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Home My WebLink AboutBLD2020-01575 Addition, Repair - BLD Application - 12/28/2020 soy tea' : MASON COUNTY COMMUNITY SERVICES PERMIT ASSISTANCE CENTER: Permit No •BUILDING •PLANNING•PUBLIC HEALTH•FIRE MARSHAL y 615 W.Alder Street,Shelton,WA 98584 RECEIVED Phone Shelton:(360 427-9670 ext.352•Fax:(360)427-7798 Phone jjaj4'a5-4467•Phone Elma:(360)482-5269 DEC 2 8 2020 ' BUILDING PERMIT APPLICATI PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: Malk j� er Grl`st/'uChOn &C MAILING ADDRESSJO D)( '12.2,Cj MAILING ADDRESS: pp Ann 7 9 CITY: it STATE: VjA ZIP: L)997- CITY: Mdrichesfer STATE: u/A ZIP:yg 3 5-3 PHONE#1: (3W) $'St>-FS 5D( (VC m Cell) PHONE:(21&0)56-f-7,?V5 CELL: &q•M�c PHONE#2: CW)$S''p-e's by (Cto(j- S+udtry3 Cell) EMAIL :sSUSC,1 r@ 9Mai 1. Corn EMAIL: ksfii.d er tts 2(MyMm(:( Cam L&I REG#MARK SSC R5 R a pj EXP. 9 //s'/20Z PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAME tMbcr(4 c der'(4r EMAIL �'s�'ud�Ccud�@�Ma 'I-Ca✓�+ MAILING ADDRESS 190 Qdx 22,29 CITY 2elrru4 STATE IyA ZIP 9&yzz PHONE CELL f3W)8 -MI PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 1 aa0 G 13 9 0121 ZONING I -KQ,fl*;� 74/ yca?h i'q LEGAL DESCRIPTION(Abbreviated)TR ILA Ot 2,0WC TQ /-A 0 Sal III TR A at_gR it FIRE DISTRICT 16 2z 4o sv7 /3� SITE ADDRESS I qa 80 �&R 16 CITY DIRECTIONS TO SITE ADDRESS abV R� �v, f{GX�3 fn BpJ �� , oo, 7/jam=&um Aoca 77i LeP- fi7jT ucUJGv DAY fa �LI c Ra�� aid �GiIT�� G¢a,� h�.e ali MR 4„Ire„ AatC-- IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOZ 6.VOWLM 1�0 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 ❑ ALTERATION ❑ REPAIRX OTHER ❑ USE OF STRUCTURE ( sider:ce,Garage,Commercial Bldg,Etc)��,�'/(�e/��, IS USE: PRIMARY SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMSZ. HEATED STRUCTURE? YES (Whole Bldg)I YES (Part(.c]of Bldg) ❑ NO ❑ (Add f H6A/4POi- /-S NOF/lea DESCRIBE WORK 2 I IN' Whim we a& tlm _ { SQUARE FOOTAGE: (propose+ex'ng I ST FLOOR, 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* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC,� SEWER❑ / NEW ❑ EXISTING • PLUMBING IN STRUCTURE? YES ❑ NO ,Z If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NO❑ EXISTING SQ. FT. EXISTING BEDROOMS_� PROPOSED BEDROOMS TOTAL BEDROOMS 3 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 regar •ng this pro'ect. The owner or legal — -- ---- WEST PROP... IY l E — QpZ rn — — mn x t)�► cs' — �, SC 4LE 1.20 — M2-0 m RI � d�1 c� c D 5TREAM .1�.� U - )> - P_C�� CD_ cc N 5 E A 0 -tip o ri1 NOONm C7 (` � O r — — — - - CD 7r ON 4i ;�\-------------------------- �-------- ---- \\ 9'm l� z m -nI.mt�ca " E r t� � � �•.m fl, :: D EXISTIN (� } r 5TRUGTU H7 , _ . m - — <N . e •. �_ ° . Q C L� �' i•, '° r E HIM --------- ,D EAST PROPERTY LINE tom, Namestuus Parcel # �dQM I, Qo I � BLD# Z6W -0 1 Sl Mason County RECEIVED BUILDINGartment of Community DevelopmeiDEC 2 8 2020 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'. '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. '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 Table Surface Type Length X Width = Area *All dimensions in feet Buildings 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 = Patios/Walks X = Oka— 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 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 CouW y are granted access to the above- describ d pr erty for revie d inspection as may be required. tJUrj On`+IZCL I iZ .1.5 Zo&o 7C gent/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 I 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 S 04WATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Sto r inag on Small Lots, The Small Parcel Stormwater Site Plan will be instal led in their entirety AND the system will be located as o adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional de 'gn 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