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RECEIVED
FEB 14 2008
SELFAIR OFFICE
MASON COUNTY PERMIT N (G��� •QQL-]Q
BUILDING PERMIT APPLICATION -5
426 W. Cedar• P.O. Box 186, Shelton, WA 98584 J I YtiI.J Shelton (360) 427-9670 • Belfair(360) 275-4467• Elma (360) 482- 69
On the web www.co.mason.wa.us
APPLICAN ORMATION CONTRACTOR I MATT 7 .. ���
Owner Company Name
19,
Maili JA �esss_632 Maili Ad Iress
City �jfj
Zip Code City tate Zip Code
Phone Other Ph. Phone -- Other P
Lien/Title Holder . Contractor Reg. # Exp.
E mail addressCj E Mail Address . `
Drivers Lic.# _ DOB - Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to ter System Name of Water System
Well_,Water System Name of Water System
PARCEL INFOR ATION- 12 Digit rc No Fire Distri
Legal Description .Pael
Site Address(Ple in Jude street nanum er and cityDir tions to siteWill timber a cut and sold in parcel prbA
es NIs property within 200' of Saltwater River/Creek I�_Pond -*L.&_.
Wetland tha _Seasonal Runoff _Stream v-c� Slopes or Bluffs > 15%
Is this permit submittal the_result of a Stop Work Notice,Correction Notice or other enforcement action? es o
TYPE OF JO New Add Alt Repair O h r
Use of Buildin PRIMARY RESIDENCE SEASONAL ❑
9 Describe ork I
No. of Bedrooms No. of Bathrooms�Square Footage- 1st Floor
oor ck a/_ Covered Deck �
Gara Attache Other -�'- Sq.ft.__,. �-
ached� Carport,� Attached _.�. Detached ,�
MANUFACTURED HOME I ORMATION -Make M
Length Width Serial No. o. of Bedrooms No. of Bathrooms
Type of Heat ase rice$ Replacement Unit? Yes/No
Inst a Certification No.
OWNER/BUILDER Acknowledges 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,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
requirj'.n
rom any eas nt holder or an other a proposed in the application,I have obtained
y party in interest regarding this application or the work r
permi fro m to ply for this permit and con ct the work proposed. The owner or agent on owners behalf,represents that the information
provid ccurate an rants employees of Maso ounty access to the above described property and structure for review and inspection.
PR OF CONTI TION OF W BY M NS OF A PROGRESS INSPECTION.
Date'
r/ ners Re resentative/Contr for indicate which one
FO FFICIAL USE BEYOND THIS POINT Accepted by: ' Date
,QtePARTMENTAL REVIEW APPROV17D,. DENIED NOTES
Building Department 1
Planning Department
Environmental Health Department
Public Works Department •�p3
Fire Marshal
FEES
Building Permit Fee Site Ins ection
Plan Review Fee EH Review Fee '
Plumbing&Base Fee a (o
Plannina Review Fee
Mechanical&Base fee t5l— $ Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal vZ�g IS
Valuation$ 1 C49)46 Q TOTAL FEES
oN-srArF MASON COUNTY
A C ° DEPARTMENT OF COMMUNITY DEVELOPMENT
s N = Planning Division
i� N y Y P O Box 279, Shelton,WA 98584
(360)427-9670
1864
NOTIFICATION OF INCOMPLETE APPLICATION
March 12, 2008
JAMES M SCOTT
5371 NE NORTH SHORE ROAD
BELFAIR WA 98528
Parcel No.: 123073490043
Project Description: Building New Hiline Home (2006-0003) to replace existing MFG
home, the MFG home will be removed prior to final inspection
Dear Applicant:
You have submitted a permit application (case no. BLD2008-00170) for proposed
construction or development in the county. Upon review of your application, I have
determined that the contents of the application are incomplete or do not provide
enough detail for review.
Therefore, review of your application will not proceed until the necessary information
is provided (see the comment section of this letter for details.) Once the information
is submitted and the application is complete, I will continue to process your
application accordingly. If the additional information is not provided to the County
within 180 days of this request, the application shall expire and no further action on
the proposed development shall take place.
Please contact me at (360) 427-9670, ext. 294 if you have questions.
Sincerely,
J mes Sc Iz
Land Use Pla r
j Mason County Planning Department
i
3/12/2008 Page 1 of 2 BLD2008-00170
I
NOTIFICATION OF INCOMPLETE APPLICATION
3/12/2008 Case No.: BLD2008-00170
Comments: The proposed project is located within 300' of slopes greater than 15%,
and therefore, a Geotechnical Assessment will be required to evaluate
slope stability per 17.01.100 E.1. The assessment must meet the
requirements of the Mason County Resource Ordinance section
17.01.100 EA. (enclosed). The assessment must also state that the
hazards of the landslide area can be overcome in such a manner as to
prevent harm to property and public health and safety, and must also
assure that project will cause no significant environmental impact. See
Mason County Ordinance section 17.01.100, E.7. A Geotechnical
Report may be needed if through a Geotechnical Assessment it is
determined necessary or if it is determined that there are slopes over
40%.
If you have any questions, please don't hesitate to contact me.
I
I
3/12/2008 Page 2 of 2 BLD2008-00170
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Name.,,A1' A-'e) SCO& Parcel# ���p�-3�—�'���3 �BLD
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Mason County 7
Department of Community DevelopmXVA R C�'—
y "-
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces, structural development
including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
.............................................
.:::::::::::::::::.:..::.>:::.;;:.::.;:.>:.;:.::.::.;:.:............................
Surface Type Length X Width = Area "All dimensions in feet
Buildings X =
X = Measurements for buildings are taken at the
perimeter of the farthest projections(example:
X = eaves/gutters)
X =
Driveways X
X Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved, gravel or packed area per definition
above table
Patios/Walks 140 =
X = Any paved, gravel or packed area per definition
X _ above table
Others
X =
X =
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t t3t Q ,fit.atka.A�ra..s tt .al.atl..areas
......:......:.:::::::::::::.........................................
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XX
If the Total Impervious Surface Area is ESS THAN 2000 S uare Feet, lease read, acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowle t of such is by signature below. I declare that I am the owner, owner's legal representative,or the contractor. I
further owl dge that the informati provided is accurate and employees of Mason County are granted access to the above-
des ed pro rty for review and in ection as may be required.
er/Agent/Contractor(circle one)Date:
If a Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read, acknowledge and sign
e information provided on page 2 of 2.
1-0 BE Kc
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Page 1 of 2 ;