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BLD2021-00989 SFR - BLD Application - 6/25/2021
MASON COUNTY COMMUNITY SERVICES Permit No: Ad 2=LZ-1 6696 l PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352.•Fax:(360)427-7798 Phone Belfair.(360)275-4467•Phone Elma:(360)4825269 J U N 2 5 2021 BUILDING PERMIT APPLICATION �� PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: R��7a NAME:�oyee. r�zvG�RaS/�t�nQy ! NAME: LUGS 6 ` MAILING DRESS: p0_ x 69 9 MAILING ADDRESS: 2)04 CITY-,eyye�rk Pmiku STATE:LOA- ZIP:9R.�3RS CITY:y UBof4. STATE: wA- ZIP: q Oev9- PHONE#1: PHONE:IU3- 33 7�r�CELL:12:s3-III- PHONE Qj #2: 9053 -739-- 39S5' EMAIL:..-T"sse,.( Aeft,ST12 ohe_- hbr,¢S,covN EMAIL: w y&N/g a-WO maorl get 9 404, L&I REG*,4A 14a 3'93 ly EXP. PRIMARY CONTACT: OWNER❑ CONTRACTORS ^THER NAME ' 5'(-�V - :fAfiSSEn EMAI $EN ,4RMS7R006-11-10401e5 n MAILINGADDRESS 9,709 Avow-n &j4-/ n- CITY t,13ryR14 STATE t-AJ4- ZIP!1?2010�- PHONE 3— �t 2_33 � CELL a. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) /�4-/J q-5'3-on/yg ZONING LEGAL DESCRIPTION(Abbreviated) h1,9R7ST,FNt' fl:y r IY&y FIRE DISTRICT SITE ADDRESS . $3C P&JOTAS 191110C W 71" CITY Sly e�7b7, DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NO IV IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check all thatappiy): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEWX ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,commercial Bldg,Etc) _57;jK Z fletwooft— IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS_, HEATED STRUCTURE? YES(Whole Bldg)$ YES(Part[sI of Bldg)❑ NO❑ DESCRIBE WORK H1 oilttu 3 8ZjWLM^ hbAld- w1T;'o" A7T4CA-D C-4dt/;6C SQUARE FOOTAGE:(propose+e:fisting) G 1ST FLOOR_Wjk sq.ft. 2ND FLOOR /©i0 sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK L t I sq.ft. COVERED DECK (ed sq.fL STORAGE sq.fL OTHER — sq.ft. GARAGEf sq.ft. Attached'K 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: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWERX / NEW❑ EXISTING$ PLUMBING IN STRUCTURE? YES;(' NO❑ If yes,attach completed Water Adequacy Form PERI METERNOUNDATION DRAINS PROPOSED? YES❑ NOJK EXISTING SQ.FT. EXISTING BEDROOMS 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:APLI�CTION OF 180 DAYS OF RE-WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) x 12 $i a of OWNER(Must be signed bvthe OWNER) Date D TMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: 16t =1- Q6gS(q PERMIT ASSISTANCE CENTER: •BUILDING •PLANNING •FIRE M � RECEIVED 615 W. Alder St-Shelton, WA 985 PLDIN hone e Shelton:(360)427-9670 ext. 352 • Fax:(360)427-7798 JUN 2 5 2021 Phone Belfair:(360)275-4467• Phone Elma: (360)482-5269 615 W. Alder Street PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Jvyc� t`l�ocll Nino R u peA e& NAME: f-�P r6TACn6- 0e/12r oc_7 ./Slue Cj'r�z C1. MAILING ADDRESS: © 6q7 MAILING ADDRESS: St!7oq gv0&4 'u'v 4& CITY:5co-14 Pg»11zir STATE: W - ZIP: "39S CITY:,quBc.;►zN STATE: W0- ZIP: 9JA Pt PHONE: a S 3- 93,9,- N G. X PHONE:gS3--0.33-33S5 CELL: 4qr 69f g 2"PHONE: EMAIL &a /�4.`/n5%G�y4G �-Nvmes sCla/� EMAIL: Wyomi t) q0 f ot,,err, L&I REG#aR mS%cly 393 1Y0 EXPo.L- /k7_/a PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): r a il9- �3- �'�l � Zoning: LEGAL DESCRIPTION(Abbreviated):4!#gnizne- i9glnT 107'/Zlq, SITE ADDRESS: SS3 •'- � PhOT6, /Ai t u- we-W CITY: E*eilo^ DIRECTIONS TO SITE ADDRESS: TYPE OF JOB: NEW__?C—ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS— 11T FLOOR 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES (SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_ Toilets -3 Type of Unit No. of Units Fees Bathroom Sink Furnace / Bath Tubs f Heat Pump Showers 2r 3 Spot Vent Fan Water Heater I Propane Tank 0— Clothes Washer / Gas Outlets C3 Kitchen Sinks 1 Wood/Gas/Pellet Stove O Dishwasher Kitchen Exhaust Hood I Hose bibs `a 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 CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signa Owner Date DEPAR MENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUt DING DEPARTMENT quo-a/ PLANNING DEPARTMENT FIRE MARSHAL RPv-1/27/201 n IFIN �^ I G G G /, Q �l�,G�,q Name �1d GVZI" 6d !� l Parcel# 12• 1 19 - ��j ~ 6oIq i� BLD��p (4Oi � I IBIJ'��`N G Mason County Department of Community Development JUN 2 5 2021 Small Parcel Stormwater Management Application/Worltl}1e&(P-#9VP3 QP)et 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 Mgnr$Tsr+- X10AInO OgtRv49,4 N45 ft ►nMP- FJArr` 10-- PJA-of— A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in *ir tirety 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 Owne(Agent/Contracto circle one)Date: py;q 'Page 2 of 2 Name Parcel# BLD# 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 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 X = w(-Iq G: iM(c X Measurements for buildings are taken at the WJ 17�k5 _ perimeter of the farthest projections (example: X ® ' eaves/gutters) X = i Driveways X = o� 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) �yY 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 I of 2 APPROVED SITE PLAN AND RECEIVED IN TOPOGRAPHIC SURVEY JUN 25 2021 COUNTY DCD G PROJECT BENCHMARK iJMASON SITE PLgN E �E BB O .BB FEET AT roP CENTER OF HATER HEM � FOR RQ'JI. G BE ON SI CHANG � sU ,LOT TO APPROVA� J. MEDEIROS AND N. R UFENER 615 W.Pder Street IOT A49 IN k By _Date 44#1 — i SE 114, NW 114 !Q `\\ i ,,;• SECTION 19, TOWNSHIP 21 NORTH, RANGE 1 WEST, W.M. s i SITE ADDRESS: HARTSTENE POINTE NO. 4 LOT 148 PARCEL N0. 12119-53-00148 -GRAB' 0 PLANNING: R IOT148 '- PLANNING \ \ >:=ea.BB � ,' `.�, .��/ ALL S %E.TBACi'I�E�Xf BUILDING �� FROM THE FURTHEST , � i1xE PROJECTION OF Tl:- BUIL v2 / --_---- FOUND 3'BRASS DISC IIITH PUNCH(VISITED 0 _ DECEIBER 2020) c� co C2 / ca + W PO}ER VAULT C5 ca \�\ cia 0 p �--p—WATERPROXCF LEGEND BENcmrARE ' y/ // YF•r.rrfF CAP N HBOL6fAN LS�ISB53' FOUND/5 IRON BAR IN TREE ROOT� � / (R)= RECORD NOTES: so v / a�= ALRsuRED FOUND BAR M CAPSULAIAI BY 1BE °A \ // TREE LARGER THAN B' ROOT OF A E C®AR O.OB'FEET NDRTB AND 0.08 OF THE CALCULATED C� J eh P73DTON POWER IS UNDERGRO °° SCALE: 1'=10 FEET T19O7.46 t4. / �/' BE'A NII 114 0 5 10 20 REFERENCE S UR IELEPH100 / // F k ,.•� LGARISTENE PoDIl'S PTA(' / /' .7 ➢ULUYE B OF PLATS PAGES M-BN / / CURVE TABLE 1 9171 �• /' NO DELTA RADIUS AENOTH / Cl 4521'23' 40.00 31.BB C2 4425'00- 40.00 31.01 C9 44'39'25' 40.00 31.11 20-144TD1YC / C4 45'30'00' 40.00 -31.77 20-144T.ASC C5 45031'35' 40.00 31.7E N.SEC. 19, TWP 21 M. R I w CS 44-30'00' 40.00 31.07 C7 44.4337' 40.00 31.23 C8 4525'00' 40.00 31.71 POUND 9'BRASS DISC IIPfH PUNCH( CB 152O'OB' BB0.00 290.29 asccel�ER zozo) SCALE HOLMAN & ASSOCIATES / C10 35SSY5' S05.00 91B.B0 DESIGNED CMF' JOB NUMBER aRa►mc xvAmaR VERTICAL DATUM yy i 3o DHAIrx cA� I-= 10• 20-144 PQ BOz� zo-144T ASSUMED Q�' CHECKED DFH �,ID Cam, DATE PROi�IOXAL LAIm SU1RVEYORS APPROVED DFH BOOK CUF DEC, 2020 (�0)a>Rf- R°1rEt/A(.0 427-ZS06 FAZ SREEI 1 OF 1