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Date By 7( Data By DECKS
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Date By Data By PROPANE TANKS
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Date By OTHER
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PLANNING
APPR VED
MASON COUNTY DCD PLANNING PLANNING:—
SITE PLAN REQUI ED TO BE ON SITE ALL SETBACKS ARE MEASURED
CHANGESSUBJ CTTOAPPROVAL FROM THE FURTHEST
By Date �' PROJECTION OF THE BUILDING
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MASON COUNTY
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VATCHEN/OM19bG
0,/ 20811 SOFT. BEDROOM �13
O 130.78 SQ r r.
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LIANG ROOM
MASTER BEDRCXw 321.94 SQ.FT.
184.61 S0,F1
BEDROOM yy��
t3OLIS SO.Fr.
m 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 j L STANDARD MASTER BATHPLA
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4P52S68 1408 SQ. F'T.
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PLANNING :ALL SETBACKS ARE MEASURED RECEIVED
Option exterior-with 4/12 roof shown FROM THE FURTHEST
APR 0 12009
PROJECTION OF THE BUILDING
MASON COUNTY
05/22.i'2009 15:41 FAX 360 613 0785 The UPS Store 0 001
0. .
May 22nd 2009
To whom it may concern
Please note that my final inspection is berg set up for next week at the location
noted,below in bold_I request that if final is approved that a temporary occupancy
certificate be applied to so that we can move our possessions to the new house.The
trailer will be moved to the below location in red once our possessions have been moved
within 2 weeks.
if you have any questions please call me @ 360-372-2466. Thanks for you time in
this matter.
Address: 191 NE Mahogany CT.BeMdr WA
Parcel #:223097790310
Permit#: BLA200"0787
Address: 1071 NE MUNSON BLVD BELFAIR
Parcel#: 223097790310
Case#: BLD2009-00283
Frank E.Jones
ACCESS & GRADE INSPECTION PERMIT #:_ '<
ADDRESS I �� �t / /YIC��-��-�'� Z�
INSPECTOR ��" ��� DATE: -ice
DRIVEWAY ACCESS
Length: Width: Surface•
Size of turn-around:
Condition of shoulders:
Vertical clearance:
) need post at end of driveway with reflective address numbers
GRADE,OF DRIVEWAY %, OF ROAD %
ROAD ACCESS
Length: Width: Surface:
Condition of shoulders:
Vertical clearance:
( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE.
( ) LOT INSIDE SMZ, 4X4 FIRES ONLY.
( ) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED.
LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES.
REMARKS Ny /-SSc-Je S 4LX
(continue remarks on back)
Name Parcel# as I • (D•owLac) BLD#
Mason County
Department of Community Development
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 surface'.
'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.
'Common 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.
■�.V {IM a�i
Surface Type Length X Width = Area *All dimensions in feet
Buildings X =
M X = Measurements for buildings are taken at the
+iDM X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X =
rl v EW A X = —] 20 Length of drive begins at the right of way
X =
Parkin Areas X =
X = Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X =
X = Any paved, gravel or packed area per definition
X _ above table
Others X =
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area (sum of all areas)
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please 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.
Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
J
Name Parcel# BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website:
http//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to"Title 14, Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a Stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details*are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A)'X The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT.450
Mail: P 0 Box 1850,Shelton WA 98584
Physical:415 N 6th St,Shelton WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other, parcel. You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone:(360)-427-9670 EXT.352
Mail: P 0 Box 1666,Shelton WA 98584
Physical:426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent 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,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
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MASON COUNTY PERMIT NO.
BUILDING PERMIT APPLICATION i 14 0
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 �y
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner - �L EZLI�G;L7� Company Name
Mailing Address Mailing Address CO
City. State Zip Code City State Zip Code
Phone 3UO 7-79-i 1'7-ther Ph. Phone Other Ph.
Lien/Title Holder I Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# DOB /, �zy-C/,E_ I Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Water System Name of Water System
PARCEL INFORMA_T)ON., 12 igit Par�ql -q 1A-fMloO FireDistrict
Legal Description ` 9
Site Address (Please include street name,street number and city)
Directions to site
Will timber be cut and sold in parcel preparation?Yes(No_---'
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Describe Work
No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq. ft.
Garage Attached Detached Carport 1. Attached Detached
MANUFA D HO, E INFORMATIQN,= ke <i a r.l Model ` Year i
Length-:.-= Widt�Serial No. ' -- No. of Bedrooms__ 3 No. of Bathrooms_
Type of Heat Purchase Price$ Replacement Unit? Yves o
Installer Name �'<J ,L�r, r 5" 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
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is a rate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF ONTINU TION WORK IS BY MEANS OF A PROGRESS INSPECTION.
X. `r ::!:el
Date`�-�
Owner/Owners Re resentative! ontractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: .- Date r U
DEPARTMENTAL REVIEW APPROVED DENIED J NOTES
Building Department .?,0
Planning Department
Environmental Health Department IVA
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee Z-161 EH Review Fee
Plumbing & Base Fee Planninq Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES