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BLD2021-00125 Addition - BLD Application - 1/26/2021
MASON COUNTY COMMUNITY SERVICES Permit No PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING-PUBLIC HEALTH•FIRE MARSHAL 40 615 W.Alder Street,Shelton,WA 98584 Phone Shellon:(360)427-9670 ext 352•Fax:(360)427-7798 Phone Belfalr.(360)275-4467•Phone Elms:(360)462-5269 BUILDING PERMIT APPLICATION P INFORMATION: CONTRACTOR INFORMATION: 1In�,��� NAME: '� t- �It NAME: Ar`SG;.W0V&(W &"000 A°AACT MAILING ADDRESS: MAILIN AD RESS: 90C) F— o r CITY:SlAeUdA STATE: ZIP_ l�k CITY: _STATE: ZIP: E#1: 4 21 b- 3 PHONE:3b0 Q2� l Sm CELL: 3 q0 r� #2: EMAIL: 1b 3 o L&I REG . i/ /- V V PRI A OWNER❑ CONTRACfORF OTHER[]NAME EMAIL Sew 9 M1.L" MAILING ADDRESS Q- CI STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) `L, 50 `2f! ZONING LEGAL DESCRIPTION(Abbreviated) Yoiy4eLo FIRE DIST CT s SITE ADDRESS LYJ r CITY f)J0ol'l. DIRECTIONS TO ITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO R SNOW LOAD: tepsf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION ff ALTERATION t ❑t REPAIR[]r OTHER ❑ USE OF STRUCTURE(Residence.Garage,Commercial Bldg Etc) Y�[ F1�AC G?) , 1 ltldl .�tIaI( IS USE: PRIMARY;4 SEASONAL❑ NUMBER OF BEDROOMS Z NUMBER OF BATHROOMS_ HEATED STRUCTURE? YES(Whotewg)p YES(Part(s]ofatdg)❑ NO❑ DESCRIBE WORK Z e f SQUARE FOOTAGE:(proposed) 1ST FLOOR_35(0 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 HOME INFORMATION: "4 COPIES OF THE FLOOR PLAN REQUIRED' MA MODEL YEAR LENGTH 01'IDTH BEDROOMS BATHS ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER IF? / NEW❑ EXISTING PLUMBING 1N S'I RUCTURE't YES W NO❑ Ifyes,attach completed Water AdequacyPorm PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ,FT. EXISTING BEDROOMS 2 PROPOSED BEDROOMS TOTAL BEDROOMS 2 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 8 void if work or authorized construction is not oommenced'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 PPLICATION OF 1806AYSbOF MORE WILL CAUSE THE APPLICATION TO BE XPIRED.(MASON 1._ COUNTY CODE 14.08.42) c5U b M LJ4-� 1-21p-2a?�x C'° Q 01 -2-2. 2,©2 Signature of OWNERDate DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT —/ — PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: - 0I;1 PERMIT ASSISTANCE CENTER: RECEIVEY .BUILDING •PLANNING •FIRE MARSHAL 615 W. Alder St-Shelton, WA 98584 JAN 26 2021 www.co.mason.wa.us . Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 + `� 'Al. Adder Street Phone Belfair. (360)275-4467• Phone Elma: (360)482-5269 P I ftl%HANICAL PERMIT APPLICATION OWNER INFORMATT CONTRACTOR INFORMATION: NAME: o -f S .p./ NAME: yam!^o ��n(I16rb C'�n cJ-r_j MAILINQ ADDRESS: MAILI G DDRESS: 3r)() CITY: S STATE:Wt7 IP: CITY: STATE: 14le ZIP:�j I'PHONE: 2 p (�3 �- PHONE: I&W CELL. d 2'PHONE: EMAIL : �YUvixAl2sJCCjI��ACT�lUGC4�1f��L EMAIL: L&I REG#6,V:NjyAC1-833 5r EXP._4_/A/Z PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): 2 / D 060 3 Zoning. LEGAL DESCRIPTION(Abbrevi ted): r o SITE ADDRESS: !-7- CITY: DIRECTIONS TO SITE ADDRESS: TYPE OF JOB: NEW ADD 0 ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS— 1ST FLOOR 21`DFLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Tyne of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless, Toilets —_� Tyne of Unit No.of Units - Fees Bathroom Sink I Furnace X�' 1 Bath Tubs � Heat Pump v9r_--,Y� �'f" Showers Spot Vent Fan Water Heater TIRt1Y1_�_`t/ Propane Tank Clothes Washer _ Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood _ Hose bibs Dryer Vent Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER acknowledge 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 OFTHIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. 5Ubrnd+Xc 1 I— 2 g , o,)L—1 X ► �, DI - 202-� Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT J I?- 41(2- PLANNING DEPARTMENT FIRE MARSHAL Rev: 1/27/2016 JBN Name l l[.1 Parcel# 12,1 1-5- 50" 00003 BLD# 2621 Oo l a 5 Mason County Department of Community Developmeltl i 1 n p i� i n Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required wheri<e d"tb{tilding application is made for residential development, or redevelopment',with more than 2,000 square feet of impervious surfaceZ. JAN 26 2i J '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 replacef3TSofunpAru"W s_UYf, ee t4at 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 X 2 X = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example. eaves/gutters) 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) 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 LS 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 pr perry or review and inspection as may be required. X Owner/Age ontract)(circle one)Date: 2-0 T! 1 1 If 4sotal Impervious Surface Area is GREATER THAN 2000 Square Feet, please read, acknowledge and sign the information provided on page 2 of 2. Parse 1 of 2 Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormv,ater 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: httn//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 i .�r/•.� ��C •�J.S,� l i �j �Lz� / j �JYI�Cjniti� -------- ---- .. . �� _ �a� I -�r1; ` •_`"�., � `� 5 �� �,\`r't�, I _ .. f( ,�✓ �la r ti i L� ' \`�e`� ,�o ` r No Te Df\/`�`� 1 t Z 8X S P G� Gf YC�G�1 t' w�'`� r—T-1�---- H� t^ ,, �{ � Q �i � I � 3 �x p�s� A5,5 �'� _._'I ' . ----- � • - .� �--- �, —�/ � \5 I'vt Ct m evl l 1 to - LJYItJP�I`� A 'd / a lam- T� y 15 \ ECEIVED z � JAN 26 2R"1 O . 0 J 615 W. Alder Street ft; 2 �fQ "� u, Ho u-s F a = ; `90 i v P UNNING of r Ilk 3a i A--12 dc 'rRDNT1 s-' - �C ._ O Qi Q,i y, v IRV ING. 1 fib. i �S` S ARE MEASUREC y L E►r �, `�:� �. i • ate. �`� .� x vse� � �� 2 J ( Rom THE FURTHEST \q.\ PROJECT ION OF THE BUILDIN" 3 r 0' �, I Fi K O t COW- amm L) N on ry-1 u V -- �12Lp0° W i STO 2 GE '- SPED / APPROVED $.�� �'�:` MASON COUNTY DCU PLANNING 5(461 3, ` � � SITE PLAN REO`JI.;ED TO BE ON SITE DiY � .vY - -�___ / i CHANGES SUBJcCT TO APPROVAL Date .�-