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HomeMy WebLinkAboutBLD2010-00393 Park Model - BLD Permit / Conditions - 6/18/2010 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 - too RESIDENTIAL BUILDING PERMIT BLD2010-00393 OWNER: MELISSA RATHBUN RECEIVED: 5/19/2010 CONTRACTOR: LICENSE: EXP: ISSUED: 6/18/2010 SITE ADDRESS: 30 E ODESSA CT BELFAIR EXPIRES: 12/18/2010 PARCEL NUMBER: 122091390010 LEGAL DESCRIPTION: TR 1 OF SP#3044 PROJECT DESCRIPTION: DIRECTIONS TO SITE: New Park Model (Approved ADU DDR2010-00001) S. R. 3 right on North Bay Road, Left on Coulter Creek Rd, Right on Marvin Road, Right on Odessa Drive, Left on Odessa Court. General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 1 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 1 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building: Valuation: Building Height: 16 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:VSI Length: 40 Ft. Front: N 50.0 Ft. Shoreline: Ft. Water Body: Rear: S 200.0 Ft. Slope: Ft. SEPA?: Modei:LAKE MERE Width: 12 Ft. Side 1: E 50.0 Ft. Shoreline Desig.: Not Applicable Year:2008 Serial No.: Side 2: W 150.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Gas Outlets 3 Mobile Home Submittal Fee PIB 5/19/2010 $264.25 S12010000 Propane Tank 1 Planning Review Fee PIB 5/19/2010 $205.00 S12010000 EH Plan Review SJC 5/19/2010 $103.00 S72010000 Water Adequacy Plan Review SJC 5/19/2010 $103.00 S72010000 Mobile Home Issuance Fee LDK 5/25/2010 $264.25 S12010000 Mechanical Permit Fee LDK 5/25/2010 $79.20 S12010000 Mechanical Base Fee LDK 5/25/2010 $28.50 S12010000 Address Fee TW 6/17/2010 $173.50 S12010000 Total $1,220.70 BLD2010-00393 Please referto the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2010-00393 CONDITIONS FOR BLD2010-00393 1) 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 Depar t prior to any further inspections being performed or approvals granted. X �/�J� 2) Owners/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X n4p; 3) 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. X�� 4) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X Ale. 5) The"approved" site plan is required to be on-site for inspection purposes. If 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. X 4W 6) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or in Iled. certification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X 7) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the J,�fffice of Manufacturing Housing (360) 725-2800. x !'1iC e BLD2010-00393 Please referto the following pages for conditions of this permit. 2 of 6 8) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting 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. By calling for a final inspection of the building permit the owner/agent/contractor is acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 9) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/Reserve requires a 10ft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. No foundattiio�n,drains within 30ft, down gradient of drainfield/reserve area. X 144 - 10) 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). X -nA 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. X 12) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy(Final Inspection)will be granted for the residence. OWN ER/CONTRACTOR(indicate which) Signature X 13) This permit is for the placemen,Land installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X �(4 14) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X IIyI BLD2010-00393 Please referto the following pages for conditions of this permit. 3 of 6 15) Placement of structure must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X / , 16) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County X rdinance o�gulation, must be reviewed and approved by Mason County prior to construction. 17) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND 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 Inspector shall be de prior to requesting additional inspections. 18) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. X 19) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks filled on site must be located a minimum of 10' from any possible source of ignition (electrical outlets, electrical fixtures, compressors, etc), mechanical system air intake(direct vent appliance, ventilation air intake, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. Propane tanks less than 125 gallons must also be located a minimum of 5'from any building opening (foundation vents, windows, doors etc). Setback to the public way, or access easements shall be the greater of 25-ft or as specified in the Mason County Development Regulations. Setback to property lines shall be the greater of 5-ft or as specified in the Mason County Development Regulations. If a propane tank is exposed to probable vehicular damage, protective bollards must be installed. X z e. 20) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All Propane tanks between 125 and 500 gallons must be located a minimum of 10' from any building, possible source of ignition (electrical outlets, electrical fixtures, compressors, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. Setback to the public way, or access easements shall be the greater of 25-ft or as specified in the Mason County Development Regulations. Setback to property lines shall be the greater of 10-ft or as specified in the Mason County Development Regulations. If a propane tank is exposed to probable vehicular damage, protective bollards must be installed. ^ X 21) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks must meet the i sWIlation requirements and minimum setbacks as listed in the Mason County Fire Marshal's Standards for the Installation of Propane Tanks. X 22) Fuel piping shall be inspected after the installation of fuel piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall not be used until the final inspection has been performed and approved by a Mason County building inspector. X BLD2010-00393 Please referto the following pages for conditions of this permit. 4 of 6 23) The placement of small propane tanks are not normally subject to a permit review by the Planning Department; however, propane tanks are subject to Planning Department regulations. Such regulations primarily consist of setbacks from shorelines and features considered to be critical areas (streams, wetlands, slopes, etc.) If you think such featur s exist on or nearby your property, please contact the Planning Department so that exact setback requirements can be determined. X 09- 24) All property lines shall be clearly identified at the time of foundation inspection. X 25) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The 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 Coun ordinances and building regulations. X 26) 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 (older have prevented action from being taken. No more than one extension may be granted. 27) Pressure ++treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connecto s d flashing. Install metal connectors approved for contact with the new types of pressure treated material. XW 28) Retaining walls needed to support a surchar a uch as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 29) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures meet the setback conditions listed. X 4 30) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approve S Plan"to ensure these structures are shown and meet the setback conditions listed. X 31) 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 1-800-64747�. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 32) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X ' t- 33) Approved conditions of Accessory Dwelling Unit permit DDR2010-00001. X BLD2010-00393 Please refer to the following pages for conditions of this permit. 5 of 6 34) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. OWNER OR AGENT' ���� ��T 'fib DATE: D BLD2010-00393 Please refer to the following pages for conditions of this permit. 6 of 6 W o CONCRETE MECHANICAL MANUFACTURED HOME oDate By �m o Footings I Setbacks Gas Piping Ribbons o Intenor Date By Interior-Date By Date By C 0 Exterar Date By Exterior-Date B ? <,> Sot-up ic Point Load!Isolated Footings INSULATION Date (� -- b Ely ( ) m BG f SLAB INSULATION r Date By Data By FIRE DEPARTMENT Cl) Foundation Walls Floors Date By n Date By Data By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING Vault Data By Date By OTHER Groundwork Attic Date By Type. Date By Date By D.W.v DRYWALL Type- Date Brace Wall Date Esy Date By Date By FINAL INSPECTION 0 v Water Line Oa�Fire Soporatirxt 8y Date (JI v f v By �K O � Date By � O Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Dane By Comments CD ET �% �,� 7L7,(C> � Tom , 72'Cn w ' t sS I/111 _�0- 1 a �" 0 a a f 0R U CD h To: Melissa Rathbun May 15, 2010 Purchaser I understand and agree with this initial proposal. You will be putting a park model trailer (approx. 400 sq ft) on the land you intend to buy as per our discussions. Tim Nelson���fi Seller /�( Melissa Rathbun P.O. Box 14 Allyn, WA 98524 May 15, 2010 Tim Nelson Owner-seller P.O. Box 564 Allyn, WA 98524 Dear Tim: Herds the promised summary of where we are on the land piece I would like to purchase from you. If you disagree with anything I've written, let me know. Lot 1, N 1/2, SW '/4,NE '/4 . 9-22. Range 1 West, W.M. This is the lot across the road from you bordered by Marvin Road, Odessa Place, the Taylors'property, and the VanNash property. It is my intention to reach an agreement with you in the near future on a price and terms. In the meantime I would like to agree to my having the right-of-first-refusal on the piece so I may plan to move onto the site. I'll check with you once more before this plan goes into effect. I hope we can come to some terms that are mutually satisfactory without involving intermediaries. Please sign this to show your agreement. Sincerely, Melissa Rathbun 3 All tt Y W m rss Y s r _ w in raga '- ...... .c- -. __._.... -c ., ., .... •ti:•.,.-:::•r-. ...y. - _ �.�.... _� . .. . � n Y rD d C7 rD m F Optional Pickot Gunrdrail with t t• Wardrobe Cabinet 32"Lazy Susan VC(loll Caprail and Foutrail PH � CIBATH L f TV ^ O tl7 ional 10'Porch JL J v0 we / a CFull Llte210 Nh5 LIVING ROOM 3 Eern('.Isrealay Wlvbwf in UgM WMM ;,�Shown withF �F- �F- � 0 Optional GFI Raised Bay O Window 50 Galion Electric I Water Heater over O LP Gas Furnace cD m (0 Pitch Root, p.Siding � P Snow Load 30 Yr.Arch.Comp. Lake Merwin w Optional Porch 30 Double Pane Vinyl Windows w/Low E Genuine Wood Cabinets and Trim 32r X 12" Cabin VST - Vacation Structures,Inc. O a TIHESE'PLANS MUST FOR 111,9SPECTICY '... L lo-c�v3�3 (�zf� 6,A � ,���, FILE � COPY A-J- -U( qo� l" APPROVED MASON BUILDING INSPECTOR CHANGES SUBJECT TO APPROVAL DATE ,v Documents attached to approved plans: Site plan: _ Plan review checkl&=FVertical Pa :s: Engineering: Y Number of pages—l— VIESE PLANS MUST 5,- 0v1AN ON T►� E JO'B SITE MUST MEET ALL CURRENT SUBMIT CHANGES FOP APPROVAL FOR IS-3SPECTION WASHINGTON STATE CODES PRIOrt TO PERWIMING`.NOF"< VENT ATISqFt Per 150SgFi r ,. y �,, k r ',.}i. ,.. L`�•CJ �G' `• ,�FQtvp L©YIT'1' P1P� 9 CAP f jMg MAY i ' � C W. CEDAf� ST, s 89`74'29" E 1328.07 1 ., t cue. C as a PRO` PL NN` �0, �� CJVP1dCJ LQ1�f7T f 1°' 1 �. -w ...... ON g1l CAFE', 0 3:3 N. 07' _ d M'�';,t 6 l.dM!1°tQl� p'! 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Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 -S On the web www.co.mason.wa.us AP NT INFORMATIO CONTRACTOR INFORMATION © Owner rnQ-\\ SSc-, Company Name Mailing Address t 4 Mailing Address City State_S Zip Code City Stat Zip Code Phone Other Ph. 0- $ Phone Other Ph. n L t l <'7� --D-5'- I Contractor Reg. # Exp. l SE-) E Mail Address Drivers Lic. # SOB a SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System v PARCEL INFORMATION - 12 Digit Parcel No 220 - 1 — 9 D 1 Fire District t Legal Description__Lo-k-A I i N tf Z a S W y N E '/4 9- 2 2, ar`AR 1 l�eS r W M Site Address (Please include street name, street number and cit ) 3 U 0 Ap_%s� Ce._r� Directions to site_74 02 Y)oy- 4--'X- La A- C_V-ej j< Q& rN `C t h� c�� v _ Will timber be cut and sold in parcel preparation? Yes/No Is property within 200' of Saltwater N 0 Lake River/Creek 11�0Pond NO Wetland _Seasonal Runoff �t VQ_Stream�{I{_Slopes or Bluffs > 15% NO Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Y /No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCEA SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make \1aCktbn S"'LICk-"f- Model Year 2Oo� Length ` 0 Width St rig l No;�'^S� re "`""4"` �dr r of Bedrooms No Bathrooms Type of Heat rch�uase Price $ 0W Replacement Unit? Yes N� Installer Name up =Y-,t p _ Certification No. Mi. = 'S k D A: -KC- 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 the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X vW Date bb(pl t o Owner Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: AjOnlk Da 11 i DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department 0 t�L Planning Department r bG 26 j Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NOA- I�I�ZO1� � � l PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar- P.O. Box 186, Shelton, WA 98584 Shelton (360)427-9670-Belfair(360) 275-4467- Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address (Please include street name, street number and city) e Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:ElectriG_ LPC-L Natural Gas_ Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets a Kithen Sinks Wood/Gas/PelletStove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date. Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building De artment Z Occ Grou �f T e Constr.��a 1411 Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES Name m fu SSA Parcel# 1,�aQ9 - 13- 9 0010 BLD#,ZO lb bu n ; 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'. '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 = fp X 115 = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) NX = —Driveways ILn = 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 are z4QQ If the Total Impervious Surface Area is LESS quare 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 review and inspection as may be required. X / " Owner Age Contractor(circle one)Date: If the Total Impervious Sur ce Area is GREATER THAN 2000 Square Feet, please rea knowledge 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 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 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