HomeMy WebLinkAboutBLD2018-00708 Replace MFG Home - BLD Application - 7/5/2018 aeon Coa4•� ; MASON COUNTY COMMUNITY SERVICES
PERMIT ASSISTANCE CENTER. Permit No:2) aO VE)-T5
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•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 9858 RECEIVED
Phone Shelton:(380)427-9670 ext,352•Fax:(360)4 �Ocf-DIAIG
e
Belfair.•(360)275-4467•Phone Elma:(360)482-
JUL 0 5 2018
BUILDING PERMIT APPLICATION 615 W. Alder
Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Gregory Loddo NAME: Sniith ShnrP(pnstrurtinn
MAILING ADDRESS: PO Box 8 MAILING ADDRESS: PO B,.963
CITY: Allyn STATE: wA ZIP: 98524 CITY: Belfair STATE: WA ZIP: 98528
PHONE#1: 360-275-5739 PHONE:360-509-1342 CELL:
PHONE#2: EMAIL : southshore@q.com
EMAIL: n/a L&I REG# SOUTHSCO16NL EXP._C)2 / /
PRIMARY CONTACT: OWNER ❑ CONTRACTOR[y OTHER❑
NAME EMAIL
MAILING ADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 12208-42-00010 ZONING
LEGAL DESCRIPTION(Abbreviated) TR 1 OF E 1/2 NW SE PCL 2 BLA#98-29 FIRE DISTRICT
SITE ADDRESS 1611 E North Bay Rd CITY Allyn
DIRECTIONS TO SITE ADDRESS �4W y 3 N p VTN `fib \ 1 LA D r-F IOU AD I-FoL uw
V1LTbg "lidI Or-f- Tb END :13SW VAOHI COW-INVE !Z11WILFt, ZED-OMVEW Y M W�
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO [�}/
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 ❑ REPAIR❑ OTHER g Replacement
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) Residence
IS USE: PRIMARY Y SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(Whole Bldg) Y YES(Part[s]of Bldg) ❑ NO ❑
DESCRIBE WORK Install and replace a new MH for residential use
SQUARE FOOTAGE: (propose+existing)
1ST FLOOR 1904 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*
MAKE Fleetwood MODEL WESTON 28684V YEAR 2018 LENGTH 68
WIDTH 28 BEDROOMS 3 BATHS 2 SERIAL NUMBER N/A
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES ['� NO ❑ If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NOr� EXISTING SQ.FT.
EXISTING BEDROOMS p PROPOSED BEDROOMS 3 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 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 ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
COUNTY CODE 14.08.42)
Si na a fe of OWNER (Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT JTL
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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Bedroom 2 Bath 1 ,812 Square Feet
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4021 State Hwy 16 W Rr. merton, WA 98312 360.479.4663 Man-Sat 9a-Sp Sun 12p-5'p I�
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FILE
COPY
REVIEWED FOR
CODE COMPLIANCE
MASON COUNTY
/L/
�UILDING DEPARTMENT
�- rr Date _ /G—/S-
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'_ V Documents at--tajjrh-ed to approved plans:
Site Plan
Plan review checkli t: �a Pages
eering Engin : Y Lateral Vertical
�. � Nlumhnr of napes
RECEIVED
Name Parcel# JUL 0 5 2018 BLD#
MasgW'(W, d �Ier Street
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
Buildings 28 X 68 = 1904
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example.-
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 =
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) 1904
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-
described property for revoK and inspection as may be required.
X )
1 Z,17_z�zl
Owner/Age Contractor rcle one Date: 07/03/2018
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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
JUL 0 5 2Q18
3,.ss' 615 W. plder Street
GREGORYLODDO
1611 E.NORTHBAY RD.
SCALE 1"=40'
82.89'
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PLANNING:
PLANNING
ALL SF_TL''P-�CKS ARE MEASURED
FROM THE FURTHEST
F ROJECTION OF THE BUILDING
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