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Home My WebLink AboutCOM2023-00105 Relocate Storage Connex - COM Application - 12/7/2023 MASON COUNTY COMMUNITY SERVICES PermitNoL 4)m Zb2) -6blv�j PERMIT ASSISTANCE CENTER: { '. •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 815 W.Alder Street,Shelton,WA 98584 Phone Shelton (360)427-9670 ext.352•Fax (360)427-7798 Phone Belfair(360)275-4467•Phone Elma:(360)482-5269 -� BUILDING PERMIT APPLICATION PROPERTY OWNER INNFORMATION-. CONTRACTOR INFORMATION: NAME:_GO�� r�O Qeif he S NAME: O MAILING ADDRESS: Z 3 2 C�1q ING ADDRESS: CITY: S 1 A I n. ITY: ATE: ZIP: PHONL r.i: 2541510 � PHONE: CELL: PHONE# : 25 HI 3 b EMAIL: t Cyt Tq& Q WI2l • CO rtn EMAIL: eMe/4 I Or- -cow iAi REa# PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAME e D EMAIL "j'�C(a-h in (,86 e 9 m4a chi MAILING ADDRESS CITY STATE ZIP PHONE L4 25 9 Lt 1 3 ia6 1WCELL PARCEL INFORMATION: /� �( PARCEL NUMBER(12 Digit Numb.) 1-1s ✓� 1'u I JG 3 Pr 0 O� ZONING LEGAL DESCRIPTION(Abbreviated) FIRE�D,ISSTRICT SITE ADDRESS ► 9-1 W 119DfA$u CAL W LA/ CITY S ILA DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NO IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cheetah dmt apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND[] WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Roddmm CxwW Casrrclal B14 fig) IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YEs Fygl YES(Pa.t(i)ajBh(y❑ NO❑ 1,j1��'1LiX D CR1BE WORK L/Lt/Y1 L TAG :(p.upare+avxefgl 1ST FLOOR %kQD sq. L 2ND FLOOR sq.R 3RD FLOOR sq.ft. BASEMENT sq.ft. 1 DECK sq.ft. COVERED DECK 9q.ft. STORAGE sq.ft. OTHER sq.It. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXIST NG❑ PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. v EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.AdmoMedgement 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 permitlapplication becomes null 8 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 �— ERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X 13-I -202fj Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDMONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH ZO (Aj Aw If*)t w-W se v v 0 —A ' �., _fir �1.�+ - 1 t� __ 1 IL LA Vk' VT F- "Air -t�5S -AL'I A V, LA C �AJACI 'A Ir r) XV Nam Parcel#4Z ,w w i(.) P � Mason County Department of Community Development 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 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 X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) 4zz:) 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 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. L 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. 1 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. Page 1 of 2 Name Parcel# 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) 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 fmal 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 MASON COUNTY COMMUNITY SERVICES Prrinit- LI 2� -Db1U12 " a PERMIT ASSISTANCE CENTER: `L U rz I V _ 4 ;•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 815 W.Alder Street,Shelton,WA 98584 _ Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone DEC 0 7 2023 Belfair.(360)275-4467•Phone Elms:(360)482-5269 BUILDING PERMIT APPLICATIOkr) W. Alder Street PROPERTY OWNER I FORMATION: CONTRACTOR INFORMATION: NAME: 0 ef i (o NAME: 0 MAILING ADDRESS� 3 2 i�j` i LyUa ING ADDRESS: CTfY:-'��r� S Air,.�- P t TTY: TA TE: ZIP: PHONL rt: 2S j t 251 � PHONE: CELL: PHONE#2: H 2S C1Lq1 3 w EMAIL: e r q (p 9 mQ i CO r,1 ttt� EMAIL: Q.InCL erY e ( Lie -CUM L&I REG# 'EXP. PRIMARY CONTACT: OWNER&--CONTRACTOR❑ OTHER❑ NAME TeA L)Q EMAIL c CtQ.h t" I B6 a ck MAILING ADDRESS �' nn-a- CITY STATE ZIP PHONE q 2-5 9 4( 3 o64 CELL PARCEL INFORMATION: 3;/j � 1O d PARCEL NUMBER(12 Digit Number) F""',� ��-1 � 0' ZONING LEGAL DESCRIPTION(Abbreviated) FIRE LD,ISTRIICT" SITEADDRESS �9) UJ 'H�r1EcISt{f�(LIe LA/ CITY She-1 Iu DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (ChenEan&x apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Reside ,Garage,Cmmnemial Bldg,Etc-) IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES Ie Bldg)❑l YES(Parr[,]of Bldg)❑ NO❑az n rV—X D CRIBE WOELK�t= A&L- A t t 11Ct' " ' ) ula G" 8� I kd6AMOTAG t ECG tL . u fi(1V� (Propare+ezirring) 1ST FLOOR %kaQ sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.fL STORAGE sq.& OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENWRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES❑ NO❑ Ifyes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT. v\\l EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Adcnowledgement of such is by A 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.1 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 permitlapplication becomes null&void if work or authorized construction is not commenced within 180 /1 days or if construction work is suspended for a period of 180 days. V PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS ,-- ERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) x !o�-F -2-L,L� Signature of OWNER(Must be signed by the OWNER) Date c DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE . TAGS/NOTES/CONDTTIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH