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Home My WebLink AboutBLD2019-00801 Addition - BLD Application - 6/23/2019 MASON COUNTY COMMUNITY SERVICES PERMIT ASSISTANCE CENTER: Permit No: •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 185 4 JUN 2 3 2019 Belfair. (360)275-4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION615 W. Alder Street P + OWNER INFORMATION: CONTRACTOR INFORMATION: NAME t NAME: MAILING ADDRESS: n MAILING ADDRESS: CITY: STATE:W ZIP: ! CITY: STATE: ZIP: PHONE#1: - 1-{b`3- a3�. PHONE: CELL: PIIONE#2: EMAIL : EMAIL: L&I REG# EXP. PRIMARY CONTACT: OWNER 10 CONTRACTOR❑ OTHE ❑ NAME EMAI MWI�fL �36110 - a► v� MAILING ADDRESS Ca L R CITY STATaN g' ZIP 1 PHONE ELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) a.� ,, OC _>; i V-) ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRIC SITE ADDRESS z< — CITY DIRECTIONS TO SITE ADDRES 1S THE PROJECT WIT MN 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 ❑ STREAM ❑ TYPE OF WORK: NEW ❑ ADDITION'. A ERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) IS USE: PRIMARY ❑ SEASONAL ❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS HEATED STRUCTURE? YES (Whole Bldg) YES art[s]of Bldg)Iq NO ❑ DESCRIBE WORK ( ,C> � S UA OO TA + (propos +existing) 1ST FL R1�S`7sq ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. ft. DECK COVERED DECK sq.ft. STORAGE sq. ft. OTHER sq. ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq. ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAK MODEL - _ y i _LENGTH IDTII BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ❑ SEW130k NEW ❑ EXISTING ❑ PLUMBING IN STRUCTURE? YES14 NO ❑ Ifyes, attach completed Water Adequacy Forin PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NC�j EXISTING SQ. FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS 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 APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) X Lj_ - 7 ' � / II Sign ure of O NER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED D TE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY RECEIVED COMMUNITY SERVICES Building,Planning,Environmental Health,CommunityHealth JUN 2 3 2019 Physical and Mailing Address: 615WA/derSt., Bldg 8, Shelton, WA 98584 BUILDING 615 W. Alder Street Shelton Phone: (360)427-9670 ext 352 Fax (360)427-7798 PLUMBING & MECHANICAL PERMIT APPLICATION Permit#: 1�ld 2/A - olowI OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: r), �,'r MAILING ADDRESS: "�"\ ) MAILING AD ESS: CITY:_ STATE�ZI CITY: STATE: ZIP: 1St PHONE: S'O\c, -b2--s PHONE: CELL: 2nd PHO o EMAIL: EMAIL: L&I REG# EXP. PARCEL INFORMATION:PARCEL NUMBER (12 Digit Number): qb-Ja —00�_21LP Zoning: LEGAL DESCRIPTION (Abbreviated): SITE ADDRESS: �`�� C ^�� CITY: c DIRECTIONS TO SITE ADDRESS: J TYPE OF JOB/WORK: NEW ADD_ ALT REPAIR OTHER USE OF BUILDING PLUMBING FIXTURES MECHANICAL UNITS [] Electric in-wall heaters(no ee) Type of Fixture No. of Fixtures Fuel Type Fees Type of Unit No. of Units Fuel Type Fees Toilet(s) ( Furnace [E/G/LPG] Bathroom Sink(s) T Heat Pump [E/G/LPG] Bath Tub(s) o Ductless H.P. [E/G/LPG] Shower(s) ` Spot Vent Fan Water Heater(s) T [E/G/LPG] Propane Tank I gal.] Clothes Washer(s) [E/G/LPG] Gas Outlet(s) Kitchen Sink(s) 1 Heat Stove [FJ G/LPG/W] Dishwasher(s) Kitchen Exhaust Hood Hose bib(s) Dryer Vent Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee final Inspection Fee Final Inspection 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 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 com d within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INS ECTI .INACTIVITY O�T IS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE �THE APPLICATION. X 1 / -L�Z�n`� S nature of App- a Date X Owner/Owners Representative/Contractor riot Name (Circle one) DEPARTMENTAL REVIEW APPROVED AT DENIED DATE TAGS/NOTES/CONDITIONS O Building O Fire Marshal 17 O Permit Tech (OTC permit only) Visit us on-line: http://www.co.mason.wa.us/comrrlunitv_dev/ Rev 3/08/2017 LJVIIII I IVIIIVV VLV 545 Summit Lakeshore Road Olympia Wa, 98502 RECEIVED S IT E L A Y O U T Parcel # 12218500043 JUN 2 3 2019 Plat 12 Phase 2 }� 615 W. Alder Street AL L i t5`�aBA PLANNING u LANNING : t5 LL S --TBACKS ARE MEASURED �S A F ROM THE FURTHEST 0i CTION OF THE BUILDING _ r .•' `zJ Sewer 00 3 � � EIIeWc11 PMN •, I I; Q ^Q �_ Tf 49'-0" -0' 1'►" OGO �y-- ,'� Sewer MP ��NQANG 5`�VB� ID 'I Water Line G` r Power 9y 95._0.. a Storm Catch Basin o d e r b e r g R o a d I I I SCALE 1" = 20' North - PJCJJ rvn;- min 20 in 6-6 IWL I 0 Vv«►n Name Parcel# I - 5 `'{ BLD# q- b 1 01 Mason Co L N G RECEIVED Department of Community Development JUN 2 3 2019 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 surface2. '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 = X 11465 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 ar If the Total Impervious Surface Area is (ESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provi d a Stor water Site P n I OT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. owledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I rther cknowledge that the information provided is accurate and employees of Mason County are granted access to the above- d crib property for yew d inspection as may be required. n q 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. Pagel 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: h //www.co.ma on.wa—us/code/commissioners/index.htm Please follow the ' s to "Title 14,Chapter 14.48 Stormwater Management". Regulated activities sh be conducted only after Mason County Public Works approv a stormwater site plan ' (Mason County Code Tit 14 Chapter 14.48 section 14.48.70).You will receive a py of the Public Works document entitled "Managing Storm D inage on Small Lots,The Small Parcel Stormwater ite Plan".This document will assist you in preparing the necessary formation and plans for Public Works to revi and approve. Per Department of Public Works this document wi constitute an approved plan if all oft relevant details* are to be installed in their entirety AND no part of the s rmwater system adversely affec any septic system (see Environmental Health information below). If an alternative s tem is to be used a plan will ed to be submitted to Public Works for approval. A design by a registered professional may a required for more co lex sites. *These details are found in the docume Managing Storm Dr inage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE ST ATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drai ge Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not t adversel ffect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional d ign will be submitte o the Department of Public Works for approval AND the system will be located as not to adversely affect septic systems on this, any other,parcel. If you have further questions pertaining parcel drainage and stormwater nagement Mason County's Public Works Department can provide additional ins ctions,guidance and examples. (Sects 14.48.130)contact Public works at: Phone: 360-427-9670 ext 450 100 W. Public Works Dr Shelton.WA 98584 If this development has,o will have,a septic/drainfield system you may need to conta Mason County Division of Environmental Health t ensure that the stormwater system will not adversely affect the eptic system of this,or any other,parcel. Yo ay also wish to consult with the septic design professional involved wi the project. Mason County Division of vironmental Health can be reached at: Phone: 360-427-9670 ext 400 415 N. 6th St--Bldg#8 lower level 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