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HomeMy WebLinkAboutBLD2007-02080 Final Replacement SFR - BLD Permit / Conditions - 12/30/2009 r Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 i� RESIDENTIAL BUILDING PERMIT BLD2007-02080 OWNER: KENNETH LANGHORN RECEIVED: 12/27/2007 CONTRACTOR: BAYSIDE BUILDERS LICENSE: BAYSIB"942LO EXP: 6/20/2008 ISSUED: 4/10/2008 SITE ADDRESS: 500 NE TIGER WY EAST BELFAIR EXPIRES: 10/10/2008 PARCEL NUMBER: 123054290020 LEGAL DESCRIPTION: TR 2 OF W1/2 SE TR A OF SP#516 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Single Family Residence- replacement From Old Belfair Highway go West on NE Bear Creek-Dewatto Road, turn Right on NE Tiger Way E to end on Right General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R3/U Lot Size: Deck: 518 Type of Work: NEW Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:3,911 Garage-Attached 1,296 Valuation: Building Height: Occ. Status: Primary Basement: cov deck 658 Manufactured Home Information Setback Information Shoreline & Planning Information Make: Length: Ft. Front: W 40.0 Ft. Shoreline: Ft. Water Body: Tiger Lake g Rear: E 413.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: N 38.0 Ft. Shoreline Desig.: Urban Year: Serial No.: I Side 2: S 52.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee TAM 12/27/200 $1,330.26 B12007000 Hosebibs 2 Furnace<100K 1 Planning Review Fee TAM 12/27/200 $170.00 612007000 Kitchen Sink 2 Gas Outlets 2 Building State Fee MAL 3/27/2008 $4.50 612008000 Laundry Tray 1 Ventilation Fan 6 Building Permit Fee MAL 3/27/2008 $2,427.35 612008000 Lavatories 4 Woodstove 1 Mechanical Base Fee MAL 3/27/2008 $26.60 612008000 Showers 2 Heat Pump 1 Mechanical Fee MAL 3/27/2008 $179.00 612008000 Water Closets (Toilets) 4 Dryer Vent 1 Plumbing Base Fee MAL 3/27/2008 $23.10 612008000 Water Heaters 1 Plumbing Fee MAL 3/27/2008 $152.41 812008000 EH Plan Review CMH 4/10/2008 $75.00 B12008000 Bath Tubs 2 Clothes Washer 1 Total $4,388.22 BLD2007-02080 Please referto the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2007-02080 CONDITIONS FOR BLD2007-02080 1) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure these structur s meet the setback conditions listed. X 2) Prior to final approval, all upland areas disturbed or newly cr a d by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 3) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads o ect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 4) Landings and stairs must meet the same setback conditions as any permitted structure, and, must be shown on your site plan. Please check your "Approved Site n"to ensure these structures are shown and meet the setback conditions listed. X 5) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. , X 6) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-09 'Je person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 7) Approve a imensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X BLD2007-02080 Please referto the following pages for conditions of this permit. 2 of 6 8) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building Department prio any further inspections being performed or approvals granted. X 9) Owner/AgeW sponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 10) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removal of appp d documents will result in failure of required building inspections. X 11) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 12) The "approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and shall be collected by the Building Depart prior to any further inspections being performed or approvals granted. X 13) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window (Max U-Factor):0.35, Skylight (Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the underside of tJ��eof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X 14) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIZPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X 15) Per 2003 IRC - SECTION R905- REQUIREMENTS FOR ROOF COVERINGS- R905.1 Roof covering application. Roof coverings shall be applied in accordanc the applicable provisions of this section and the manufacturer's installation instructions. X BLD2007-02080 Please refer to the following pages for conditions of this permit. 3 of 6 . r 167) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the .� owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. `NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting 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. By calling for a final inspection of the building permit the owner/agent/contractor is acl�r/rpWedging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 17) In buildings of unusually tight construction, fuel-burning appliances (excluding cooking appliances and domestic clothes dryers) shall obtain combustion air from outside ' accordance with the international codes. X �� , 18) The use, handling and storage of hazardous matt ials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X ((// 19) This structure is limited to U-occupancy use only(private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the international c s and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. X 20) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and sh ollected by the Building Department prior to any further inspections being performed or approvals granted. X 21) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocation. X 41 22) Installation of heating equipment in single family residences shall meet the requirements of the current Washington State Energy Code. The furnace to be installed shall not exceed 150% of the heating and cooling design load. Heating and design load calculations for the purpose of sizing HVAC systems are required and shall be calculated in accordance with accepted engineering practice, including infiltration and ventilation. Design calculations shall be available for inspection during the framing inspection. Warm-air furnaces shall have a minimum efficiency of 78%AFUE or higher or 80% combustion efficiency. All ducts shall be securely fastened and sealed with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric systems or tapes installed in accordance with manufacturers installation instructions. Du t e is NOT permitted as a sealant on any ducts. Ducts in unheated spaces shall be insulated to R-8. X BLD2007-02080 Please referto the following pages for conditions of this permit. 4 of 6 23) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located withi 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X A6� 24) Placement of str care must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X 25) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regu t n, must be reviewed and approved by Mason County prior to construction. X 26) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international c des as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be prior to requesting additional inspections. X 27) Owner/applicant must obtain a seperate permit for t lacement of any size propane tank serving a fixed appliance within a dwelling structure or unit prior to the placement of the tank. X 28) Fuel piping shall be inspected after the installation of fuel piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall not be used un 'I h final inspection has been performed and approved by a Mason County building inspector. X 29) All property lines shall be clearly identified at the time of foundation inspection. X 30) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason CountVpnances and building regulations. X 31) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have pre t action from being taken. No more than one extension may be granted. X BLD2007-02080 Please referto the following pages for conditionsof this permit. 5 of 6 32) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, aZE hing. Install metal connectors approved for contact with the new types of pressure treated material. X 33) Retaining walls needed to support a surcharge. as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property nd structur for reytqw and inspection. OWNER OR AGENT: DATE:_�/0'—©8 BLD2007-02080 Please referto the following pages for conditions of this permit. 6 of 6 00 ` CONCRETE MECHANICAL) �j MANUFACTURED HOME o Date G Y/ v / By �- —�- Z CD Footings/Setbacks Ribbons 0 Gas Piping oN Interior Date By Interior-Date By DAP By = _J_o Exterior Date _ �� BY Exterior-Date B Set-up Z _ Point Load!Isolated Footings INSULATION� -- Date By + BG!SLAB INSULATION �^��� X Date _Z v BY Data L yc�g By FIRE DEPARTMENT Z Foundation Wails Floors Date By m ByData By DECKS -I FRAMING Wails Date By = Date �- 20-L, By Data 7-c? BYZWd PROPANE TANKS PLUMBING vault _©y Date `> _ BY T/ Date OTHERe_--0 Groundwork Attic TYPelrAfiQG-,� Data By Date By Date 7 Z/^p$ BY D.W.v DRYWALL - ' - Type:Sf/� ��; �'`9�✓S 6 Int Brace Wall Date S � By W `sate - Date BY FINAL INSPECTION ni Water Line Fire Seperalion Date 2 �/ t�r7 By/-7 Date -� - By Date /L -3p _C> By O � V Pass or Request Inspect. N Type of Insp. Fail Date Date Done By Comments o s _S 91_/SZV u CD in G�4Rirr�£ �,4ss o 8 7LyOg V t-,c X/-6-4-5 Lp o ,ice Sr✓ �->/ Fl? tt/o/ 1/au/ �z.- -fly Z G� 0 ■ FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. PLEASE PRESS HARD BUILDING PERMIT APPLICATION DD-0 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION / CONTRACTOR I Owner kE^� L�►"J�Ho'�^� _ Company Name ys io F BK�ta Soo W'e Tr 4 c, - WR y rr Mailing Address Mailing Address City��LFit�2. State �✓� Zip Code 9a's2•� City PoMt O►-eha tate�_ Zip Code 983G[ Phone-360-2'7 r QFF1 ter Phone -760 - 27S-7o77 Other Ph.340- 420- 7190 Lien/Title Holder Contractor Reg.# g psi g*'�2 L0 Expxp . E mail address ti' a�-sk'�� 'ems„ E Mail Address 6n�rs�dabu;llr,-f Q_,,�01•8 Drivers Lic.# Lf/ 4 H KF .j/ aT DOB / -3 v 'S� Drivers Lic.#4gr-�wRF37oNP DOB oa-i�-c3 SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. /23 to.6 2-- - o oz o Fire District Legal Description NW Se-/r S- 2-3-/ Site Address(Please include street name, street number and city) Soo fj'E Tita"-W,+x Directions to site '" 9ld 3ErFrt"� H"', WEsr o►1 /jE BE•aK- C^ecW� _ Dcw Q r,t o.J NE TI -w l✓9 Eri eH etOh R ' Will timber be cut and sold in parcel preparation?Yes ID Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluff—s>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 5FO2-- Describe Work No. of Bedrooms 2- No. of Bathrooms 3 Square Footage- 1st Floor 222 D 2nd Floor //2-R 3rd Floor Basement Deck Covered Deck S48 Other Sq. ft. Garage /2S 7 Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/ No ( Installer Name 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 informaticn provided is accurate and grants employees of Mason County access to the above described property and structure 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 IS MEANS OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPL CATION.BY X Date' caner/Owners Representative n rac o (indicate which one) t: s FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date a7 `r DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department :i Environmental Health Department ` Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview Fee s Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal i Valuation $ TOTAL FEES MASON COUNTY PERMIT NOJ i.}­, ' BUILDING PEFII4IT APPLICATION 426 W. Cedar• P.O. f'ox 186, Shelton, WA 98584 Shelton.(360)'427-9670 • Belfair (360) 275-441.7 • Elma (360) 482-5269 On the web www.co.mason;wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION c ,�;r ! :�� r,,+c ✓ Company Name Owner k' I Mailing Address `c,C r.z d� �'✓ r Mailing Address Cityf),- t;;a„c Stater✓ f Zip Code `t L"-$ -� �' Cityp-"' r L <) I a State t� t Zip Code`1 x >4 C 1 I� . ' Other Ph -d ' , „,, Phone 3 e n , ' z ` Other Ph. Phone Contractor Reg. #h,'YA, 5" q.L L,, Exp; Lien/Title Holder ,,,,, /� �, , / ,<, > ii. E mail address "6'4 s�` 'f `" S'� r�"` E Mail Address es k t .7' Drivers Lic.#L/ltil l l k r �;✓l ta^r DOB / - 3, - S Drivers Lic.j � 7,n �r� ' DOB-, r 7 c SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire District " Legal Description wv + -`-- ;-,, L 3 - / Site Address (Please include street name, street number and city) S oc `i'.ry' :r /J kr/�Mt C, n C IL. !�C 6•J h 1� V ,�E� 1 tf Y I. Directions to site F >,,' C• id ''r '"it"'c4 0 `� Af r ~t , c r., t•✓,n, a Will timber be cut and sold in parcel preparation?YesliD 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 X Add Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building >'t~ Describe Work No. of Bedrooms —No. of Bathrooms -3 Square Footage- 1 st Floor Z�- 2nd Floor /' z- S�,rr' 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage-1-2 -5 -7 Attached ' Detached Carport Attached Detached �-- MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/No Installer Name Certification No. R Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. OWNER/BUILDE Acknowledgement such is a 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 accurate and grants employees of Mason County access to the above described property and structure 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 IS BY MEANS OFAPROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. Xr....-----���,.-�, c .- ,V Date /2 • S r 2 wner/Owners Representative n rac (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by:` Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planninq Department Environmental Health Department Fire Marshal FEES Site Ins ection BuildingPermit Fee Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO.JLAJO--LJ PLEASE PRESS HARD BUILDING PERMIT APPLICATION DQJO 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 Shelton (360)427-9670 - Belfair(360) 275-4467 - Elma (360)482-5269 j / On the web www.co.mason.wa.us / APPLICANT INFORMATION CONTRACTOR I Owner l�EAJ Lsf1jc s�oX' / Company Name ys Mailing Address .fno i✓E 7_15y.E.4- Way F. Mailing Address City$k Ld+1,S- State W/L Zip Code 98'si8 City fort Oreha tate Wft Zip Code 9834G Phone 36O - 27s-7o77 Other Ph.340_ 61-0- 79 to Phone 36o-11 r p&sah OFF11fter Ph. Lien/Title Holder Contractor Reg.# Ysi 8 1,42-Lo Exp. E mail address w 4 sk-Icr . sn . E Mail Address Awsilchtee Iderns 2 �2in s/- c-" Drivers Lic.# LA 4 KF 42./ 427- DOB / -30 -S8 Drivers Lic.# DOB o;r-i7-c3 SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic'k Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Dirgit Parcel No. /23&0 6-- 2- — o ox o Fire District 2-- Legal Description NW —S�/sr Site Address(Please include street name, street number and city) SOD 14— Titan W,4V E_ 8f_L-F*fa_ 98si8 Directionp to site w) OId tiw x a* WEsr oa NE BE.r►� G^ecl�_ D�w�, rr. �2-P . TK.h Q.r h.?- o,J 11►E T� w WA E 7l eN o R '�..�- Will timber be cut and sold in parcel preparation?Yes Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluff 5% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - Newj'<' Add Alt Repair Other PRIMARY RESIDENCE SEASONAL �] Use of Building SFR— Describe Work , No. of Bedrooms 2 No. of Bathrooms 3 Square Footage- 1 st Floor 222 0 2nd Floor //Zo 3rd Floor Basement Deck Covered Deck S6,r Other Sq. ft. Garage /2-S7 Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/No Installer Name 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 accurate and grants employees of Mason County access to the above described property and structure 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 IS BY MEANS OFAPROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Date: /2 —10- v caner!Owners Representative n rac o (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date_ D0 ,_4� DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department CfatAj 1wigia? i Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee l �' 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 MASON COUNTY PERMIT NO11 if _ BUILDING PERMIT APPLICATION o:). U 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 Shelton-060)*"421-9670 • Belfair (360) 275-4407 • Elma (360) 482-5269 On the web www.co.mason.Wa.Lc, �y APPLICANT INFORMATION CONTRACTOR INFORMATION Owner E'"` Company Name '8 A ys to f B k << o e-, s Spo Ale 7atr r� w a/ e Mailing Address 10 Box /oZ 3 Mailing Address State W'3 Zip Code q 36 L City er CFA rr� State w'} Zip Code 1E- 4 8' City Port d r cchcu fd ' Phone?6,O ' 2-7s - 70-1-7 Other Ph.36O - Gap. '798'0 Phone3l,0 -2"71 -3oZz Other Ph. Contractor Reg.#6A Ys 10 9y2.t- Exp; Lieri/Title Holder ba s,ee bu'./de,s E E mail address ev Q XA s k a v►r z n •c a E Mail Addr ss �"" Drivers Lic.#b4 P H Kr 4 .7 ar DOB 11- 3 0 ' s�' Drivers Lic. 6ALtAaF37aN�' DOB®a �� c3 i SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic I Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 1 30 2.. - 010 o 2- C, Fire District CLegal Description N'4 !/' - 5C %y S- 2-3 - 1 Site Address(Please include street name, street number and city) �eO Directions to site Gv2w1 Old GF-jrA'rt IJWX a v WEST orJ NE dr•aK Dew-A-Tr• n2QA . k, a t o,4 NF T, rr WA 4 E - e��d or Will timber be cut and sold in parcel preparation?Yes CO Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes gr Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New X Add Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building 5FRL- Describe Work No. of Bedrooms No. of Bathrooms 3 Square Footage- 1 st Floor 22 2.D 2nd Floor I 1 Z-0 3rd Floor Basement Deck Covered Deck 5*6 8 Other Sq. ft. Garage 12-� 7 Attached -e< —Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model 'fir Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/ No Installer Name 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 accurate and grants employees of Mason County access to the above described property and structure 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 IS BY MEANS OFAPROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. ` X Date: caner/Owners Representative n rac (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: r Date 7 DEPARTMENTAL REVIEW APPROVE DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal ( FEES BuildingPermit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Z3�� Planning Review Fee Mechanical & Base fee 'uQ S oq Other 4 Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST BE COMPLETED IN INK PERMIT NO. PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar•P.O.Box 186, Shelton,WA 98584 Shelton (360) 427- 7(�•Belfair(360)275-4467•Elma(360) 482-5269 n t e wepp www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INF RMATION Owner �--' mcrN`vte- J Company Name r s Mailing Address ,Soo Abc �,�, r.✓.vy Mailin Address 4d?LL City Re-�j 1r- State Zip Code Ifs 2A City o� Dr "L., a rState d-- Zip Code Phone 14v 7077 Other Ph Phoned&&- -'7/-3,o2--+- Other Ph. Lien/Title Holder Contractor Reg.#89144i'8 1VI�R Exp. E mail address T/o e"14/ccskiw ins , ce»1 E Mail Address 6`��s��l�6k�j'd�''s P'?r"a;/ Drivers Lic.# NG N F 42-1 aDOB 11-3!?-: Drivers Lic.#� A-� 3�o N�' DOB �-i7-4.s SEPTIC INFORMATION - Connect to New Septic Existing Septic. C Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No. 23 AS- 2 - no2- 'o Fire District Legal Description N"/yq - SC- YX -S 2J- Site Address (Please include street name, street number and city) Soo N�- Ti' c.- �/ 004 .-Sza Directions to site F"a"1 F it 1 %w y tW W o•-r w i ttrn R�' of T -cv A CEO 4012 Is property within 00'of Saltwater Lake x' River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs � 15% TYPE OF JOB - New Add Alt Repair Other Use of Building S F Location of Fixtures/Units- 1st Floor 2nd Floor. Basement Garage—Closet PLUMBING FIXTURES(S ow Number of each) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric_ LPG_ Natural Gas— Heat Pump_ Toilets Type of Unit Now Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Z Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Z Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER AdmWedges 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 accurate and grants employees of Mason County access to the above described property and stricture for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: /Z 8 o -/ - 7 er/Owners Representative/ rector (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Grou T e Constr.- Planning Constr.— Planning De artment Environmental Health Department FEES Plumbing&Base Fee Site Inspection Mechanical&Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other ' Violation Fee TOTAL FEES PERMIT NO. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar•P.O.Box 186, Shelton,WA 98584 Shelton (360) 427-g6n the welb w(36 )275 on67*Elma(360) 482-5269 us APPLICANT INFORMATION O CONTRACTOR I!N! RMAT.ION/Cc ,d u i ld�✓s Owner L-AN N�'� Company Name P A t/s//� ,,Sao ti/� ��t�r� way E Mailing Address �¢'' �� /,0 z 3 MailingAddress o�,T B City 6454-r !''- State�Zip Code '��'� Z Phone eo ate Zip 96�G L 22L 7077 Phone ��� ' Other Ph _ . o Exp. Lien/Title Holder Contractor Re y2 L E mail address r e ake kir-6- @ .ems— c-4— EMailAddress6a4S/dC�aa Id�r s � �rna�1 • G.�rn Drivers Lic.#LANG N KIF 42) a 7- DOB 1/- 3 v. S X Drivers Lic.#E!A t t A A c y l o N 0 DOB 0R i7 SEPTIC INFORMATION - Connect to New Septic, Existing Septic Connect Xo.Sewer System Name of Sewer System PARCEL INFORMATION- 12 Diait Parcel No. 2 3 0 5- y 2 - oc>z d Fire District Legal Description w / - Se / S-" Site Address (Please include street name, street number and city) Soo Nam- -ro e r wa Directions to site 1rbn� 1 I) Et F t+� 1 �" J 0�1 QE r ttk _ ewA v 12.r� 2 rn#'Ir 00 Is property within 00'of Saltwater Lake �� River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New. Add Alt Repair Other Use of Building s �- Location of Fixtures/Units - 1st Floor 2nd Floor Baseme nt Garage—Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. o F'ctures Fees Fuel Type:Electric LPC Natural Gas— Heat Pump_ f Toilets Twe of Unit No. of Fees Bathroom Sink Furnace Heatpumps Bath Tubs Showers Spot Vent Fan 7 Water Heater Propane Tank Clothes Washer Gas Outlets Wood/Gas/Pellet Stove / T Kithen Sinks Kitchen Exhaust Hood I Dishwasher --L-- Dryer Vent Hosebib / Other Other r Base Fee Base Fee ` TOTAL PLUMBING TOTAL MECHANICAL i 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 have obtained the permission from all the necessary par permit and to do the proposed in the application.I declare that I 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 i provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. 'f PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. D 2 "��- a7 Date: J X wrier/Owners Representative/ ractor ((iinJ�di�cate which one) i. 1CIAL USE BEYOND THIS POINT fi Accepted by: F' Planning Pd Ck# Date Bld Pd Receipt No. I DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. i Plannin Department Environmental Health Department FEES Plumbin &Base Fee Site Inspection Mechanical &Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES ■ FORM MUST BE COMPLETED IN INK PERMIT NO. PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar•P.O.Box 186, Shelton,WA 98584 Shelton (360) 427-9670h•Belfair(360)275-4467• Elma(360)482-5269 On t e web www.d .mason.wa.us APPLICANT INFORMATION CONTRACTOR INF RMATION [�}NGyvi2 Company Name r s Owner Mailing Address-soo 'y E 7�t-, t'✓�y Mailin Address 4d?L L City State,l•✓�t- Zip Code 9'�S�-� City �r ®` a'' tate�— Zip Code Phone36v-2-� 2 /-3- z Other Ph. Phone 36v-Z�5- 7c77 Other Ph Bq sig'r9502� ' Contractor Reg.# � Exp. Lien/Title Holder /9¢rla ke sJc;w Ms•►, co»t E Mail Address�s�scbc� 3�c+-s Email addressl� Drivers Lic.#1./�NGH Kf �21 Gtr DOB Drivers Lic.#6.gci A--' 37o N�' DOB -i�-�S s SEPTIC INFORMATION - Connect to New Septic Existing Septic C Connect to Sewer System Name of Sewer System ° PARCEL INFORMATION- 12 Digit Parcel No. 2 3 d s- - ncz to Fire District Legal Description AWZY - S� 7 9�sza 5- - Site Address (Please include street name, street number and city) Svo N¢ Ti' cr 6✓ Be/�a Directions to site Flow. Old 6t F ,,- 1 END ors �' i urn Rt' T `� �x River/Creek Pond Is property within 00 of Saltwater Lake Wetland Seasonal Runoff—Stream—Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building SF Location of Fixtures/Units- 1 st Floor 2nd Floor Basement_________Gara a Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No.3f Fixtures Fees Fuel Type:Electri�_ LPG— Natural Gas_ Heat Pump_ Type of Unit No.o� Fees Toilets Furnace --.— Bathroom SinkEFE "— Heatpumps �— Bath Tubs Spot Vent Fan Showers Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Z Wood/Gas/Pellet Stove / �— Kitchen Exhaust Dishwasher Hood / Dryer Vent Hosebibs Other Other Base Fee Base Fee TOTAL MECHANICAL TOTAL PLUMBING a OWNER/BULDER 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 receiveis �s permit and to d0 the work as proposed in the application.I declare that I have obtained the permission from all the necessary pa per ication,I have obtained required from any easement holder or any other party in interest regarding this dThe own4er or agent on or e work on oownorsbehalf d in eep�resents that the information permission from them to apply for this permit and conduct the work proposed. provided is accurate and grants employees of Mason County access to the above described properly and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY M EANS OF A PROGRESS INSPECTION. } Date: /2-If X er/Owners Representative/ ractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr.— Planninq Department Environmental Health Department FEES Plumbina &Base Fee Site Ins ection Mechanical &Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES PERMIT NO. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar•P.O.Box 186, Shelton,WA 98584 Shelton (360)427- 67 0 B 7a7 a.Elma(360) 482-5269 wOntheweawwcom4us APPLICANT INFORMATION CONTRACTOR INF�JRMATION ArvGt1r �'/�J Company Name qc sr! i r��vrl�rp r Owner ,,�.. 1023 Mailing Address �" ^'` ``r,�'` +.✓<a y Mailing Ad%ess , i y t� zip Code a City/ 7 t r< State 1"v r� Zip Code , 6. G F City State t.yr. p °k a z : 4 7 7" 7�r7 Phone O hoer Ph. Phone ��� � Other Ph t Lien/Title Holder Contractor Reg. p f �� tn , Ca«.� ) 1 41t1G rLc. felCrc .rta / GJq E mail address 7°)c` Ia A c s'"�`✓ E Mail Address .l � Drivers Lic.# L,I P6 r v K 4 '�" v 0�r DOB 1!• 3 5 �' Drivers Lic.#I(",I t ' o ''' N'� DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic,, Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 1 Digit Parce No. Fire District i �F Legal Description 44 ri,a Site Address (Please include street name, street number and city) B r, w. o!a) ! e l tNtI— (Ittt/ , .9 W d+,e 60'.')r Cr CC 1+ . F e,..,i r-t r - , Z .rs1r Directions to site .a _, „ Is property within 00'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New_,?' Add Alt Repair Other Use of Building Location of Fixtures/Units- 1 st Floor 2nd Floor Basement Garage—Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPC Natural Gas Heat Pump_ Type of Unit No. f�c.Units Fees Toilets Bathroom Sink Furnace Bath Tubs +- Heatpumps Showers ;6' Spot Vent Fan Water Heater T— Propane Tank Clothes Washer T— Gas Outlets Kithen Sinks X7 — Wood/Gas/Pellet Stove- Dishwasher �— Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowredges 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 on�this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all he necessary parties. pe required from any easement holder or any other party in interest regarding this application or the work rop� in 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 accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF NUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. Date: 12 ... 1If- ©? X wner/Owners Representative/ ntractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bld Pd Receipt No. F RTMENTAL REVIEW APPROVED DENIED NOTES g Department rou T e Constr.n Department Environmental Health Department FEES Plumbing& Base Fee Site Inspection Mechanical&Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES ■ MASON COUNTY DEPARTMENT OF HEALTH SERVICES ,t January 09, 2008 PO BOX 1666 Shelton WA 98584 Shelton (360)427-9670 Fax (360)427-8442 KENNETH S LANGHORN Elma (360)482-5269 500 NE TIGER WAY E Belfair (360)275-4467 BELFAIR WA 98528 Case No.: BLD2007-02080 Parcel No.: 123054290020 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Approved septic records or approved septic design for 2 bedrooms Report within the last three years from either a septic tank pumper or an Operation and Maintenance Specialist. Please call me at(360)427-9670, ext. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services Comments: 1/9/2008 1 of 1 BLD2007-02080 I r 1 s Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2 Topic Index ( Contact InfoLaborand Industries 1 — ! Search Home Safety I Claims&ksurance Workplace R1gIAts Trades B Licensing Find a Law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber Printer Friendly Version General/Specialty Contractor A business registered as a construction contractor with I-Ed to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. License Information License BAYSIB'942LO Licensee Name BAYSIDE BUILDERS Licensee Type CONSTRUCTION CONTRACTOR UBI 602616802 Verify Workers Comp Premium Status Ind. Ins. Account Id Business Type INDIVIDUAL Address 1 1908 SNYDER AVENUE Address 2 City PORT ORCHARD County KITSAP State WA Zip 98366 Phone 3602713022 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 6/20/2006 Expiration Date 6/20/2008 Suspend Date Separation Date Parent Company Previous License Next License Associated License https://fortress.wa.gov/lni/bbip/Detail.aspx?License=BAYSIB*942LO 4/10/2008 ■ Mason County Permit Assistance Center Planning Intake Checklist Owners Name: 6�� Dater Project: ` Reviewed By: Commercial Development: YES O omments: Planner: GBM TSC KJM PBC RDH JMS ite Plan: North Arrow �X S� Property Dimensions: _ Streets and Driveways Shown. Road name: All Existing Structures shown with setbacks Septic and Drain-field Shown with setbacks Identify all surface water(streams, ponds, shoreline, wetlands, etc.) Topography(slopes) Proposed Structure Se L t. becks(Directi.crl/Setback)� — F: �_/ Q R: / S 1: f-:�:Z S2: S Utility and Drainage emen s: es No (if yes enter condition#5022) Other Easements Accessory Appurtenances L"% ounty Access Permit Needed(add condition#0010) tate Access Permit Needed(add condition#0020) HSim- dard Conditions to be added to all Building permits that planning reviews: #5019 and 40700 Are there any impedime is that ay restrict access to your site? (dogs/gates) Shoreline and Planning Info y� ' Setbacks: Shoreline: ii:E�D Slope: 1 H' Shoreline Designation: Comprehensive Plan: ral Zoni ❑ Not Applicable ❑ Agricultural MMIF R 2.5V50 20 [I Urban ❑ In-holding ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy ❑ Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet ❑ RT _ ❑ Urban Growth Area ❑ MPR ❑ UnknownW IfownUnknown Water Body of water if unnamed): SEPA: Yes o nknown Flood Plain: YES NO U o Map# Aquifer Recharge: YES NO nkno Map# Tags/Cases: m 'GI RLC/SPI Case: U 6-Year Dev. Moratorium: YES Eagle Nest Tag: YES NO Other YES O a��_J Addressing: Check box if needed ❑ Reviewed by: Revised:12-19-200 7 — 1:\PLANNING\PAC\PLANNING INTAKE z Name / 9NU HOX,.-J Parcel# /Z3os- `J oo2.o BLD# �:�J O BE KEPT r Mason County � Department of Community Development ARCE Small Parcel.Stormwater Management Application/Worksheet (page 1 off) Y Per Mason County Code,Title 14,Chapter 14.48 a stormwatsr 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. 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. ::.:::.:::.....:::•::::::: :... .. :::•? !.. .:: r ;.. q r,...•.r fr i rT :r:•, I US •: ... /. LIM ryr$f..r.:/.•?.]:.. •}$;�.,v, r..+F.:S Surface Type Length X Width = Area *All dimensions in feet + Buildings 411 X 6 s' _ 4172- �s,yE X 2 G 2 8G Measurements for buildings are taken at the X = perimeter of the farthest projections(example: /° eaves/gutters) X = Driveways X /80 = / G 0 X = Length of drive begins at the right of way X Parking Areas 'fZ X z y 8 X = Any paved,gravel or packed area per definition above table X = Patios/Walks X �.� = F 0 X = Any paved,gravel or packed area per definition above table X = Others- X X = !:}$>.. »'•`:$$:•G•• }> .i r'.:i %? 'e}r:):.r� •;3r:'3: :to S.fir s F i }}$$•+.:v. ;�,$F.�+. i :}" •x::4 i'r' / /.. I V � } iy.$i,7?�5;/.f �rA;:¢�'• 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/Age �Contraircle one)Date: t� 7` If the Total Impervious Surface Area is GREATER THAN 2000 Sgpare Feet, please read, acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 4P ti Parcel# /L2 oS_- y 2- -900� o BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Work-sheet (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: httn//www.co.mason wa—us/code/commissioners/index htm Please follow the links to "Title 14, Chapter 14.49 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 ANC.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 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) 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/Age Contractor ' cle one)Date: Page 2 of 2 E pv-F , r -90 WAV CP \ v� Vt r 0 N f• ss\ " .`fie, �� � M- o J -- - 45� HE tJfl lJI�aN NNO Q° 3L i fi _ O i I 4 � N �t N � I { 1 { e Iw ca n N W C: m � �•; 0vv0 i "! a0 Sz. g 0m o z Ln z � O O co r cn V o0OW � � 0r- r- AmO ! m C v co O 0 0 v p < c N N (D �D 3 v -� m m v 5 ? m m v m < cD To r o CD m O CL m Q m o c� N -I m N yCC m n CD Uy 5.`� a N �, c o 3 O . 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