HomeMy WebLinkAboutFLD2022-00022 BLD2022-00727 - BLD Application - 4/19/2022 (IGO
MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES FLD a -- 6
Building,Planning,Environmental Health,Community HealthO
.
615 W.Alder Street—Bldg,8,Shelton,WA 98584 Date Rcvd ..�
Phone:(360)427-9670 Ext.352♦Fax:(360)427-7798
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FDPO Development Permit Application
Applicant: Contractor:
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Mailing Address: Mailing Address:
Q 1a>o ?0 Box Z-Z,3�
City, State, Zip q G City, State, Zip
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Phone: (qZS) (0�1. ly�t'1 Phone: T3,6;0) 7 1 C7 —L.149 3
Email: b me, �� e--6r, Email: l�t�r►��b`ik de
Parcel Number: U Property Address:
222c)9 — 5C) U W22 W(-x3 QF- K�cs A'hS�oy �
I understand I am making application for a permit to develop in a designated flood hazard area. The
undersigned agrees that all such work shall be done in accordance with the requirements of the County Flood
Damage Prevention Ordinance,building codes and all other applicable Local, State and Federal regulations.
This application does not create liability on the part of the County or any officer or employee thereof for any
flood damage that results from reliance on this application, or any administrative decision made lawfully
thereunder.
Applicants Signature: Date: L4-1 'ZZ
Official Use:
A. Description of Work(complete for all work):
1. Proposed Development Description:
New Residence (section C) ❑ New Manufactured home (section C)
❑ Commercial (see section E) ❑ Fill/grade
Addition/Remodel/Repair to an existing structure (see section D)
2. The parcel has been identified in the following Flood Hazard Area:
❑ A XAE ❑ AO ❑ VE.. .
3. Are any other Federal, State, or local permits required? Must attach copies of permits.
❑ Yes El No If yes, list type:
4. Is the proposed development in an identified floodway?
❑Yes No
5. If yes to#4, a No Rise Certification must be attached.
❑ Yes ❑ No
B. Complete for Historic Structure.
1. Provide documentation of historic registry from Federal or State.
2. Provide a detailed letter requesting a variance.
Letter must include parcel number, address of site, scope of work and mitigation items regarding
wetproofing or floodproofing that are available.
No work can affect or result in increase flood heights or additional threats to public safety.
All mechanical and plumbing must be flood or wetproofed.
No variances will be granted in a Floodway.
C. Complete for New Structures and Building Sites:
1. A FEMA Elevation Certificate is required, must be completed by a Washington State licensed Surveyor.
Elevation Certificate must be attached.
2. Base Flood Elevation at the building site: /S feet NAVD 88
3. Required lowest floor elevation (including basement floor): feet NAVD88
4. In flood hazard areas without a base flood elevation (BFE), what is the highest adjacent.
Grade? (HAG)
Structure must be a minimum of two (2) feet above the HAG.
The required finish floor height is
D. Complete for Alterations, Additions, or Improvements to Existing Structures:
1. What is the estimated market value of the existing structure? $_ 505
Attached:
Assessor's Parcel Detail Report OR
Appraisal from a Washington State Licensed Appraiser Cy
2. What is the cost/valuation of the proposed construction? $ �� . �p� Percentage 15.45/d
Attached:
Contractors Bid (FEMA Criteria) OR
County Valuation per Mason County Ordinance
3. If the cost or valuation of the proposed construction equals or exceeds 50 percent of the market value
of the structure, then the substantial improvement/repair provisions shall apply.
Is the proposed work a substantial repair/improvement ❑ Yes�o, No S-Q_t.
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If yes, complete section C above. 1""' rn' '- G°"'`)4+1
016
E. Complete for Non-Residential Floodproofed Construction:
1. Type of floodproofing method:
2. The required floodproofing elevation is: feet NAVD88
3. F000dproofing certification by a registered engineer is attached:
11 Yes ❑ No
F. Complete for Subdivisions and Planned Unit Developments:
1. Will the subdivision or other development contain 50 lots or 5 acres?
❑ Yes ❑ No
2. If yes, does the plat or proposal clearly identify base flood elevations?
❑ Yes ❑ No
3. Are the 100 Year Floodplain and Floodway delineated on the site plan?
❑ Yes ❑ No
Administrative
1. Approved: X Denied:
Planning Staff Signature Date:64-27'.�a
Building Staff Signature: Date: ?- S'Z
3. As-built lowest floor elevation: feet NAVD88
Comments/Conditions: L � vZ,mlk CI)n_r ,�+fy) CA M mGS�lY� �LT� .
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Mason County Flood Damage Prevention rdin;a i95e 41-17 & International Building Codes