HomeMy WebLinkAboutBLD2019-01091 SFR - BLD Application - 9/24/2019 MASON COUNTY COMMUNITY SERVICES Permit No C7I�
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PPBLIC HEALTH•FIRE MARSHAL
615W.Alder y 98584 RECEIVED
Phone Shelton:(360)427-9670 ext. ) 7�Phone
Beltair.(360)275-4467•Phone Elma: ) SEP 2 4 2019
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Cedarland Homes LLC NAME: J&J Development LLC
MAILING ADDRESS: PO Box 2264 L&I REG#JJDEVJD8520W EXP. 12 /6 / 19
CITY:Gig Harbor STATE:WA ZIP: 98335
PHONE#1: 253-208-8136
PHONE#2:
EMAIL: infoncedarlandforestresources.com
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER❑
NAME Joe Cedarland EMAIL info(@cedarlandforestresources.com
MAILING ADDRESS: Same as above CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 12218-50-00044 ZONING:
LEGAL DESCRIPTION(Abbreviated) Lakland Village 912 Phase II Lot 44 FIRE DISTRICT
SITE ADDRESS 610 E Soderberg Rd CITY: Allyn
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%:YES[]NO ❑
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cluck all that apply):
SALTWATER❑LAKE ❑RIVER/CREEK❑POND ❑WETLAND ❑SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEWA ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)Residence
IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg) ❑ YES (Part[4 of Bldg) ❑ NO ❑
DESCRIBE WORK New Construction-2270 sq ft SFR
SQUARE FOOTAGE: (prnpase+existing)
1ST FLOOR 2270 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.
ft.DECK Sq.ft. COVERED DECK 440 sq.ft. STORAGE sq.ft. OTHER sq. ft.
GARAGE 840 sq.ft. Attached Detached❑ CARPORT sq. ft Attached❑Detached❑
MANUFA TURFD HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
F_,MJUMMENTAL,HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER) / NEW EXISTING❑
PLUMBING IN STRUCTURE? YES NO❑ If yes,attach completed Water Adequacy Form
PERIi' iETER/FOM-iDATtON DRAINS FROPOSE"L? YES ❑ NO❑ EXISTING SQ.F`.
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 permitiapplication becomes null&void if work or authorized construction is riat carnmenci3d within 160
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
COUNTY CODE 14.08.42)
X
nature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
RECEIVED
SEP 2 4 2019
615 W. Alder Street
PLUMBING & MECHANICAL PERMIT APPLICATB$Ji . 1
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Cedarland Homes LLC NAME: J&J Development
MAILING ADDRESS: PO Box 2264 MAILING ADDRESS: PO Box 623
CITY: Gig Harbor STATE: WA ZIP: 98335 CITY:Burley STATE:WA ZIP: 98322
1'PHONE: 253-208-8136 PHONE: 253-208-8136 CELL:
2°d PHONE: EMAIL : info(a cedarlandforestresources.com
EMAIL: info(aacedarlandforestresources.com L&I REG# JJDEVJD852OW EXP. 12 /b /19
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): 12218-50-00044 Zoning.
LEGAL DESCRIPTION(Abbreviated): Lakeland Village 12 Phase ii Lot 44
SITE ADDRESS: 610 E Soderberg Rd CITY: Allyn
DIRECTIONS TO SITE ADDRESS:
TYPE OF JOB:
NEW X ADD ALT REPAIR OTHER USE OF BUILDING Residence
AT LOCION OF FIXTURES[UNITS—1 ST FLOOR X 2ND FLOOR BASEMENT GARAGE X OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:ElectFic LPG X Nauwal Gas Ductless_
Toilets 2 Type ofUnit No.of Units Fees
Bathroom Sink 4 Furnace I
Bath Tubs 2 Heat Pump 0
Showers 2 Spot Vent Fan 5
Water Heater I Propane Tank I
Clothes Washer 1 Gas Outlets 3
Kitchen Sinks 1 Wood/Gas/Pellet Stove 1
Dishwasher I Kitchen Exhaust Hood 1
Hose bibs 2 Dryer Veal I
Other Solar Panel 0
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
'irAeFWregan*ng'%is,pPcqe0t.The owryeror authorized agent 3represents that the information provided is accurate and grants employees of
Mason Oorrnty a=ess-to the above described property and structure(s)for review and inspection.This permit/appheation becomes nufl&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 18D days.PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APP ATION. p�
ignature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED BATE 'RAGS/NfYl ES/CON1F3MONS
BUILDING DEPARTMENT ( C. 1Z-1(10
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN
I6\EOM -0�0"Ai
RECEIVED
SFP2 4 2019
: '� . 0 5
615 W• P Stet
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PLA KING :
ALL !'FTBAC .sRE MEASURED
T i E FURTHEST EA VE LINE
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AWRESS
610:E.SODERB&G RD CEDARtAND HOME'S LLC
Att.A M. SW4 ce 's j `.go CC HAROW. WA 983B
219&-Bf3€r
B SITE PLAN MAP AGATE IAND SURVEYNG, PUC
s �CEDARLAND HOMES LLC
IN THE DRAW BY DAIE,09/22/2019 ,!tlR Na-4134
26237 s�1 A014 NE114 MJ8 XALE. 1 M=30,,- :t OF i
sOh. t 18; Eft, RfikY tit QW0 BY
r SGB RIE No-,P-0L_%
MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
CHAN S SUBJECT TO APPP,OV L
BY Date 330
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/Ventilation Code Compliance Application
Submit with heating/cooling system size worksheet(see instructions #41
Owner: Cedarland Homes LLC Parcel#; 12218-50-00044 Type of {project: New Construction
Total Sq. Ft. 1st Floor : 2"d floor: Heated Basement:
of heated area:: 2270 1
2270
Heating System Type: 0 Electric wall heater O Electric Central Ftx aace ,,LP{G Fumace
O Heat Pump with electric furnace O Heat pump with gas furnace O Ductless Heat Pump
O Boiler, specify fuel type: O Other:
Specify:
Prescriptive Option Table R402.1.1 (see table on previous page)
Compliance Method O Component Performance, R402.1.3 — Calculation worksheets required
Must Check one::
O Other (Specify):
Check one 0 Whole House Ventilation system Whole House Ventilation
Ventilatio using exhaust fans&window or wall In grated with a Forced Air O Other, describe:
fresh air vents (M1507.3.4). If using System (M1507.3.5)
n System window vents be sure to order
windows with vents.
laeferemliig Table R406.2,"Additional Residential Energy Efficiency Requirements,"all residential,units
must develop credits as specified in Table 406.2. Identify and describe which option(s)will be used to
comply. If the table is not attached to this form you can access the table on our website at:
http:iiwww.co.masm.wa.ussforms/Comm&watY Dev/L-cc wsec.pdf
Additional a) Description: Small dwelling units: less than 1,500 sq. feet of heated or cooled floor
area and less than 300 sq. ft fenestration area (skylights, doors, windows,etc).
Energy *Including additions to existing building that are greater than 500 sq. ft. of heated floor
Efficiency Requirem but less than 1,500 sq ft of floor area. Requires 1.5 credits
ents b) Medium dwelling units that are not included in (a) above {small dwelling}, OR (c)below
Energy {large dwelling} Requires 3.5 credits
cmdits
EXCEPT10N: Dwelling units serving R-2 occupancies shall require. Requires 2.5
required: credits. See page two for description.
3.5 c) Large dwelling unit is a dwelling unit that exceeds 5,000 sq. ft. of heated or cooled
floor area. Requires 4.5 credits
d) Additions less than 500 sq feet. Requires .5 credits
(Fenestration is defined in the IECC as skylights, roof windows, vertical windows, opaque
doors, lazed-doors that include products with glass and non-glass glazing materials.
Describe Energy Credit Option(s):
Using Option -Eff Bldg Envelope
number(s): -High Eff HVAC
-Eff Water Heating
1 a, 3a, 5a, 5c
3
"Simple Heating System Size: Washington State
This heatirc system sizing calculator is based on the Prescriotive Reouiremerits of the 2015 WashinGW State Energy Code CWSECk and,
ACCA Manuals J and S.This calculator will calculate heatina loads only.ACCA procedures for sizing cooling systems should be used to
determine cooling loads.
Please M out aN of the green drop-downs and boxes that are appkcabte to your project.As you make selections in the drop-downs for each
section,some values will be calculated for you.If you do not seethe selection you need in the drop-down options,please can the W—SU e�
Energy Extension Program at(360)956-2042 for assistance. 9 a
1
Project Information Contact fnformafion
610 E Soderberg 'Joe Ced-arfand'
Allyn 253-208-8136
Heating System!M: All otter Systems O I A PLMv
To see detailed instructions for each section,place your cursor on the word'Instructions".
Desion Temperature
Instructions rrr�rit`rrr Design Temperature Difference(AT) 47
Shelton AT=Indoor(70 degrees)-Outdoor Design Temp R
Area of Building •�C
Conditioned Floor Area
instructions Conditioned Floor Area(sq ft) ® S&D 2 / O
Average Ceiling Height Conditioned Volume Q 7 201`�Instructions Average Ce7ing Height{ft) 20,430 A
Glazing and Doors U-Factor X Area = UA
Instructions t
u-o.zs 0.280 80.08
Skylights U-Factor X Area = UA
Instructions 0.50 —
Insutation
Attic U-Factor X Area = UA
Instructions R 49 — 0.026 1',827 47.50
Single Rafter or Joist Vaulted Ceilings _ U-Factor X Area
UA
Instructions No Vaulted Ceilings in ties project. L-- �
Above Grade Walls(am r) U-Factor X Area UA
Instructions 0.056 1,944 108.86
R-21 Intermediate
Floors _ U-Factor X Area UA
Instructions 0.025 2,270 56.75
R-38
Below Grade Walls(see Figurer) ,. U-Factor X Area UA
Instructions _ 0.028
No Below Grade Walls in this project.'
Slab'Below Grade, see Fr urea. F-Factor X Length UA
Instructions 0.303
No Slab Below Grade in this project. �
Slab on Grade(see Figure 1) F-Factor X Length UA
Instructions a ---
ENo Slab on Grade in the project
Location of Ducts
Instructions Duct Leakage Coefficient
UrxondtTioned Space 1.10
Sum of UA 293.20
Envelope Heat Load 13,780 Btu!Hour
Figure 1 Sumo/UAXAT
Air Leakage Heat Load 10,370 Btu/Hour
Volume X 0.6 X AT X.018
Above G.aae Building Design Heat Load 24,150 Btu/Hour
- Air Leakage 1 E+reiope Heat Loss
� eLor fiui Building and Duct Heat Load 26,568 Btu!Hour
Ducts in unconditioned space:Sum or Building Heat Loss X 1,10
Duds in conditioned specs:Sum of Building Heat Loss X 1
Maximum Heat Equipment Output 37,192 Btu/Hour
Building and Duct Heat Loss X 1,40 for Forced Air Fumace
awidsig and Duct Hem Loss X 1,25 for Heat Pump
(B9/Ot/19)
Prescriptive Energy Code Compliance for All Climate Zones in Washington
Project Information Contact Information
' 610 E'Soderberg Rd Jae Cedarland
253-208-8136
Allyn
This project will use the requirements of the Prescriptive Path below and incorporate the
the minimum values listed. In addition, based on the size of the structure,the appropriate
number of additional credits are checked as chosen by the permit applicant.
Authorized Representative Date
All Climate Zones
R-Valuea U-Factora
Fenestration U-Factor n/a 0.30
Skylight U-Factor n/a 0.50
Glazed Fenestration SHGCb, n/a n/a
Ceiling, 49, 0.026
Wood Frame Wallq m" 21 int 0.056
Mass Wall R-Value' 21/21b 0.056
Floor 309 0.029
Below Grade Wall°m 10/15/21 int+TB 0.042
Slab R-Value& Depth 10, 2 ft n/a
*Table R402.1.1 and Table R402.1.3 Footnotes included on Page 2.
Each dwelling unit in a residential building shall comply with sufficient options from Table R406.2 so as to achieve the
following minimum number of credits:
1. Small Dwelling Unit: 1.5 credits
Q Dwelling units less than 1500 square feet in conditioned floor area with less than 300 square feet of fenestration area.
Additions to existing building that are greater than 500 square feet of heated floor area but less than 1500 square feet.
�. Medium Dwelling Unit: 3.5 credits
All dwelling units that are not included in#1 or#3.Exception: Dwelling units serving R-2 occupancies shall require 2.5
credits.
103. Large Dwelling Unit: 4.5 credits
Dwelling units exceeding 5000 square feet of conditioned floor area.
Additions less than 500 square feet: .5 credits
Table R406.2 Summary
Option Description Credit(s)
1a Efficient Building Envelope I 0.5 0.5
1 b Efficient Building Envelope 1 b 1.0
1c Efficient Building Envelope 1c 2.0
1d Efficient Building Envelope 1d 0.5
2a r Leakage Control and Efficient Ventilation 2a 0.5
Ai
2b Air Leakage Control and Efficient Ventilation 2b 1.0
2c Air Leakage Control and Efficient Ventilation 2c 1.5
3a High Efficiency HVAC 3a 1 0 1.0
3b High Efficiency HVAC 3b 1.0
3c High Efficiency HVAC 3c 1.5
3d High Efficiency HVAC 3d 1.0
4 High Efficiency HVAC Distribution System 1.0
5a Efficient Water Heating 5a 0.5 0.5
5b Efficient Water Heating 5b 1.0
5c Efficient Water Heating 5c 1.5 1.5
5d Efficient Water Heating 5d 0.5
6 Renewable Electric Energy 0.5 1200 kwh 0.0
Total Credits 3.50
*Please refer to Table R406.2 for complete option descriptions
Table R402.1.1 Footnotes
For SI: 1 foot .= 304.8 mm, ci .=continuous insulation, int .= intermediate framing.
R-values are minimums. U-factors and SHGC are maximums. When insulation is installed in a cavity which is less
than the label or design thickness of the insulation,the compressed R-value of the insulation from Appendix Table
A101.4 shall not be less than the R-value specified in the table.
b The fenestration U-factor column excludes skylights.The SHGC column applies to all glazed fenestration.
"10/15/21.+T$"means R-10 continuousinsuiation an the extemior of the wail,or R-15 on the continuous insulation
on the interior of the wall,or R-21 cavity insulation plus a thermal break between the slab and the basement wall at
the interior of the basement wall. "10/15/21.+TB" shall be permitted to be met with R-13 cavity insulation on the
interior oof the abasement wall plus R-5 continuous insulation on the interior or exterior of the wall."10/13"means R-
10 continuous insulation on the interior or exterior of the home or R-13 cavity insulation at the interior of the
basement wall. "TB" means thermal break between floor slab and basement wall.
d R-10 continuous insulation is required under heated slab on grade floors. See R402.2.9.1.
e There are no SHGC requirements in the Marine Zone.
f Reserved.
B Reserved.
h Reserved.
' The second R-value applies when more than half the insulation is on the interior of the mass wall.
d;Reserved.
k For single rafter-or joist-vaulted ceilings,the insulation may be reduced to R-38.
' Reserved.
m Int. (intermediate framing) denotes standard framing 16 inches on center with headers insulated with a minimum
of R-10 insulation.
Table R402.1.3 Footnote
a Nonfenestration U-factors shall be obtained from measurement, calculation or an approved source or as specified
in Section R402.1.3.
J
Window,Skylight and Door Schedule
�'roed m{onnabon Coi +Iron
610E Soderbe .Joe Cedariand
Allyn 253-208-8136
i (
Width Height
Ref U-`actor Of Feet loch Feet °`'h Area UA
Exempt Swinging Door(24 sq.ft.max �� 0.0 0.00
Exempt Glazed Fenestration(15 sq fl max i L_�_-_3 0.0 0.00
Vertical Fenestration(Windows and doors)
Component Math Height
Description Ref. U-factor Ot Feet °c° Feet'"`�' Area UA
FRONT ELEVATION i 0. 0.00
1028-� 2 6 ' 4' 48.0 13.44
0.28 2 1 1 15,
10.0 2.80
0.28 1 3 6 e' 20.0 5.60
0.0 0.00
RIGHT SIDE ELEVATION 1 0.0 0.00
0.28 2 5 4 40.0 11.20
1 0.0 0.00
REAR ELEVATION 0.0 0.00
1028 1 5 j 4 20.0 5.60
-- 0.28 1 1 6 14 24.0 6.72
0.28 1 1 3 6 20.0 5.60
0.28 1 4 3 14.0 3.g2
0.2R 1 6 6 A 40.0 11.20
0.28 6 5 30.0 8.40
i 0. 0.00
i.EFT SIDE ELEVATION 0.0 0.00
028 ! �2 2 I 5. 20.0 5.60
0.0 0.00
0.0 0.00
-� 0.0 0.00
0. 0,00
I 0. 0.00
M00.00
"
9 0. 0.00
t 0.0 0.00
r--- 0.0 0.00 -
-��- 0.0 0.00
0.0 0.00
0. 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
1 0. 0.00
Sum of Vertical Fenestration Area and UA 1 286.01 80.08
Vertical Fenestration Area Weighted U=UA/Area 0.2
Overhead Glazing(Skylights)
Component Width Height
Description Ref. Qt. Feet Feet hd Area UA
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
Sum of Overhead Glazing Area and UA 1 0. 0.00
Overhead Glazing Area Weighted U=UA/Area 0.
Total Sum of Fenestration Area and UA (for heating system sizing calculations) 1 286.01 80.08
Name Cedar1and Homes LLC Parcel# 1221&-50-00044 BLD#
Mason County
Department of Community Development h
Small Parcel Stormwater Management A lication/Worksheet t!o
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,tie creation or addition of impervious surfaces,stmetwal development
including construction,installation or expansion of a tbmid'ing 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 62 X 58 = 3596
X = Measurements for buildings are taken at the
perimeter of the farthest projections (example:
X = eaves/gutters)
X =
Driveways 45 X 20 = 900
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 =
Pati+os/Wailks 24 X 12 = 238
32 X 8 = 256 Any paved, gravel or packed area per definition
above table
X =
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) 5040
If the Total Impervious Surface Area is LESS THAN 2000 Sguare 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 Sguare Feet, please read, acknowledge and sign
the information provided on page 2 of 2.
Page I of 2
Name .Cedarland Homes LLC Parcel#12 2 1 9-50-OOW BLD##
if
Mason County
Department-of Community, Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
)BasedUpon 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 websste:
httn//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14, Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section I4.49.70). 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 ADM 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) X 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 mkd/or professional:design will be submitted to the Department of Public Works for approval ARID 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 61h S4 Shelton WA.98584
if this development has,or will have,a septic/drainfield system you may need to contact Mason Country 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,propet ty fior review inspection as may b qu.ired.
X01Owner/Agent/Contractor(circle one)Date:
Page 2 of 2