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Home My WebLink AboutBLD2018-00402 Park Model Mobile Home - BLD Application - 4/23/2018 °din , MASON COUNTY COMMUNITY SERVICES Permit No: B0 2�D I t c o lloz PERMITA5515TANCE CENTER: Recv'd.• •BUIL DING•PLANNING•FIRE MARSHAL 615 W. Alder St- Shelton, WA 98584 _ s Phone:360-427-9670 ext. 352 Fax:360-427-7798 C^ 1854 http://www.co.mason.wa.us/communit dev/ BUILDING PERMIT APPLICATION APR ?3 2018 PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: erS NAME: TM 12-1 E NAME: t MAILING ADDRESS: F.p. ScK ZSZ. MAILING ADDRESS: CITY: 411Vep STATE: } ZIP: JWz4 CITY: STATE: ZIP: PHONE#1: ' 731 -ZI Z5 PHONE: CELL: PHONE#2: EMAIL : EMAIL: o r o L&I REG# EXP. CONTACT PERSON : OWNER PV CONTRACTOR ❑ OTHERMELOW ❑ NAME: 15A*67 MAILING ADDRESS: 54M 45' CITY: STATE: ZIP: PHONE: CELL: S 4e77 6- EMAIL: 4AC'4y c)ec5on o3 0-, qm&( .GOy►. PARCEL INFORMATION: BUIL INGPARCEL NUMBER 12 DIGIT NUMBER � O 000`, 0NINP LEGAL DESCRIPTION(ABBREVIATED) '1't12RLT -) of S�uj[ , tS FIRE DISTRICT SITE ADDRESS 1 ZO C sTezTy4 16tA4-_p A). CITY C QAPeV teL-_) DIRECTIONS TO SITE ADDRESS -ch bgW 1712 r,7VZT+c.N IS L t^-n U Imo_ IS PROPERTY WITHIN 200 FT: (Check all that apply): SALTWATER ❑ LAKE❑ RIVER/CREEK ❑ POND ❑ WETLAND [SEASONAL RUNOFF❑ STREAM ❑ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14% YES❑ NO TYPE OF WORK: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) IS USE: PRIMARY Fr SEASONAL E- NUMBER OF BEDROOMS 1 NUMBER OF BATHROOMS- HEATED STRUCTURE? YES(Whole Bldg) R YES(Part[s]of Bldg) ❑ NO❑ DESCRIBE WORK I I X '3 S IL dYl O D Z SQUARE FOOTAGE:*tMCV- 15 pax. 'Va`'B, NO P4j2 I6 K_ 1ST FLOOR gS sq.ft. 2ND FLOOR -- sq.ft. 3RD FLOOR sq.ft. BASEMENT_ — sq.ft. DECK 4 COVERED DECK sq.ft. STORAGE sq.ft. OTHER — sq.ft. GARAGE — sq.ft. ATTACHED ❑ DETACHED ❑ CARPORT — sq.ft. ATTACHED ❑ DETACHED ❑ MANUFACTURED HOME INFORMATION: •4 COPIES OF THE FLOOR PLAN REOUIRED MAKE 4 �� MODEL FOR4e5 r B eoo K YEAR ZOO q LENGTH_-3 WIDTH BEDROOMS I BATHS I SERIAL NUMBER 1 W 9 1 — 01(0S' L 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 or owner's legal representative. 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 IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT ;APPLIC I ATI L USE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) Signature of 6W ER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT -C>&e_ �•K• PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS Intake By: Approved&Ready for Pick-Up: I Name f'1►'I/OIX s&L Parcel# 1o8-75-o oo-7a BLD# Z01h ^0v IGZ BUILDING Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) /P Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application iA F�V made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface's `C kk �I8'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development -1� O including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not as part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. @f -'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete•This Tattle Surface Type Length X Width = Area *All dimensions in feet Buildings 35' X 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 above table X = PatiosMalks 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) 3 8)S� 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- describ 7e,for review and inspection as may be required. 7 X Owner/Agent/Contractor(circle one)Date: If the Total Imper-vi urface 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 Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet ($age 2 6!r2y 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/commissi oners/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 450 100 W.Public Works Dr 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 400 415 N. 6th St— Bldg#8 lower level Shelton. VVA 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/Contraetor(circle one)Date: Page 2 of 2 r r t f ' Fq ' cx� 0rmc o10s0+—F c'`f5�'PLC NING ��A mat!?!s LQ ACC F.., �; Jj 13 I � f JY !r PLANING: 1.0 D r� �, ` APPROVE', Hall SETBACKS,ARE MEASURE ,, -- �4s W ter'} _ • FROM THE FURTHEST '� � MASON COUNTY DCD ANNLNG 4' i OF THE BUILDING r SITE PLAN REQUIRED TO ON SITE PROJECTION , CHANGESSUBJECTTO 'R // By ' , Date G Ole APR 2 3 2013 2 w iw WA 93S4G . AA) 615 W.Alder Street � f � > > PLANNING` 3- , ,3 3iax 4"'so _ ._ __. _ _ - b 3 Z x 3 S,y �w is E a CLOSET / L ---- FWF LINE _•_--___- rt__ 405 4RECEIVED r APR 2 3 2018 615 W.Alder Street I I NVIRONMENTAL HEALTH ,,,,yw` P4.0 ci frk p p 0 VE f a 1 JUN 2 7 2018 "SON CC;. . -' ;'IRONMENT j I AL HEALTH i APR 2 3 �r i .�j rzang &on70 W Alder Street