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Home My WebLink AboutBLD2019-00588 Final Replace MFG Home ADV2019-00067 - BLD Permit / Conditions - 8/26/2019 ' T Mason County Mason County - Division of Community Development 615 W. Alder St. Bldg. 8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us E 9-00588 MANUFACTURED HOME REPLACEMENT DESCRIPTION: MFG HOME REPLACEMENT ISSUED: 08/26/2019 ESS: 51 NE HARPOON DR BELFAIR EXPIRES: 02/22/2020 PARCEL: 123305200011 APPLICANT: MANUEL HERNANDEZ DIEGO OWNER: MANUEL HERNANDEZ DIEGO P0 BOX 1318 P0 BOX 1318 BELFAIR, WA 98528 BELFAIR, WA 98528 1.360.649.5474 FEES: Paid Due Modular/Manufactured Home $275.00 $0.00 Fee - 1 st half collected at submittal Modular/Manufactured Home $275.00 $0.00 Fee -2nd half collected at ready to issue Planning Review Fee $240.00 $0.00 Building Plan Review/Change of $110.00 $0.00 Use - Onsite Sewage Totals : $900.00 $0.00 REQUIRED INSPECTIONS Setback Inspection Set-Up Inspection Footing Inspection BLD-Final Inspection CONDITIONS * When parcel development requires direct access to county road(s), a Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at (360) 427-9670, ext. 450 or 100 W Public Works Dr. Shelton. The building permit will not be finaled until the permit holder can show proof that the access permit from Public Works has been finaled and approved. Printed by Genie Mcfarland on 08/26/2019 10:55 AM Page 1 of 4 N, Mason County Mason County - Division of Community Development <r 615 W. Alder St. Bldg. 8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us MANUFACTURED HOME REPLACEMENT BLD2019-00588 * All construction must meet or exceed all local and state ordinances in addition to 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. * Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28 and 14.17. * Mason County has four areas with ground snow loads between 25#-55#. The owner/agent of this permit acknowledges that if the unit permitted under this permit does not meet the area snow load rating, there is a potential for failure due to weight accumulation beyond that of the design criteria for the unit. If you are uncertain please contact Department of Community Services for snow load or vist our website at www.co.mason.wa.us. * The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. * REQUIRED INSPECTIONS (Footing Inspection-prior to pour (set-up manual must be on-site), Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. Until resolution of any/all problems no occupancy (Final Inspection)will be granted for the residence. OWN ER/CONTRACTOR(indicate which) * All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor increase the velocity flow entering or abutting to any state or county culverting/ditching system or road way. * Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three feet of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or installed. Certification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 * All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. * The stamped 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, 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 Department prior to any further inspections being performed or approvals granted. * 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 codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. Printed by Genie Mcfarland on:08/26/2019 10:55 AM Page 2 of 4 Mason County Mason County - Division of Community Development 615 W. Alder St. Bldg. 8 * Shelton, WA 98584 -= 360-427-9670 ext 352 www.co.mason.wa.us MANUFACTURED HOME REPLACEMENT BLD2019-00588 " 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 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. * Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. • The foundation/footing must be placed on undisturbed, firm-native soil. • 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 acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. 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. * The plan review check list and corrections are part of the approved plans and must remain attached. It is the responsibility of the applicant, owner or contractor to make the required 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 approved documents will result in failure of required building inspections. * By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your "Approved Site Plan" to ensure these structures meet the setback conditions listed. • All property lines shall be clearly identified at the time of foundation inspection. • All building permits shall have a final inspection performed and approved by 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 County ordinances and building regulations. * If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (NCSBCS/ANSI A225.1). * All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration. Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No more than one extension may be granted. Printed by.Genie Mcfarland on'.08/26/2019 10:55 AM Page 3 of 4 Mason County Mason County - Division of Community Development �. 615 W. Alder St. Bldg. 8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us MANUFACTURED HOME REPLACEMENT BLD2019-00588 * All RED stamped 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 prior to any further inspections being performed or approvals granted. ' This permit is for the placement and installation of the manufactured home only and does not imply approval or review for any other items indicated on the plot plan. * Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. * Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. RR5 * Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state/local law regulating construction or the performance of construction. Issued By: Contractor or thorized Agen t: V Date: Printed by Genie Mcfarland on:08/26/2019 10:55 AM Page 4 of 4 615 W.Alder St.Bldg 8,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 352 COMMUNITY SERVICES BELFAIR:360-275- 467,EXT 352 F}uilding,Pla ut ny,Ce....... ELMA:360-482-5269,EXT 352 - www.co.mason.wa.us INSPECTION CARD AND CERTIFICATE OF OCCUPANCY" To schedule an inspection call or visit hfp:/twww.co.mason.wa.us/community-services/bid-inspection.php Permit Number BLD2019-00588 Date Issued 08/26/2019 Issued By Project MFG HOME REPLACEMENT Site Address 51 NE Harpoon Dr Applicant MANUEL HERNANDEZ DIEGO Contractor Contractor Phone Primary Code UPC IBC,IRC,IFC,IEC,IMC,& Type MANUFACTURED HOME Occupancy Permit Type REPLACEMENT -APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS. -DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED. -THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION, FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY. -ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION. -OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION. "'THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.— PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET Public Works Access/Driveway Other Health Septic Well Deptartment Planning Site Inspection Department Fire Marshall Fire Apparatus Access Fire Sprinkler Auto Fire Alarm Hood and Duct Other Final Building Building Official: Community Services Designee Department Concrete Setbacks L Slab Footing Per' et Point load Footing Footing Interior Footing Decks/Porches Foundation Stem Walls Other Rough-In Groundwork Plumbing Framing Groundwork Mechanical Plumbing Groundwork Gas Pipe Mechanical Gas Piping Shear Wall Nailing Underfloor Other Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Interior Wall Brace Panels Fire Walls Nailing Other Final Building Manufactured Setbacks Z� ��! i��K Setup Home Concrete Foot/Runners Final Other LD 20 (Z330 -S-2 -Coo(( THESE PLANS MUST BE MUST COMPLY WITH CHANGES ON THE JOB SITE SUBMIT CHANGES FOR APPROVAI. FOR INSPECTION PERMIT CONDITIONS PRIOR TO PERFORMING WORK MUST MEET ALL CURRENT APPROVED WASHINGTON STATE CODES MASON BUILDING INSPECTOR CHANGES SUBJECT TO APPROVAL :-EC--DATE Documents attached to approved plans: Site Plan Plan review checklist: _ � Raga; Engineering: Y 6j Lateral Vertical Number of pages Cover pye >' .4Gt (yuS��l/��J�� usfrc,�fr6lit S' l�l?US ie mc4.5,.k Par .441 j,uSX4f)0& S FIL COPY CL . PlQ^l C) ' l � 33 0 SZ a�v�'1 .�� AS 4� P 5 b4 a ` �� W,�{'*,, ?1c� S,� N Ii,"Ll / 1 /� La 9.+, S N fy�/,V s,00 1a �'-cam G/• G �r Y r�i! CINDY E si Lc N1 MgSON00 4 � .i ENSED DE IGNER T' 14 2 U�6 a � NNTY SNVIRON .3 'JB 4AC HFACTN. 1. Soil logs 2. Existing septic tank to a properly ab od t ' 3. 1200 double chamber eptic tank o DOH ap di"st ''° 4. D-box with speed level rs placed vel�k(q�p " /RECEIVE D with access riser to r de MAS1 .;, 9 ON COUNTY -- 'r""'' JUN O 3 5. Existing water line - - - --- - �1VVIRONMENTqL / 2019 6. Effluent filter hEALTH 7. Observation ports / 615 W. Alder Street 17-7' 0' Prop.ate. "Ay\. Vy b� 2 ,"_j z- '�� 06N, \k(\, 6A W/ op I IUj, qu O �i APPROVED SON COUNTY DC PLANNING z CANNING. �u ' 2a� S 9LANRE OBE ON SITE BJEC.TT0APP OV. ALL S :TBACKS ARE MEASURED r qy Date 7 L G rj\jN1 THE FURTHEST PRQJECTION OF THE BUILDING Imo' / ' WW l IV f II44iL POVA-7 oc�oG PI a AfAfjtjG oo°`R RECEIVED AUG 2 12019 615 W. Alder Sheet No 12�1irfc� C�►� 000 Liz-, ►'Yl � r� � 1 q,mu/u- r d v • ` T�°N tiFF RFM 09 of GRT Fqs. 3` 00 aba TtiF UFST URFo ' 2GSCA�,r✓ P o r-f! APPROVED, A SON COUNTY DCp PLANNING SITE PLAN REQUIRED TO BE ON SITE ! ,+ !U r 4gS SUBJECT TO APP OVAL By DateB ZL i'iintod from ivlot>on County DNA,) RECEIVED .. .. ^ . . Floorpian JuNo 3 2019 1 Jib f- leetwood 2 Bath 615 W. Alder Street 2 bed 930 Sqft BUILDING ram- -- - - -- -- --- 66'-0'---- - -- ---- -- -- -- -- >' I Im t - , 4 p ► � +�. �3 �, Qom, a T = t � Q Name %AA^"4 Parcel# 1 23 3t sa.oo O\\_ BLD# �60-8, xiopl Mason County Department of Community Development JUN 03 2019 togarcel Stormwater Management Application/Worksheet ( age 1 of 2 Per ason 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 2. '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. To Calculate"Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area ` All dimensions in feet Buildings to(4I X I L4 t = a1,�-{ 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 X _ above table Patios/Walks H X r = N ( X = Any paved, gravel or packed area per definition above table X = 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) q'1� I f the"Total Impervious Surface Area is LES THAN 2 re 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. Pagel of 2 Namet- v*A2� Parcel#12- 3 C a- l7 DO�\ 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 sso prr MASON COUNTY COMMUNITY SERVICES permit No I/Il/! R�� IT ASSISTANCE CENTER: DING!PLANNING•PUBLIC HEALTH.FIRE MARSHAL 111��J 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)0)427-9670 ext.352•Fax, (360)427-7798 Phone I Belfair.(360)275.4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION J 7U�QYt?'19 PROPERTY OWNERIINFFORMATION: CONTRACTOR INFOR M%p ppbt NAME: A%XA *1141%4 Z NAME: MAILIJiG ADDRESS: V0 a" 13 A MAILING ADDRESS: CITY1364h 1 C STATE. ZlIII CITY: STATE: ZIP: PHONE#1: (pq Q_ 1 PHONE: CELL: PHONE#2: EMAIL: EMAIL: L&1 REG# EXP. PRIMARY CgNTAC OwNE> CONTRACTOR❑ OTHER❑ NAME EMAIL MAILINGADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: _ PARCEL NUMBER(12 Digit Number) '13 3 d 5 2 Inil00kk ZONING LEGAL DESCRIPTION(Abbreviated) _ C. 51✓S �.6+:I 1 Ft E DISTRICT SITE ADDRESS CITY �&C' DIRECTIONS TO SITE ADDRESS 4 00 ► ", t /c4< IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOR o tr'' ' IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chock all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER` USE OF STRUCTURE(Residence,Gamge,Commercial Bldg,Fic.) t� Q IS USE: PRIMARY[ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTU ? YES(Whole BOO)� YES(Pan/5)of81dg) NO❑ DESCRIBE WORK $ UARE FOOTAGE:(pmpme+exisriW ISTFLOORqtq sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED ED`` aHOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED- MAKE TIIOIOa MODEL YEAR\ q 1 ff LENGTH V�O, WIDTHII-I I BEDROOMS 'L BATHS SERIAL NUMBEFn9irrL4CAIL34 ENVIRONMENTAL HEALTH: J SW&2019 SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES4 NO❑ Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. EXISTING BEDROOMS �. PROPOSED BEDROOMS _ TOTAL BEDROOMS_—I, 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 1 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 PE MIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) ignature of T NER(Must bi signed by the OWNER) Date DEPARTMENTAL EVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS, BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH i MASON COUNTY Mason County Permit Center Use: C MMUNITY SERVICES ADV ao19 j' nning,Environmental Health,Community Health Alder St.—Bldg.8,Shelton,Wa 98584 Date RcvdIL 3" one:(360)427-9670 ext.352♦ Fax:(360)427-7798 Q Fee: $130.00 Request for Administrative Variance for RECEIVED Reduction in the Required Setbacks JUN 0 3 2019 For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot lines and 10 feet for front and rear lot lines or any access easement. Request for fv@tWW4'At"r Street requires a standard variance. Setbacks are measured from the furthest projection of the structure, including roof eaves and gutters. Applicant/Owners: ffidnULL A.FM1Qn'dP'2' Mailing Address: �• ► x �7 City:. L State: Zip: 5 Telephone-3tk• I Aq•S`C 7-A Email: If this reduction is tied to a building permit, please give permit case number. BLD 22019 - co Jf Parcel Number(s):1�?�� - J�oZ - �� ZoningT� Site Address:Vr( nE 4,ILDnoC��U ��11L. CJ A C1 A5Z8 Requested setback variance: C _ 15' ft. ❑ Front ❑ Rear L ,Side 5' ft ❑ Front ❑ Rear Side as 2U ft. J�ont ❑ Rear ❑ Side ft `❑ Front ❑ Rear ❑ Side Front Setbacks—From access easements and road right of ways. Minimum 10 feet. Rear Setbacks—From the rear property line. Minimum 10 feet. Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations. An illustrated site plan is required. Your site plan must show the following: north arrow, abutting street or easements, and set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic,well and driveway. Show all proposed new development. E FRONT AND OR REAR YARD REDUCTION REQUESTS: For existing lots of record as of March 5, 2002; „ You must meet one of the following: 1) One of the following exists on the lot (check all that apply): � , ❑ a) steep slopes, wetlands, or streams present; , ❑ b) soils that restrict building or septic development; ❑ c) lot width at the front yard line of no more than 50 feet; ge lot size of no more than one-fourth acre; ) existing improvements of buildings, septic systems, and well areas. SIDE YARD REDUCTION REQUESTS: For existing lots of record as of March 5, 2002; You must meet one of the following: 2) One of the following exists on the lot (check all that apply): ❑ a) steep slopes, wetlands, or streams present; _ ❑ b) soils that restrict building or septic development; ❑ c) lot width at the front yard line of no more than 50 feet; ❑ d) lot size of no more than one-half acre; ge) existing improvements of buildings, septic systems, and well areas. Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones. . � 11600 Owner/Agent (please indicate) L n"C( 4kLu�2- 2-1 Signature Date Of Use Only Approved by: Date Denied by: Date Reason for denial: