HomeMy WebLinkAboutBLD2022-00006 Pole Barn - BLD Application - 3/30/2022 U1 MASON COUNTY COMMUNITY SERVICES Permit No: l
PERMIT ASSISTANCE CENTER:
1 •BUILDING•PLANNING-PUBLIC HEALTH•H� A"RJ'
'�•]U 615 W.Alder n 98
Phone Shelton:(360)427-96 � ) Phone MAR 3 0 2022
Belfair:(360)275-446777�'���hhhona ma:(360)4825269
Q0 BUILDING PERMIT APPLICATION 615 W. Alder Street
O -
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:�'A" ST AL 4A)$ NAME:bNC CA11 UKOLIft-Drt. L(L
W MAILING ADDRESS: E L101t. Wve_Cowj-f MAILING ADDRESS:�I t{ S•
S CITY:hLUr— STATE:lM4 ZIP: �lY CITY--r14Gpr)Aa STATE: _zip:q 0e)
PHONE#1: 760 )'X' Xi PHONE: - ,T:f- !6t EITLL:
PHONE#2: r 3 (/9176 EMAIL ?-L
EMAIL: r AVi L&I REG# EXP.i i/Zt/ 2,5
PRIMARY CONTACT: '- 5 OWNER❑ CONTRACTOR OTHER❑
NAME EMAIL
MAILINGADDRESS CITY STATE ZIP
'^ PHONE CELL
PARCEL INFORMATION:
^ PARCEL NUMBER(12 Digit Number)�,2 d s�� b OOo y ZONING
]0 LEGAL DESCRIPTION(Abbreviated)L44101baJ J-W /F Sit ) FIRE DISTRICT_L �r
' SITE ADDRESS&2S"1 F. ta4a 2j.94,A"x 1,el CITY .gY.L.,W� `yot
DIRECTIONS TO SITE ADDRESS
C� 5T A-61 A I.14'f d rt/t/►• �t42*O ,S 2` /PLO/Y✓s
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO[SNOW LOAD:_psf
IS PROPERTY WITHIN 202 FT OF THE FOLLOWING: (Cheekall that apply):
N SALTWATER❑ LAKE RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK NEW PF ADDITION❑ ALTERATION Pp REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)/ ?0Cof Pb)C imfl—
C IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(Whotemdg)❑ YES part[VofBldg)❑ NO
DESCRIBE WORK
SOUARE FOOTAGE: (proposed)
1ST FLOOR_ _ _sq.ft 2ND FLOOR sq.ft 3RD FLOOR sq.ft BASEMENT sq.ft.
QDECK sq.& COVERED DECK sq.ft STORAGE sq.& OTHER 5: (Q sq_ft
GARAGE 51�Q sq.ft Attached❑ DetachedK. CARPORT sq.ft. Attached❑ Detached❑
AIANUFAC *4 COPIES OF THE FLOOR PLAN REQUIRED*
M MODEL YEAR
IDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWS ❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES❑ NO Ifyes,attach completed WaterAdequacy Form
PERIMETERTOUNDATION DRAINS PROPOSED? YES❑ TT NO* EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 1) ��T""^" TOTAL BEDROOMS a
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 1 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 conshuction 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 APPLIC TION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
_ COUNTY CODE 14.08.42)
X 2-22
ignature of OWNER(Must signed by the bv�eOWNER1 Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDTITONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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Name l.r1'rnO ?fi . Parcel#J oOt';Oa-rj2-tOODOO BLD#
74Lb��6..) Mason County N
MAR
3 0 2022
Department ofJ Commu !Ott
�
tiSmall Parcel Stormwater Management Aon/Workshee�� �� �� Str
eet
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 Cakutate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings -2!A 2-41 S
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 =
X = Any paved,gravel or packed area per definition
above table
X
Others X =
X = ff the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stonymrater 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 Mormwater 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 ew and inspection as may llbe required.
X '� c r Owner/Agent/Contractor(circle one)Date: of oa•oZ o2
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:
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
firrther 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