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Home My WebLink AboutBLD2023-01530 SFR - BLD Application - 12/21/2023 Permit No: ~" MASON COUNTY COMMUNITY DEVELOPMENT DEC 2 1 2023 Permit Assistance tenter,Building,Planning ` BUILDING PERMIT APPLICATION 615 VV. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Shelly Burtis NAME:Shelly Burfis D m r l)(�,►n� �. ,.. MAILING ADDRESS:Po Box 1374 MAILING ADDRESS:PO Box 1374 + CITY:Hoodsport STATE:WA ZIP:98548 CITY:Hoodsport STATE:WA ZIP:98548 • PHONE#1:206.396.7707 PHONE:206.396.777 CELL: PHONE#2: EMAIL:shellyburtis@gmafl.com • EMAIL:shellyburtis@gmail.mm L&I REG# EXP. PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑ NAME sh+y8u* EMAIL sheltyburtis@gmail.mm MAILING ADDRESS PO Box 1374 CITY HooaspM STATE WA ZIP98548 PHONE 206707 CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number)42210-34-90281 ZONING LEGAL DESCRIPTION(Abbreviated)LOT:A OF SP#1697 PTN TR 28 SE SW SURVEY 31/40 FIRE DISTRICT Hoodsport SITE ADDRESS 10 N Broken Arrow Dr CITy Hoodsport DIRECTIONS TO SITE ADDRESS Hwy 101 North,Left at N Lake Cushman Rd(SR 119),Go 2 miles,Right on N Broken Arrow Dr. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOD SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (awkau that apply): SALTWATER❑ LAKE❑ RNFR/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Rid.,.,Garag.,Ca.a.rc7a1B14 Ex)Single Famlly Residence IS USE: PRIMARY 2] SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(WhokBidg)❑ YES JPanlsjofB1dg)❑ NO❑ DESCRIBE WORK 1861 square toot single story home. SQUARE FOOTAGE: 0,.poa.d) 1ST FLOOR 1861 sq.ft 2ND FLOOR sq.fL 3RD FLOOR sq.ft BASEMENT sq.ft. DECK sq.ft. COVERED DECK 404 sq.ft. STORAGE sq.R. OTHER sq.ft GARAGE 1180 sq.ft Attached❑ 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 0 EXISTING❑ PLUMBING IN STRUCTURE? YES[a NO❑ Ifyes,attach completed WaterAdequaey Form PERWIETERNOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS 3 TOTAL BEDROOMS 2 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 penmit/application becomes null&void ff work or authorized construction is not commenced within 180 days or if oonstruction work is suspended for a period of 180 days. PROOF OF NTINUATION OF WO ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS P PT PLICA ION OF 180 S OF MOR WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON CODE 14.08.42) N Mu i ned b the OW ER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDTTIONS BUILDING DEPARTMENT 1 6:G 1.( . V PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Permit No-J' id 262:�-015�0 p :=- h MASON COUNTY COMMUNITY DEVELOPMENT C Permit Assistance Center, Building,Planning PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Shelly Burtis NAME: Shelly Burtls MAILING ADDRESS:PO Box 1374 MAILING ADDRESS:PO Box 1374 CITY:Hoodsport STATE:wA ZIP:98548 CITY:Hoodsport STATE:WA ZIP:98548 I"PHONE:206.396;707 PHONE:20s 396.7707 CELL: 2"d PHONE: EMAIL :shellyburtts@gmafi.com ENIAIL:Shellyburtis@gmail.com L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number):422103490281 Zoning: LEGAL DESCRIPTION(Abbrevi ated):LOT:A OF SP#1697 PTN TR 28 SE SW SURVEY 31/40 SITE ADDRESS:10 N Broken Arrow Or Hoodsport,WA 98548 CITY: DIRECTIONS TO SITE ADDRESS: Hwy 101 North, Left at N Lake Cushman Rd ( SR 119), Go 2 miles, Right on N Broken Arrow Dr. TYPE OF JOB: NEW 0 ADD=ALT=REPAIR=OTHER=USE OF BUILDING LOCATION OF FIXTURESIUNITS—IsT FLOOR ✓=2NDFLOOR=BASEMENT=GARAGE=OTHERO PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Tvpe of Fixture No. of Fixtures Fees Fuel Type:Electric=✓ LPGQNatural Gas=Ductless= Toilets 2 Type of Unit No.of Units Fees Bathroom Sink 2 Furnace 1 Bath Tubs 1 Heat Pump 1 Showers 2 Spot Vent Fan 3 Water Heater 1 Propane Tank Clothes Washer 1 Ga&OOutlets Kitchen Sinks 1 to4cen Gas/Pellet Stove 1 Dishwasher 1 Exhaust Hood 1 Hose bibs 2 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 Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT r—c— 147 PLANNING DEPARTMENT FIRE MARSHAL Re+ '(?o )EN 1 Name Shelly Burtis �,,u. # 42210-34-90281 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 m.then-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. Acknowled ent of such is by signature below. I declare that I am the owner,owner's Jegal representative,or the contractor.I Furth c wledge that the informa ' rovided is accurate and employees of Mason County are granted access to the above- d Mob view s on as ma quired. Owner/Agent/Contractor(circle one)Date: Page 2 of 2 Name Parcel#42210-34-90281 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'. '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 = 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 I of 2 Z PLN Approved w�l. w- Z�3 01/03/2024 w m Mason County Community Development ' Gavin Scouten o PARCEL#/42 2 1 0349028 1 All Changes Subject to Approval 1 PLN SETBACKS z I j + Front(West):25' a ih Sides:20' I , n Rear:20' i 'all setbacks measured from the farthest I w W — " projection of the building PR P05ED DRIVEWAY 'subject to EH setbacks o I + 7R`+ t PROPO- D 3 Q I i , 11BEDRoo SFR z EH Setbacks l O + A.) Drainfieid/Reserve requires 10'setback from footing/foundations K , U B.)Septic tank(s)requires 5'setback from all footing/foundations $ m I ,53 { M C.)No foundation/Perimeter Drains within 30ft,downgradient of o z j I R \ Drainfield/Reserve area N \ D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within 6 3 No development to occur within I I + S. 50ft,down gradient of Drainfield/Reserve area 50'downgradient of drainfield o _ _ (attenuation zone) I 1 N m —Attenuatio one - ' s° EH APPROVED OG `9 Rhonda Thompson 01/17/2024 I 4� 1645 \ � I \ /sa ` Cv� 650 ShMg41\ SITE PLAN a69"')-a i53o I m=40ft THE PROPERTY LINES IN THI5 MAP ARE APPROXIMATE AND ARE NOT INTENDED TO 13E U5ED A5 5URVEY. C-I c� z � w w - W zLnZ cn z pow i PARCEL #422 103490281 0 0 I � z ` + o� W w : m z z I , w I � � w w w PROP05ED DRI VEWAy 20� C) , PROPO ED 3 Q I BEDROOM 5FR I + mI 53 i � z� 0,0 i ,- - - zo 00 I � J 645 I ` N CO\ \ G 50 Sti \ DRAWN 8Y: \ ` CL4 SITE PLAN \ \ \ ab a�_ b�y �� PROJECT# 161\ 23-235 1 in = 40f \ THE PROPERTY LINES IN TH15 MAP PRINT DATE. ARE APPROXIMATE AND ARE NOT 11'22/2023 INTENDED TO BE USED A5 SURVEY. SHEET: C- I