMILY IFNF
•
•
$ 98• d78 n f.4
R fro.. (�, a� -iC;�Z !8'a b(�1 OO�p�O In X'
�u ,mP�a
r=0A-4007ig" m z
m�
u �eo,o C� 300>r'.4o r
�- °.m 0 r
M Fcm• dz CO 2
m L oo�o� ci
In, `EP o o
tU+'O Ov=iym >
i5 Z
1 g 1, Ti Site Plan ."; wr !R u —,I
i
^' I Ni 1 Omdahl Residence __._._ $(1
9.S f to •£ Tn I 100 E Emiy Lane -1 +
�T a
L N i A' Shelton,WA 9B554 t 1 za 9Cs,N 44, L I * l
y, i For Jancr a Omdahl D
L._ —
l
I
g
A
J 1
t \ k$ �/
1 a s \ a \ g a8
'al /
e
CD
CD
0 r
0.
P
til
.1 .c .
tn
v0 ', _ _ , j WRIT, , EiJ
KA
Z.
'.l
a
LA
00
280.73' • I
I
F EYILY INV
S z iaF9Gy HZPp4z 5
wO-1vszsz :1z >_
e m-e.g ,, p-pRlrm T� C s
�'0 4 —m. S K�j KSKCp In
P (;n tmo C mT _S
am <aZn 0
i2 n S9 C 70Y
ilrt.P
0 cici
0
1 ti"r -i R 141 51te Plan «V ••EM (�
pw1• , 3 Omdahl Residence & R — ' r
i C! A i " z'a i 100E Emil lane -- —
Lu+o "' + o j R A.
5hel[on,WA 98584 �gg�sl F e:
u i' For Janen5a On,dahl { 3 V oci
1 Y