HomeMy WebLinkAboutBLD2021-00488 SFR - BLD Application - 6/9/2023 DocuSign Envelope ID:ICA86460-CO49-42A2-B599-OOBBD6BADAF2
MASON COUNTY COMMUNITY SERVICES [��rlfiiit�,b LD2021-00488
PERMIT ASSISTANCE CENTER: , ` V 1C_
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584 ty�
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone v �0��
Belfair.(360)2754467•Phone Elma:(360)482-5269
\\ - BUILDING PERMIT APPLICPAI& • Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Dave&Debbie Musselman NAME: Suprema Homes
MAILING ADDRESS: 99O Kw7ac PI SF MAILING ADDRESS: 1 S31 S SOth Ave F
CITY: Port Orchard STATE: WA 98366 CITY: Tacoma STATE: WA ZIP: 98446
PHONE#1: 916-730-4286 PHONE: 253-331-1490 CELL:
PHONE#2: 360-932-1619 EMAIL: construction@supremahomes.com
EMAIL: debbiemusselmanOgmail.com L&I REG# SUPREHL807Q3 EXP. 11/2�/24
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER
NAME Kevin Klein/Go Feasibility EMAIL info(a)gofeasibilitv.com
MAILINGADDRESS P.O. Box 1176 CITY Sumner STATE WA ZIP 98390
PHONE 206-219-OS6S CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 12216-75-90032 ZONING
LEGAL DESCRIPTION(Abbreviated)TR 3 OF SURV 15/99 TR 2 OF SP#2107,S 49/224 FIRE DISTRICT 5
SITE ADDRESS 51 E Pendragon Dr CITY Belfair
DIRECTIONS TO SITE ADDRESS Head E on W Alder toward N6th St,take the 1st exit onto N1st St,turn
left on E Pine St,onto WA-3 N,onto E North Bay Rd, onto WA-302 E, Propedy is on the left.
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[R STREAM
TYPE OF WORK: NEW K ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Coaeaercia/Bldg,Eic.) Residence
IS USE: PRIMARY[g SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(WholeBW® YES(Pan/sjgfBkW❑ NO❑
DESCRIBE WORK_ Construct a new 3447 SaFt SFR
SQUARE FOOTAGE:(proposed)
1 ST FLOOR 2641 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK 50 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE 756 sq.ft. Attached W 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:
SEWAGEISEWER SOURCE: SEPTIC® SEWER❑ / NEW® EXISTING❑
PLUMBING IN STRUCTURE? YES[R NO❑ IJyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NON EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 4 TOTAL BEDROOMS 4
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
Eik*QP6)CATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
218/2023
EWiOAVd�NER(Must be signed by the OWNER Date
DEPARTMENTAL REVIEW APPROVED- DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT L 7•/0.Z3
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
DocuSign Envelope ID: 1CA86460-CO49-42A2-B599-OOBBD6BADAF2
MASON COUNTY COMMUNITY SERVICES Permit No:BLD2021-00488
PERMIT ASSISTANCE CENTER:
.BUILDING •PLANNING .FIRE MARSHAL RECEIVED
615 W. Alder St- Shelton, WA 98584
www.co.mason.wa.us u
Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7JU&N —9 20?3
Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269
C• 1
PLUMBING & MECHANICAL PERMIT APPLICATION
`,t
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Dave & Debbie Musselman NAME: qiinrpma HnMPS
MAILING ADDRESS: 990 Kazac PI SE MAILING, D RESS:
CITY:Port Orchard STATE:WA ziP:98366 CITY:Tacoma STATE: WA ZIP:98446 `
I"PHONE: g16-73Q-4286 PHONE: _ _ CELL:
2°d PHONE: 360-932-1619 EMAIL :constrFlctionaa s Ipremahomes-com
EMAIL: dehhlem sselmana- H corn L&I REG# S- IPRFHI 8-01Q3 EXP. 11/91/24
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): 12216-75-90032 Zoning:
LEGAL DESCRIPTION (abbreviated): TR 3 OF SURV 15/99 TR 2 OF SP #2107, S 491224
SITE ADDRESS: 51 E Pendragon Dr CITY: Belfair
DIRECTIONS TO SITE ADD SS Head E on W Alder toward N6th St take the 1st exit onto
Nist St, turn left on E Pine St, onto WA-3 N, onto E North Bay fed, onto WA-302 E,
Propert
i is on the left.
TYPE OF JOB:
NEW ✓=ADD=ALT=REPAIR=OTHER=USE OF BUILDING
LOCATION OF FIXTURES/UNITS—1 sT FLOOR=2"D FLOOR=BASEMENT=GARAGED OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric=PCJ natural Gas=Ductless=
Toilets 3 Type of Unit No.of Units Fees
Bathroom Sink 4 Furnace
Bath Tubs 2 Heat Pump 1
Showers 2 Spot Vent Fan 7
Water Heater 1 Propane Tank
Clothes Washer 1 Gas Outlets
Kitchen Sinks 2 Wood/Gas/Pellet Stove
Dishwasher 1 Kitchen Exhaust Hood
Hose bibs 2 Dryer Vent 1
Other Solar Panel
Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge 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 � �Q FTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
ILLL IN�T HE�ATION.
X 2/8/2023
'VIONAWWbWner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT LSEc' 7•tC1'23
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN
"w - - (b
'NOTE: FOR THE SCALE TO BE CORRECT SHEET MUST BE PRINTED ON 8.5"x 11—
RE EIVED
JU -9 2023
615 W Alder Street
r------ ------------------------ - -----
ADJACENT LOT
PIN-12216-75-90031
Catch Basin ;
i
w
Q
w
w / / I / srRE 25
«zs�CwF-
/ 20 / NOTES:
9, 1
( ----(CREEK)
_ _ _v_ _ _ _ _ _ _ _
ADDRESS:
XXX E STATE ROUTE 302
PORT ORCHARD,WA 98528
SITE PLAN
Retaining Wall
PARCEL ID:12216-75-90032
LOT AREA:1.15 ACRES
IMPERVIOUS AREA CALCULATION PLOT SIZE:8.5X 11"
DRIVEWAY:4,169 SQ.FT. DRAWING DATE:01/20/2023
HOUSE:3,692 SQ.FT. DRAWING SCALE:1°=80'
TOTAL LOT AREA:51,283 SQ.FT.
TOTAL IMPERVIOUS AREA: 7,861 SQ.FT.= 15.32% N
MASON COUNTY Mason County hermit Center Use:
COMMUNITY SERVICES ADv ISO �p� e..Qa'ol
Nullding.Plann04 Environmental Health,Community Health
615 W.Alder tit..-nldg.8.Shelton,Wa 98584 Date Revd
Phrnte:(360)d 7-9670 ext.332♦ Fax:(360)427-7798
REC Fee: $130.00
tive Variance
JUN -9 2023 Request R duct on in the�Reauired Setbacks
or
Adder Street
9
For admidistAive review,the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest protection of the structure
including roof eaves and gutters.
Applicant/Owners: Kevin Klein/Go Feasibility
Mailing Address: P.O. Box 1176
City: Sumner State: WA Zip: 98390
Telephone: 206-219-0565
Email: infb@gofeasibility.com
If this reduction is tied to a building permit, please give permit case number.
BLD BLD2021 _00488
Parcel Number(s): 12216-75-90032 'Zoning RR5
Site Address: 3271 E State Route 302, Belfair, WA 98528
Requested setback variance:
5 ft. ❑ Front ❑ Rear Side
ft ❑ Front ❑ Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks--Front access easements and road right c?f► ttys. Minitnunt 1O feet.
Rear Setbacks—From the rear property line. Minimum I0,feet.
Side Setbacks—From the side property litre. Minimum 5 feel except,for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, and set backs to all
property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
BRUNT AND OR REAR YARD REDUCTION REQUESTS:
For existing lots of"record as of March 5, 2002;
You must meet one of the following:
I) One of the following exists on the lot (check all that apply):
LI a) steep slopes, wetlands, or streams present;
LJ b) soils that restrict building or septic development;
Ll c) lot width at the front yard line of no more than 50 feet;
U d) lot size of no more than one-fourth acre;
LJ e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) One of the following exists on the lot (check all that apply):
0 a) steep slopes, wetlands, or streams present;
U b) soils that restrict building or septic development;
LI c) lot width at the front yard line of no more than 50 fieet,
LI d) lot size of no more than one-half acre,
LJ e) existing improvements ol'buildings, septic systems, and well areas.
Explain flow these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
In order to accommodate the footprint of the proposed home and maintain
--appropriate setbacks from type N stream, a side yard.-variance is required
Owner/Ag (please indicate)
Cj/ I LL-z-
gill re Date
Qf Licial Use OWE
Approved by: Date
Denied by: Date
Reason for denial:
DocuSign Envelope ID. 1 CA86460-CO49-42A2-B599-OOBBD6BADAF2 RECEIVED
Name Musselman/Go Feasibility # 12216-75-90032 JUN -9 2023LD# BLD2021-00488
Mason Co6dfyW. Alder Street
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page To
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
;i
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"
D
P E 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
furtheackgowl�lae that the information provided is accurate and employees of Mason County are granted access to the above-
o u egne
d sc7bbewprop �1j'4or review and inspection as may be required.
Owner/Agent/Contractor(circle one)Date:2I1/2023
Page 2 of 2
1
DocuSign Envelope ID: 1CA86460-CO49-42A2-B599-OOBBD6BADAF2
Name Musselman/Go Feasibility Parcel# 12216-75-90032 BLD# BLD2021-00488
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 = 3 642
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X = 4,169
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 = 50
X = Any paved, gravel or packed area per definition
above table
X =
Others X
X If the total impervious area ofthe 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) 7,861
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. 1
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:
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
MASON COUNTY COMMUNITY SERVICES Permit No:
PERMIT ASSISTANCE CENTER.
-BUILDING-PLANNING-PUBLIC HEALTH-FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427--9670 ext.352.Fax:(360)427-7798 Phone
Belfair(360)275-4467-Phone Elms(360)4825269
BUILDING PERMIT APPLICATION 615 141
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Dov ck t NAME: LAC.
MAILING ADDRESS: 66 Sw%;VS C, MAILING ADDRESS: ZO LS %L T4%. f F
CITY: STATE:(,k ZIPA S 8 CITY: -VO Lyo,o. STATE: WA ZIP: qg t,Iu s
PHONE#I: 3/e 0 -Q 31-l b I q PHONE: '360-(o(r2'/f7,dCELL:
PHONE#2: 4 1(e- 7 30-(A 7.$G EMAIL:Cco-5k rHC.A,(on o'Jcn�w.��M+nez.Carve
EMAIL: u-.. ovV► L&I REG#(-AV& (..BQc(
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER❑
NAME O �O:S�b��.11N I IS�V�Y� KWs-, EMAIL f - CA
MAILINGADDRESS P-0. SO)K 1k"1(0 CITY Suvtnv%cr STATE ZIP 3410
PHONE Z O 'Zlq- ,S(p S CELL
r. ,.,
PARCEL INFORATION:M !
PARCEL NUMBER(12 Digit Number) a,Z k(e-I T- q 003'L ZONING
LEGAL DESCRIPTION(Ahhreviated)`%3 A, U" %V q %1 QR QQft2JaIRE DICS�T-R'ICT
SITE ADDRESS E cA , 307- CITY
DIRECTIONSTO SITE ADDRESS tieoh CE or 1�j e�� F f �C Iowa M &'" Z•�\�° k�e �`''�x;3- orb
A) 0, S7 r_L"rvw LtSk orE E p nc piko WA-IN.,CVk& E QoIFh�;7Cr�1a Wh-30Z,Ow`the ke.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: Kheckolttharapply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF Df STREAM IC
TYPE OF WORK: NEW N ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Remdmcq Garage,CommerolalBldg,Brc)
IS USE: PRIMARY tK SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS 2.S
HEATED STRUCTURE? YES(Whole Bldg)% YES(Part[sjofstdg)❑ NO❑
DESCRIBE WORK 0. h 1A 151 S �c C e
SQUARE FOOTAGE: (proposed)
1 ST FLOOR 14 sq.fL 2ND FLOOR_L�sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK_318_sq.ft STORAGE sq.ft. OTHER sq.ft.
GARAGE_J1Z& sq.R Attached® Detached❑ CARPORT sq.R Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: 51.�7�j 2o2( 002 b e)
SEWAGE/SEWER SOURCE: SEPTIC® SEWER❑ / NEW EXISTING❑
PLUMBING IN STRUCTURE? YES X NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO® EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 5 TOTAL BEDROOMS 5
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 permillapplication 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
-N� I,— COUNTY CODE 14.08.42)
Signature of OWNER(Must be sianed by the OWNER) I Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
'. MASON COUNTY COMMUNITY SERVICES Permit No: IdZbZI W lob
PERMIT ASSISTANCE CENTER:
•BUILDING .PLANNING •FIRE MARSHAL
615 W.Alder St-Shelton, WA 98584
, :•�'°� www.co.mason.wa.us
RECE.
Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798
Phone Belfair:(360)275-4467• Phone Elma.(360)482-5269 APR 0 5
PLUMBING & MECHANICAL PERMIT APPLICATION'S W. A1,
OWNER INFORMATION: CONTRACTOR INFORMATION•
NAME: � bav e. Mutsse\W%.. NAME.- C o v a\ V�owe :) L1-C
MAILING ADDRESS: VL 'SE MAILING ADDRESS:_Z023
CITY:QoA 0,rc�-Ard STATE:W ZIP: a856G CITY: ax- a STATE: W p ZIP:g8g(4r
It"PHONE: ej 1(o- T30- gM6 PHONE: 'S 0�66 2-15"ZO CELL:
2nd PHONE: %0- Q32- 461q EMAIL to acovc&ovv%et Cove,
EMAIL:de\a$Q;e v�n�.cse\v,..r.�n g„ ,A Com L&I REG#COVIk%,BQNQD EXP. tl / ((/_oZI
PARCEL INFORMATION ,,
PARCEL NUMBER(12 Digit Number): 12? G 4003Z Zoning:
LEGAL DESCRIPTION(Abbreviated): :ER5 % ' R a I
SITE ADDRESS:_ E . & (� 4L 2. CITY: gekya'a-
DIRECTIONS TO SITE ADDRESS:_oA a b}``St �-1\e 4 16'ST
- 3 on4o vt W Pt- 30Z E
TYPE OF JOB:
NEW ADD ALT REPAIR OTHER USE OF BUILDING L.pt (,t R_25 1c >n
LOCATION OF FIXTURES/UNITS—1sT FLOOR. 2NDFLOOR )C BASEMF,NT GARAG OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric_L_LPG Natural Gas -Ductless
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heat Pump
Showers Spot Vent Fan IC,
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks 1 Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hose bibs Dryer Vent
Other Solar Panel
Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge 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 CPNVWOTION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WI INVA96ATE THE APPLICATION.
ki -----
Signature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN
Name M.� Parcel# VLI\�- 7 5 - 100 3Z BLD# WZ� iI Uy
RECEIVtu
Mason County
0 5 70?1 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 stoimwater. 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 = m
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)
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 review and inspection as may be required.
X Owner/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.
Page 1 of 2
Name KmsS yw y h Parcel# '22-1K�` 5 - �Z 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:
hU//www.co.mason.wa—us/code/commissioners/indcx.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
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
r '; MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES ADV
Building,Planning,Environmental Health,Community Health
615 W.Alder St.—Bldg.8,Shelton,Wa 98584 Date Rcvd 1 r /
Phone:(360)427-9670 ext.352♦ Fax:(360)427-7798
Fee: $130.00
Request for Administrative Variance for
Reduction in the Required Setbacks
For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including roof eaves and gutters. ,,n
Applicant/Owners: �Quj /2"4 bc>r-�-'kA
Mailing Address: 900
City: n�� fi ;, State: UJ Zip: Vd J(0
Telephone: (P--73D " —1 Z 6{o
Email: e C m a a__t � � , ��'�^ CEI V Ep
�� NOV
3 2021
If this reduction is tied to a building permit, please give permit case number.6 VV Alcl
sLD Zo21 - w4d er Street
Parcel Number(s): 2 2-14, --7 ':Sr—q Ott 32— Zoning
Site Address: 0 6 5 a&y+-Q 0J02—
Requested setback variance:
J 1 ft. ❑ Front ❑ Rear 'Side PLANNING
ft ❑ Front ❑ Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks—From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks—From the rear property line. Minimum 10 feet.
Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, and set backs to all
property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
FRONT AND OR REAR YARD REDUCTION REOUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
1) One of the following exists on the lot(check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-fourth acre;
❑ e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) O e of the following exists on the lot(check all that apply):
`Pa) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-half acre;
❑ e) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
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Owner/Agent(please indicate) l ( Z I
Signature bate
Official Use Only
Approved by: - Date b
Denied by: Date
Reason for denial:
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2 RIM PROPERTY OWNER NOTE,
\ \ D IELD Carefully review ALL aspects of this septic
\ \` \ design.ANY costs incurred due to changes to
TYPE-Ns STREAM(CREEK) \ D-BOX Z this design after submission to he property
and y owev. er.
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N87.05'47"W 360.00 10'O 4"A M 43034 CO SLOW EFFLUENT VELOCITY
PROJECT DESCRIPTION: MASO APPROVED N COUNTY DCD PLANNING P R RY
CONSTRUCT NEW 5— BR SFR WITH PUMP TO GRAVITY OSS SITE PLAN REQUIRED TO BE ON SITE o W- ANTUNG
• Lawrence°.Purdum•
CHANGES OBJECT TO APPROVAL LicENSLrS bESIGrIER
CONSTRUCT NEW 2— PARTY WELL Q
By Date `—2-q "Z } EXPIRES 2/25/2023
SOILS INFORMATION: APPROVED
S L 1 : TYPE 4 / 0.6 GAL / FT-' DAY THIS IS NOT SURVEY
0—20 DBLFS NOV 0 9 2021
20-27 LBLFS ARE BAATURES.TOPOGRAPHY.ELEVATIONSBYTHE OWNER
ARE BASED ON ASSUMED DATUM PROVIDED BY THE OWNER AND
FOR
27— 37 RBLFS MASON COUNTY ENVIRONMENTAL HEALTH TPIERCE
E RE IEWAN CONSTRUCTION OS.ANDAREINEDSEPTIENDED SYSTEM
TEM
THE REVIEW AND CONSTRUCTION OF THE PROPOSED SEPTIC SYSTEM
DESIGN. APEX SEPTIC DESIGN.LLC RECOMMENDS THAT A LICENSED
37— 61 L B FS PROFESSIONAL LAND SURVEYOR ALWAYS BE USED TO SET CORNERS.
COMPACT AT 61 RET ESTAN D/OR PROVIDE A LEGAL SITE P ELEVATIONS AND TOPOGRAPHY. PLANNING:
ROOTS TO 55 NOTE: METHODS AND EOUIPMENT ALL SETBACKS ARE MEASURED
IT IS THE INSTALLER'S RESPONSIBILITY TO ENSURE THAT THIS IS NOTA SURVEY.SITE FEATURES.TOPOGRAPHY.ELEVATIONS. FROM THE FURTHEST
SL2: TYPE 4 / 0.6 GAL / FTz DAY THE PUMP TANK
AND FILLED
SETTING UP THE SYSTEM.FOR
STING THE PUMP AND BENCHMARKS ARE BASED ON ASSUMED DATUM PROVIDED BY PROJECTION OF THE BUILDING
0— 12 DBLFS THE OWNER AND PIERCE COUNTY PLANNING RECORDS.AND CIS
INFORMATION.AND INTENDED ONLY FOR THE REVIEW AND CONSTRUCTION
THE BUILDER OR HOMEOWNER IS RESPONSIBLE FOR NOTIFYING OF THE SEPTIC SYSTEM DESIGN.
12— 24 RBLFS W SCAT G R APEX SEPTIC DESIGN WHEN THE PUMP CONTROL PANEL HAS BEEN FIELD MEASUREMENTS PERFORMED WITH ATOPCON GPT-9003A ROBOTIC
24-44 GRAVELLY LBMS WIRED.DESGNITHAT�TDHEY FOR PANELTUP. FAILURE TO NOTIFY APEX HASBEENWIREDMAYDELAYTHEPTIC TOTAL STATION.TOPCON ROBOTIC PRISM.TOPCONFC-200 DATA COLLECTOR
ROOTS COMMON TO 35 COMPLETION OF THE RECORD DRAWING.AND DELAY FINAL AND RAG TAPE.
OCCUPANCY OF YOUR HOME APEX SEPTIC DESIGN.LLC RECOMMENDS THAT A LICENSED PROFESSIONAL
LAND SURVEYOR ALWAYS BE USED TO SET CORNERS.ESTABLISH LOT LINES,
S L3: TYPE 4 / 0.6 GAL / FTz DAY DETERMINE SITE ELEVATIONS AND TOPOGRAPHY.AND PROVIDE A LEGAL SITE PLAN.
0— 10 DBLFS NOTE:
10—37 RBLFS W SCAT GRAVELS THIS SYSTEM IS NOT RATED FOR USE WITH A GARBAGE DISPOSAL. CLIENT:
37—45 LBLFS USE OF A GARBAGE DISPOSAL WITH THIS SYSTEM MAY CAUSE
ROOTS TO 36 PREMATURE FAILURE OF THE DARINFIELD. DAVID & DEBORAH MUSSELMAN
(206)319— 5799
SL4: TYPE 4 / 0.6 GAL / FTz DAY 0— 10 DBLFS ENGINEER/ARCHITECT NOTE: PROPERTY INFORMATION:10— 52 RBLFS W TR GRAV AND SCAT COBBLES DO NOT MOVE/ADJUST/RELOCATE DRAINFIELDS PN: 12216— 75—90032SITE ADDRESS:XXX ST ROUTE 302, VICTOR
52— 62 LBSL OR TANKS. SEPTIC COMPONENT LOCATION IS CRITICAL
*APFwX
ROOTS COMMON TO 40 TO THE APPROVAL OF THE SEPTIC DESIGN AND ISSUANCE SEPTIC DESIGN, LLC
OF THE BUILDING PERMIT. R3 DRAWN: TP. AUGUST 3. 2021 PAGE 1 OF 3 PO Box 801.Gig Harbor,WA 98335 253-509.9922