HomeMy WebLinkAboutBLD2016-00850 BLD93-01588 Addition - BLD Permit / Conditions - 9/30/2016 Inspecuon Line tseu/4t/-iznz
�ID9oN �o���p MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
'N'° RESIDENTIAL BUILDING PERMIT BLD2016-00850
OWNER: MICHAEL& SONJA FOURNIER RECEIVED: 8/26/2016
CONTRACTOR: LICENSE: EXP: ISSUED: 9/30/2016
SITE ADDRESS: 120 E BRAZIER LN BELFAIR
EXPIRES: 3/30/2017
PARCEL NUMBER: Q ,;
LEGAL DESCRIPTION: TR 6-A OF SURV 12/129 TR 1 OF SP#1894 R
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
CASE CREATED IN PLACE OF BLD93-01588.. PERMIT HAS BEEN NEXT TO NORTH MASON HIGH SCHOOLALTA DRIVE, TURN RIGHTAT
REINSTATED, WAS UNABLE TO ADD ALL FEE'S NEED TO THE 1993 RAILROAD TRESEL. GO UP ALTA DRIVE MAKE 90 DEGREE CURVE LEFT.
CASE, ATF STORAGE ADD ON. FIRST RIGHT TURN, AT END OF ROAD ON LEFT.
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U Lot Size: Deck:
Type of Work: ACC Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building: Garage-Detached 480
Valuation: $ 21,422.40 Building Height: 20 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: S Ft. Shoreline: Ft. Water Body:
Rear: N 20.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: E Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: W 20.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Building Permit Fee JBN 8/26/2016 $ 146.00 S2 2 0 1 6 00000001
Plan Check Fee JBN 8/26/2016 $227.01 S2201600000001
Planning Review Fee JBN 8/26/2016 $205.00 S2201600000001
EH Minor Plan Review JBN 8/26/2016 $ 100.00 S2201600000001
Building Permit Fee AMP 8/31/2016 $ 349.25 S2201600000001
Building State Fee AMP 8/31/2016 $4.50 S2201600000001
Total $ 1,031.76
BLD2016-00850 Please refer to the following pages for conditions of this permit. Page 1 of 4
CASE NOTES FOR
BLD2016-00850
CONDITIONS FOR
BLD2016-00850
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
X 800-64Z-9982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Department prior to any further inspections being performed or approvals granted.
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3) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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4) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of approved documents will result in failure of required building inspections.
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5) This structure is approved as unheated space.
To be considered unheated space the area may be provided with a heating system that does not exceed energy usage of 1 watt per sq. ft., or 3.4 Btu/h
per sq. ft. A permit and approval shall be required prior to installation of any heating system.
When a heating system exceeds 1 watt per sq. ft(or 3.4 btu/h per sq. ft)the heated space shall be insulated in accordance with the energy code in effect
at the time of permit application.
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6) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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BLD2016-00850 Please refer to the following pages for conditions of this permit. Page 2 of 4
•7) The "approved" site plan is required to be on-site for inspection purposes. It an inspection is requested and the "approved" site plan is not on site, then
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Department prior to any further inspections being performed or approvals granted.
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8) A separate inspection in addition to the inspections required in the IBC, Section 110 shall be required in accordance with the 2015 IBC, Section 1705.12.2
and Section 1707.1. The additional inspection is required when shear wall fastener spacing is required to be 4 inches or less. The shear wall schedule
shown on sheet 5 designate wall(s)type PORTAL with fastener spacing 4 inches or less.
The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified to inspect lateral connections,
the Engineer of record (EOR), or an authorized representative of the (EOR). The special inspectors duties and responsibilities shall be as specified in
Chapter 17. When a third party inspector is used to perform the inspection, special inspection reports shall be submitted to the Mason County Building
Department, 615 W Alder St, Shelton, WA 98584 and also available on site for review by the Building Official. Inspection reports shall be completed and
submitted to the Mason County Building Department in a timely manner and shall be submitted prior to the framing inspection of said project. X
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9) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
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10) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
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11) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation.
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12) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
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13) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
I�pector shall be made prior to requesting additional inspections.
14) All property lines shall be clearly identified at the time of foundation inspection. X I'V? _
BLD2016-00850 Please refer to the following pages for conditions of this permit. Page 3 of 4
1 b) All building permits snail nave a final inspection pertormea and approved by the iviason county tiuiiaing uepartment prior to permit expiration. I ne failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason Count ordinances and building regulations.
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16) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prevented action from being taken. No more than one extension may be granted.
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17) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors^and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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18) Landings and stairs must meet the same setback conditions as any permitted structure-, and, must be shown on your site plan. Please check your
"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed.
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19) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOTADVERSLY AFFECTANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD WAY.
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20) Satisfactory maintenance or pumping report prior to temporary/final occupancy.
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OWNER/ BUILDER acknowledges 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 OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature Date
�I LI ��' � J �v�/ c'.� OWNER )- REPRESENTATIVE - CONTRACTOR
Print Name - (Circle one to indicate)
BLD2016-00850 Please refer to the following pages for conditions of this permit. Page 4 of 4
PgoN coU MASON COUNTY (360)427-9670 Shelton ext.352
DEPARTMENT OF COMMUNITY DEVELOPMENT (360) 275-4467 Belfair ext. 352
W BUILDING•PLANNING•FIRE MARSHAL (360) 482-5269 Elma ext. 352
Inspection Hotline (360)427-7262
i Mason County Bldg. 8, 615 West Alder Street
IN54 Shelton, WA 98584 www.co.mason.wa.us
CORRECTION/INSPECTION REPORT
PERMIT/CASE NUMBER: 541-F Zo(tc Oo ko k
ADDRESS/LOCATION: kzd2 li� *X_ U)4`t
FINDINGS•
v( A,J S � Ut A2 Pbrr
ens, `C.F .
AA Zk fl :xt,,-fS COMPLY Wr-tK —rhj 5 -o`T j c.F.
Items listed above must be corrected to gain compliance.
❑ THIS IS NOT A COMPLETE INSPECTION
This structure has been inspected by Mason County Building Department and the items listed
above are in VIOLATION of Mason County laws and/or ordinances.
❑ Call for re-inspection when corrections are made before proceeding with any further work.
❑ Make corrections, items will be checked on the next inspection.
❑ OK to
Date: Co ''L� `1ko ❑ Please contact our office regarding possible
Department: C:;� structural damage incurred by recent
"natural/man made"disasters.This is NOT a
Inspector: GjL�� CORRECTION NOTICE.
DO NOT REMOVE THIS TAG
MCC14.12
CO��?
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Mason County Bldg. 8, 615 West Alder Street, Shelton, WA 98584
-_— www.co.mason.wa.us (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269
1854
Sent Regular and Certified Mail
Notification of Mason County Correction Notice
6/27/2016
FOURNIER, MICHAEL & SONJA
P.O. BOX 2933
BELFAIR, WA
98528
Notice
The receipt of this notice shall constitute service regarding notification of violations of the Mason
County Code, and shall also serve as Warning Notice pursuant to Mason County Code, Title 15,
Section 15.13.035. The violation(s) are occurring at the following property.-
Enforcement Case: ENF2016-00101
Parcel Number: 12205-78-90061
Site Address: 120 E BRAZIER LANE BELFAIR, WA 98528
Legal Description: TR 6-A OF SURV 12/129 TR 1 OF SP#1894 R
There is an expired building permit on the building in question. An addition to said
building has also occurred without permit.
THE ABOVE BUILDING IS IN VIOLATION OF THE 2012 INTERNATIONAL RESIDENTIAL
CODE R105.1 REQUIRED. ANY OWNER OR AUTHORIZED AGENT WHO INTENDS TO
CONSTRUCT, ENLARGE, ALTER, REPAIR, MOVE, DEMOLISH, OR CHANGE THE
OCCUPANCY OF A BUILDING OR STRUCTURE, OR TO ERECT, INSTALL, ENLARGE,
ALTER, REPAIR, REMOVE, CONVERT, OR REPLACE ANY ELECTRICAL, GAS,
MECHANICAL OR PLUMBING SYSTEM, THE INSTALLATION OF WHICH IS REGULATED
BY THIS CODE, OR TO CAUSE ANY SUCH WORK TO BE DONE, SHALL FIRST MAKE
APPLICATION TO THE BUILDING OFFICIAL AND OBTAIN THE REQUIRED PERMIT.
According to the Mason County Assessor records, parties named above hold legal interest in
the parcel and are therefore subject to enforcement action for failure to comply.
The parties shall respond to the county within twenty-one days of the
postmark of this notice.
Postal
CERTIFIED MAIL,,., RECEIPT
-111 (Domestic Mail Only;No Insurance Coverage Provided)
CID
C3 Postage $ (• 1 V1 985�
m '1 �
Certified Fee v / P�6
rl
Q Return Receipt Fee D ``� re
ED (Endorsement Required)
O Restricted Delivery Fee4& ONJA:FOURNIER
(Endorsement Required)0Total Postage&FeesLIMV11110HIAEL,
oPO BOX 2933
`` BELFAIR WA 98.528
SECTIONSENDER: COMPLETE THIS
■ Complete items 1,2,and 3.Also complete A. e
item 4 if Restricted Delivery is desired. ❑Agent
■ Print your name and address on the reverse ❑Addressee
so that we can return the card to you. eiv NamDitem
C.Date of Delivery
fa Attach this card to the back of the mailplece,or on the front if space permits. r "D. Is ' ry addressdifferentfrom 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below. ❑No
—HAEL & SONJA FOURNIER
PO BOX 2933 3•tr lceType
B E L F A I R WA 98528 q Certified Malls ❑Priority Mail Express'"
❑Registered ❑Return Receipt for Merchandise
❑insured Mail ❑Collect on Delivery
4. Restricted Delivery?(Extra Fee) ❑Yes
Z..Article Number 7008 1300 0001 3607 4086
(transfer from s vlce label) -
PS Form 3811,July 2013 Domestic Return Receipt
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Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION ,�,,
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 o`,p`15�$
SE PRINT
1 Owner f t2 4- De c��!/ M kc.-7 of Phone#aQ� -cam ?L -Q 115
Site Address f in ,_n Al r Fire District#
city St_1JA�L _Zip
Directions to Job Site C
GU Q bil C_ ° u
C) ner4kifling Address BOX 3
city P L st(� Zip Tladjc�y
Lien/Title Holder C
Address N
city 5 ei4h/e-, St Q fL_Zip 7 Fj.��2
#2 Contractor Name Contractor Reg#
Address Expiration Date
city St Zip Phone#
#3 If septic is located on projectsite, include records.
Connect to Septic? N Public Wate14g�pVyvsfem
W II
Connect to Sewer System? Name of
(If residential, proof of potable water is required)
#a Parcel No. f aQ 05 - 7 9 - 2QQto L
Legal Description (_01' / 5 'G1
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms/
Garage / Carport / (Circle: Attached or Detached?)
Other sq. ft. /
#6 Use of building Describe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year__:jM Model
Length id Serial No.
# Bedrooms # a rooms Type of Heat
Purchase Price $
#9 Indicate by circling the applicable e if water is on or adjacent to subject property:
River Pond Creek Stream WLIZ arsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbino Fixtures (S3 eachl Fee Mechanical Fixtures ($6 each)
No. Toilets
3 CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
_Bath Tubs No. Unfta Fees
Showers _ Furn BTU
i Hot Water Htr — Heatpumps
t —
Laundry Washer — Vent Systems
i —� Sinks Spot Vent Fans l0
_Floor Drains IN. Boilers/Compressors
Laundry Basins — HP
i Dishwasher No.. Air Handling Units
x —
Disposal — cfm#
y#
—Urinals Fire Protection Systems
_Other — Auto. Fire Alarm Sys 50•DO
_ Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 — Auto Fire Sprink Sys 25•00
No. Qlbg
TOTAL PLUMBING $ -r
G
— Gas Outlets
— Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- — 15.00
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ 2
OF 180 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. PROOF OF CONTINUATION OF WORK IS BY
MEANS OF A PROGRESS INSPECTION.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND i
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
= MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
OWNER y4gz ��
X BY
DATE / / DATE
i
.. 77
y
E
Date:
FOR OFFICIAL USE ONt_Y.Acc I3 : ""
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
4
t
i
t
Building Plan Review F
t
Occupancy Group: Type of Const:
Fire Marshal: 1
Other:
Special Conditions: FEES
c
Building Permit i
Plan Check .�
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
i
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE
1
330'
T
FRONT
5
TH E PLANS MUST BE
N THE JOB SITE
T(OR INSPECTION.
IL
AapMAL
Rh..
330'
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason County Bldg.III 426 W.Cedar
P.O.Box 186 Shelton,Washington 98584
(360)427-9670
i BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
�Qrt /7l
Re: Permit No. :
i
Dear
As per your recent re est, this fice has noted the above
permit for extension tom 1996. In order to
keepour permit valid ?o must call for inspection prior to this
Y P Y P
date. In the event that you do not call for inspection, the Uniform
Building Code allows for jurisdictions to require the renewal of
j building permits. Depending on the length of time of expiration,
:I there are two methods used. If the permit is expired by less than
one year, renewal may be obtained by paying half of the original
building permit fee at the discretion of the building official and
if the permit is expired by more than one year, the jurisdiction
can require that the permit actually be processed as a new permit
with routing to all required departments.
If you should have any further questions regarding the ,
validity of permits, please contact the Building Department at
(360) 427-9670, Monday-Friday between the hours of 8: 00am and
5:00pm.
Since ly,
ason Coun y uilding Department
CC: Property File
h - _ S
i
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date i r t by ,),I
has Piping date ........... by
FounFtation Walls date by Set Up
date by INSULATION date by
BGk/SLAS Insulation Ei Final
date Floors
d
date by ate by
FRAMING by
Walls FIRE DEPT.
date date by
PLUMBING by 1 date by
Groundwork Attic OTHER
date by
date;i by ., i-'Ii,
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
7'
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7 A
MASON COUNTY
Mason County Bldg, III 426 W. Cedars
P.Q, Box 186 Shelton, Washington 98584
a/yw' o I j x t1
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tag
ASON COUNTY
Mason County Bldg, 111 46 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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8/15/2016
Case Activity Listing 12:08:03PM
Case#: BLD93-01588
P14
Parcel #: 122057890061
Description: GARAGE
Assigned Done
Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By
BLDC250 Permit Extension l l/1/1996 6/l/1997 11/26/1996 None EXTD TLG 11/26/1996 TLG
walls are all up and framed in. Shell is done. Owner getting new mobile so work on garage will be delayed until mobile home is done
BLDA560 Permit cancelled 3/11/1999 None DONE KW 3/15/1999 KW
BLDA900 Telephone Call 7/1/2016 None DONE GMM 7/1/2016 GMM
NEW OWNER WILL APPLY FOR A NEW BLDG PERMIT THIS WILL INCLUDE WHAT WA THIS PERMIT. THE PERMIT FEE'S WILL BE AS FOLLOWS FO
OF STORAGE VALUATION 17852.00 BLDG 190.61,PLANNING 205.00,EH MINOR 100 AND 146.00 FOR FINALqp BLD93.01588..PICKUP 293.25&4.50 FOR A GRAND TOT 6.
BLDA900 Telephone Call 7/1/2016 None DONE GMM 7/1/2016 GMM
NEW OWNER WILL BE IN SOMETIME MID AUGUST TO SUBMIT PERMIT
Arrv�
Page 2 of 2 CaseActivity..rpt
8/15/2016
Case Activity Listing 12:08:03PM
Case #: BLD93-01588
NP4
Parcel#: 122057890061
Description: GARAGE
Assigned Done
Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By
BLDB129 SenttoPlanning 10/5/1993 None 10/5/1993 KW
BLDA010 Application received 10/5/1993 None 10/5/1993 KW
BLDB135 Addressing 10/6/1993 None DONE GMM 10/6/1993 GMM
BLDB130 Planning Review 10/6/1993 10/6/1993 None DONE MMS 10/6/1993 MMS
BLDB110 Structural Plan Review 10/6/1993 10/1/1993 None DONE TLG 10/8/1993 WLC
BLDA100 Approved For Issuance 10/12/1993 None DONE KS 10/12/1993 KS
BLDA500 (F)Issue building permit 10/26/1993 None DONE KS 10/26/1993 KS
BLDC110 Footing inspection 11/15/1993 11/15/1993 11/15/1993 None PASS DH 11/16/1993 CKR
BLDC130 Plumbing inspection 11/15/1993 11/15/1993 11/15/1993 None PASS DH 11/16/1993 CKR
BLDC250 Permit Extension 8/1/1994 2/1/1995 8/1/1994 None EXTD TLG 9/27/1995 TLG
.due to weather and finances,will not be able to get any thing else done.
BLDC250 Permit Extension 9/27/1995 3/27/1996 9/27/1995 None EXTD TLG 9/27/1995 TLG
photos received,framing partially doen
Page 1 of 2 CaseActivity..rpt
Nameh►'7/Cjlt f t -f _! CO�J.01% Parcel# 1 �(7 S-7� -4c�a BLD# ''�✓ /s�
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 surfacez.
'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 d-Z = S—Oa
X = Measurements for buildings are taken at the
perimeter of the farthest projections (example:
X = eaves/gutters)
X =
Ddvewa s 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)- 5'007
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.
OwnerBuilder/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-
descriribj�eddf prope eview and inspection as may be required.
X /`( fne/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.
Pace I of 2
NamelhlG ll d i A 4- 5 O/._7 Parcel# 7 F. 4 0C.i;/ BLD#
X./v , C�
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:
htto//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 sto.rmwater 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 EVTITAL 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 sommwater 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 Sormwater 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
Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
N 'Oro)Ur , MASON COUNTY COMMUNITY SERVICES 6LC01�35
PERMITASSISTANCE CENTER., Permit No:
h` • BUILDING• PLANNING• FIRE MARSHAL Recv'd.
I� 615 W. Alder St - Shelton, WA 98584
Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798
185 ' Phone Belfair:(360)275-4467 Phone Elma:(360)482-5269
BUILDING BUILDING PERMIT APPLICATION 615 W.AkIer Mid
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:!�leh a e I + NAME:S U..> �� `�✓� _
MAILING ADDRESS: v �p-, ,�-( MAILING ADDRESS:
CITY: get F4i ,1 STATE: Lj A ZIP: CITY: STATE:_ LIP:
PHONE#1: 3 6 G 4 09—9 9 f O PHONE: CELL:
PHONE#2: 3 6 a— 7 3 t —44-1t31 EMAIL :
EMAIL:_ y41400 L vilh L&I REG# EXP. / /
CONTACT PERSON : OWNER 14 CONTRACTOR ❑ *OTHER/See Below ❑
*NAME: MAILING ADDRESS:
CITY: STATE: ZIP: PHONE: CELL:
EMAIL:
PARCEL INFORMATION: i'LANNIE'V.
PARCEL NUMBER(12 Digit Number)_/-23 a S — 7 8 900w I MA
LEGAL DESCRIPTION(Abbreviated)T)Z(v/� p� Sy�y /.,s f j�,g TOt ! p� 5p 1 r'IA DISTRICT
SITE ADDRESS 1,10 F , ,)Z�2 i e�L 4N CITY a t?Li:4,n
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO b
IS PROPERTY WITHIN 200 FT: (Check all that app1w:
SALTWATER❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF❑ STREAM ❑
TYPE OF WORK: NEW ❑ ADDITION X ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)
IS USE: PRIMARY❑ SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Part[s]of Bldg) ❑ NO'K
DESCRIBE WORK_('Q,— i(1Dl t?Gtn('t�.Q.t ,i �trn,;+ �'ltnCQ.tpt.l i+'1 ��9�
AkL to ; Ui 8 QO(D't Valua ton/Pr jec id Amount: $ ),
SQUARE FOOTAGE: '
I ST FLOOR 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❑
MANUFACTIURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
KE M EL YEAR L
WI TH D OMS HS S NUMBER
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
APPLICATION OF IM DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42)
X �
Signature f OWNER Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT ��t L qkfib
PLANNING DEPARTMENT
FIRE MARSHAL
PERMIT SPECIALISTS Intake. 15 Approved&Ready for Pick-Up:
Visit us on-line: http://www.co.mason.wa.us/community_dev/ - Rev. 112712016 by AN
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