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Home My WebLink AboutBLD2021-00614 Final Pole Bldg - BLD Permit / Conditions - 6/3/2022 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 BLD2021-00614 GARAGE/ STORAGE PROJECT DESCRIPTION: DETACHED POLE BLDG ISSUED: 06/11/2021 SITE ADDRESS: 7855 E GRAPEVIEW LOOP RD ALLYN EXPIRES: 12/08/2021 PARCEL: 122295001005 APPLICANT: MATHISON RICHARD & NICOLE OWNER: MATHISON RICHARD&NICOLE PO BOX 1047 PO BOX 1047 ALLYN,WA98524 ALLYN,WA98524 1.360.801.3136 VALUATIONS: FEES: Paid Due U VB Utility, miscellaneous 1200.00 $58,548.00 State Fee-Residential $6.50 $0.00 Plan Check Fee $500.32 $0.00 Building Permit Fee $769.72 $0.00 Technology Surcharge $25.40 $0.00 Planning Review Fee $240.00 $0.00 Change in Tenant- Minor EH $120.00 $0.00 Plan Review Total: $58,548.00 Totals : $1,661.94 $0.00 REQUIRED INSPECTIONS Setback Inspection Framing Inspection Footing Inspection BLD-Final Inspection CONDITIONS * 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. Printed by:Kate Campbell on:06/11/2021 09:54 AM Page 1 of 5 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 GARAGE/ STORAGE BLD2021-00614 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. * 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. * 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. * 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. * 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. * 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent 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 IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. * 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. * All property lines shall be clearly identified at the time of foundation inspection. * Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). * 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. Printed by:Kate Campbell on:06/11/2021 09:54 AM Page 2 of 5 Mason County Mason County - Division of Community Development �'t`--"''R'�■ 615 W.Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us GARAGE/ STORAGE BLD2021-00614 * 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. * Concrete encased grounding electrodes must be installed and used at each new building or structure that is built upon a permanent concrete foundation. In Mason County the electrical code is regulated by Washington State Department of Labor & Industries (L&I). For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415- 4000. * 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. * 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. * The foundation/footing must be placed on undisturbed, firm-native soil. * The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. * 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 Plan" to ensure these structures are shown and meet the setback conditions listed. * WIND LOADS - Roof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic wind speed for Mason County is 85 MPH. * 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. * 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:Kate Campbell on:06/11/2021 09:54 AM Page 3 of 5 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 GARAGE/ STORAGE BLD2021-00614 " Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. * 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 connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. * 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. * 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. * REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer's installation instructions. A drip edge shall be provided at eaves and gables of shingle roofs. * 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. * Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. * All setbacks are measured from the furthest projection of the building. * Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained * Applicant/Owner assumes all responsibility if On-site Sewage Components are encumbered. A.) Drainfield/Reserve requires a 1Oft setback from all footing/foundations. B.) Septic tank(s) requires 5ft setback from all footing/foundations. C.) No foundation/Perimeter Drains within 30ft, down gradient of Drainfield/Reserve area. D.) No Cut Bank(s) (greater than 5ft and over 45 degrees)within 50ft, down gradient of Drainfield/Reserve area. * This structure is approved as unheated space. To be considered unheated space the area may be provided with a heating system that does not exceed maxium output of 1 watt per square foot., or 3.4 Btu/h per square foot. A permit and approval is required prior to installation of any heating system. When a heating system exceeds 1 watt per sq.ft(or 3.4 btu/h per sq. ft)the heated space shall be insulated in accordance with the energy code in effect at the time of permit application. 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 governi this type of work will be complied with whether specified herein or not. The granting of a per t does not presume to give authority to violate or cancel the provisions of any er state/local 1pyv rg6ulating construction or the performance of construction. Issued By. Contractor or Authorized Agent: Date: Printed by:Kate Campbell on:06/11/2021 09:54 AM Page 4 of 5 Mason County Mason County - Division of Community Development °Er , 615 W.Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us GARAGE/ STORAGE BLD2021-00614 Printed by:Kate Campbell on:06/11/2021 09:54 AM Page 5 of 5 �LaZ�2l—C (q 7�55€6,fA .✓Jtw GP R®Q f'�fGcJs�N-- Gzs Ruling ins iztario Dale P—Y Irawim-uatD BY i�I rates BY friar-Da's BY Ste: Point Load f Lga--d Fotdnm I ll 'nG.N D-� II BS 1,81-AS INSMA310N BY FIRE DEtRA.�EE�FT brat neY 1`aI's Dae By :DFCKS PRAWN %Wit Date BY Dat-- D�a PROPANE TANKS -- saTdia�saa� C ( OTHER DRIS BY - gy P'Pit aw gY DRYWALL s int Bra WailID F tJ Bg l � Dai= uy m Line Fire S;peratm m By i By I3a:s By m _ Pass or Requ � frispact P. Fat( ri €ate Dom By At. l - CD SA A ID IS,A b J $-�g zc � Dec-- 2ece;vj arc. favh�' PASS O-IS-2( Guvi no ,-,ally will6 3 4P a cl.ecked 61 -Cin41, Owner P(dason yMcirs & Nas ;rrf-ywii p for whseov4s ', _ ar a oa rani ht not be �� late For po �Y►stil a sS z 37� I Gtu/ss or►d Aa�mAs Pa.w..✓ k n 7 fjI 3 ti 615 W.Alder St.Bldg 8,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 352 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 352 Building,Planning.Environmvntal He Ith,Community Fiealth ELMA:360-482-5269,EXT 352 www.co.mason.wa.us INSPECTION CARD AND CERTIFICATE OF OCCUPANCY" To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bid-inspection.php Permit Number BLD2021-00614 Date Issued 0611112021 Issued Project DETACHED POLE BLDG Site Address 7855 E GRAPEVIEW LOOP RD Applicant MATHISON RICHARD$NICOLE Contractor Contractor Phone 2015 IBC,IRC,IFC,IEC,IMC,& Primary Code UPC Type Permit Type GARAGE/STORAGE Occupancy -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 (`t-2 Footing Perimeter g,(01,Z( DAL 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 Setup Home Concrete Foot/Runners Final Other -�o�f� I5IA 4 -�k�► 8-I6'Z 1 GcM . See ,4�� i • MASON COUNTY 360-427-9670 Shelton ext.352 360-275-4467 Belfair ext.352 COMMUNITY SERVICES 360-482-5269 Elma ext. 352 Building,Planning,Environmental Health,Community Health 615 W.Alder St. Bldg.8 - Shelton,WA 98584 www.co.mason.wa.us CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: FL02-02- I — oo6/y ADDRESS/LOCATION: 7855 F 6rap-e y iew Loop 2 d FIND NGS: 0--pti-I y at, .53 -'Ur Ae re e n� tnjr- ol m -c f& k e 'de w a l l . Tint en wa 1 lS a 6,0 n-, 24 {a; I y C4 I -( 4r . 1tq rt6cL(l I . G L A c retLj( 0 k An k i I I e r m o-s o nC_o oyAy WA.n OV l '/ Items listed above must be corrected to gain compliance. ❑ THIS IS NOT A COMPLETE INSPECTION ❑ This structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. ❑ Call for re-inspection when corrections are made before proceeding with any further work. ❑ Make corrections, items will be checked on the next inspection. ,X( OK to Senn koJ2� Date: g - 1 6- 21 ❑ Please contact our office regarding possible Department: 113W structural damage incurred by recent Inspector: (�r;S4;arn �(l i "natural/man made"disasters.This is NOT a CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 MASON COUNTY COMMUNITY SERVICES �Q nA /�fi PERMIT ASSISTANCE CENTER: Permit No: M 62-1 - cw 14 •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED 615 W.Alder Street,Shelton,WA 98584 Ro elton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone Ifafr.•(360)275-4467•Phone Elma:(360)4825269 APR 2 7 2021 BUILDING PERMIT APPLICATION PROPERTY OWNER EWORMAT`ION: CONTRACTOR INFORMATION: U81I 5 VV. Alder Street NAME: R�CNAQD Ir1R�l�ISOa NAME: NIA MAILINQ ADDRESS: TO %ok 1 4 MAILING ADD SS: CITY: 14 U M r-% STATE: ZIP:Cillb5t1i CITY: STATE: ZIP: PHONE#1: (31n 0%-3i3(a PHONE: CELL: PHONE#2: f p qZl- 51-13 EMAIL: EMAIL: MA—rN\5t4k f IIoTM+iiL. Ctr*l L&I REG# EXP. PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER NAME C M� %"4 EMAIL MR-CTAISaM Q gOTtt►IkIL.CcM MAILINGAD RESS PO CITY Ft It WN, STATE��_ ZIP59 a PHONE 3(90 2 - CELL 3 0 PARCEL INFORMATION: PARCEL NUMBER(I2 Digit Number) ZONING PP- LEGAL DESCRIPTION(Abbreviated)PIa a�L4\1 'J 5i IlayIQ i n�¢e�(fJ FIRE DISTRICT 2 SITE ADDRESS IM IE 4 1'6Stw Leer Q CITY D IONS TO SIT DRESS -vrn 3 .-4* a71 Q f go IV G IS THE PROJECT WITHIN 300 FT OF SLOPE(S) ATER THAN 14%: YES❑ NOW. IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all thatappty): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEWOQ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,CommerclalB/dg,Etc) 60kr IS USE: PRIMAR)X SEASONAL❑ NUMBER OF BEDROOMS A NUMBER OF BATHROOMS 0 HEATED STRUCTURE? YES(VAoleBW❑ YES(Partfsl�� ofBidg)❑ NOrK n DESCRIBE WORK EIO�r.3Ot aoJ-+iu�e W. Gc�tJ�'t l� t'�Oal SOUARE FOOTAGE:(propose+existing) 1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.fL COVERED DECK sq.ft. STORAGE sq.& OTHER sq.ft. GARAGE %t08 sq.ft. Attached❑ DetachedK CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: alk *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC g SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES❑ NO%Q Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO)( EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate Information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of Interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON X COUNTY CODE 14.08.42) Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT 'Or-(- • Z PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Name Z%LhOA Parcel# 12-2-Ly O 1 M5 BLD# XDF � OVI%WA Mason County APR 2 7 2021 Department of Community Development \Parcel li n rk a qew Stormwater Management App catto /Wo s �e� 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 surfacez. '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 EJ X 30 X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways X X = Length of drive begins at the right of way X = Parking Areas X X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = 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) 15 � 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 acknowled a that the information provided is accurate and employees of Mason County are granted access to the above- descri ed property review and inspection as may be required. X wne 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 Name Qx Or) � 1 Parcel# Z�-�-� ' �d ®I dd5 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: hgp//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) 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 lc�Z621 -OOLp 1`-4 -__- . _Q 61 Ider tr et PLANNIN —SdTBAC'KS ARE'..Lt O I THE FURTHE$ I--- F IsflJECTIOI 0 T E: U� DI C f ' 8� �`— I I { -- - i i - - -f----T 1 , t r iI - . T , t �tow I' t� TOPOGRAPHY PROFILE: 3 ✓' FL 0 SITE PLAN REQUIRED TO be N S 75" CMA, SSE SUld JET TQ AppRC1NA ,v - '616I n^Z'_/\/V �I� Direction: Scale: pproval: for office use Building Permit number: T� Ll GU C1�/ {�'! ��40 Building: Owner/Applicant: V.%(*NQA f�1P1`VAM� Date of Planning: application: Env. Health: Parcel Number: 122.Z°1 -5-a - 0100� do