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Home My WebLink AboutBLD2017-00536 SFR - BLD Application - 6/13/2017 MASON COUNTY COMMUNITY SERVICES �� ✓�� erm o:Pit N PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING •FIRE MARSHAL 0n 615 W.Alder St-Shelton,WA 98584 4 c e• Phone Shelton:(360)427-9670 ext.352• Fax:(360)427-7798 Phone / 1xsJ Be/lair.(360)275-4467• Phone Elm:(360)482-5269 UA/ 1 \\\O 'fir BUILDING PERMIT APPLICATION e1s �O�j PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: ej,s NAME: W A` "Z Q 407-I PP NAME: SAM f- AS �- MAILING ADDRESS:_4bl C- of-IMPS[ V11WkMILINGADDRESS: CITY: ViVtoN STATE: WA ZIP: RSSQZ CITY: STATE: ZIP: PHONE#1: PHONE: CELL: PHONE#2: EMAIL: EMAIL: r i1C I L&I REG# :' 'tom;. CONTACT PERSON: OWNERV CONTRACTOR❑ OTHER❑ NAME: SAM S 0%.5 ON WE MAILING ADDRESS: CITY: STATE: ZIP:_ PHONE: CELL: EMAIL: PARCEL INFORMATION: ALL-`N k"GA PARCEL NUMBER(12 Digit Number) I Z2 1-1 e5� 0 O O OOJ ZONING 1.E51pENT A L PtttzTqo LEGAL DESCRIPTION(Abbreviated) ArE I-APJP ViLL.AfaE It12 QI41FIRE DISTRICT 7 SITE ADDRESS l LO Ic STF 9.- ID l''10r CITY ALL>1 J A DIRECTIONS TO SITE ADDRESS yen M SR 3 Tug" L-F-fr T Ow/ HCM�STEAD rvtLN ✓i-%G%4T bIN OLD 9^"" ROAD JROJ (2lC2NT 00 SIT= W"61 DP-' IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOY IS PROPERTY WITHIN 200 FT: (check all that upptw: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW ADDITION ❑ ALTERRpATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) T—F S l o E-#J IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)( YES(Part[s]of Bid ❑ NO❑ DESCRIBE WORK CmW O•IS'r 2 V CT 1 - (Valuation/Project Bid Amount.$ 4� .004 ) SQUARE FOOTAGE: IST FLOOR!�>Asq.ft. 2ND FLOOR N A sq.ft. 3RD FLOOR sq.ft. BASEMENT Pik sq.ft. DECK�,3b sq.ft. COVERED DECK sq.ft. STORAGO: sq.ft. OTHER 1 CS_sq.ft. uyy FLE171 GARAGE\422 sq.ft. Attached)(Detached❑ CARPORT _sq.ft. Attached❑ Detached❑ (V-00 m MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE P I A _MODEL- _____ YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER 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 permittapplication 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) Signat&e of OWNER by the OWNER, Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT Moo PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS Intake: tanner: 4norovcd&Rcadv for Pick-Un_ Visit us on-line: http://www.co.mason.w8.US/COMMunity_dev/ Rv+,112712071eorreni *1854 ' MASON COUNTY COMMUNITY SERVICESj Z��?_QoS 3(0 PERMIT ASSISTANCE CENTER: Permit No:BUILDING •PLANNING •FIRE MARSHAL 615 W. Alder St-Shelton,WA 98584 www.co.mason.wa.us Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 BUILDING-7 Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269 PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Lv A4t` j F- G et pip S NAME: �nE AS Ow Nfi(L MAILING ADDRESS:4(otF- OL`(MPic \J11 MAILING ADDRESS: CITY: V"1011 STATE: W A Zip: 2 CITY: STATE: ZIP: I `PHONE: 3 t<,p -8ci 8 47 4c PHONE: CELL: 2"d PHONE: EMAIL : EMAIL: 5A y,. c . Co;vt L&I REG# EXP. PARCEL INFORMATION: P,IJt-Y•.+ V G A PARCEL NUMBER(12DigitNumber): J2-Z VI S $0 00011 Zoning: ��Stt7EHTA�-- LEGAL DESCRIPTION(Abbreviated): LPai_EL�AND VILL.A(2rF- �12i Q L-o"t SITE ADDRESS: 1 to t= STeAL-I#JCj 02CITY: •ALLyN , K/A DIRECTIONS TO SITE ADDRESS: FRotA S(R3 Tv RN t.F-Ft' a^.1 09- . "TuP-J-J IZtGN T oN OL-D RANeP Rora12, TURN R14MT ®N S-TeXt-tNGr Dp- . TYPE OF JOB: NEW_�ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS- I ST 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 Bathroom Sink A- Furnace Bath Tubs I Heat Pump Showers Z, Spot Vent Fan Water Heater I Propane Tank Clothes Washer 1 Otlets Kitchen Sinks i 5i2eun as/Pellet Stove Dishwasher � Exhaust Hood l Hose bibs Dryer Vent 84-e 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 VALIDATE THE APPLICATION. x � � to � 1f1 Signaturb of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev: 1;2r/,'0t6 1BN Name W Parcel# k Z-L_(—(S3y OOO 1 BLD# 4017-60 53(Q 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 = O X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways 3 X fl = q o C) 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 = 00 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 lmpervipus Surfa6e Area(surr of all aie�s) 0'� 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 T�amcP`f►sue R i P� Parcel# `ZZ 11 `� 9 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 Storm water 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: hap//www.co.mason.wa—us/codc/commissioners/index.htm /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) W( -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- desc bed property for review and inspection as may be required. X V` Owner/ gent/Contractor(circle one)Date: (C to 1 Page 2 of 2 RECEIVED JUN"1-- 3 2017 PLANMNG �15 W.Alder Street t.POVED 127•-6• MASON COUNT Y L : ' '► A.NNI G w.!"rC P1 AN REQUIRED TO BE uj'� : ,TE S SUBJECT TO APPR A Date Z OWNER: 2�•- WAYNE AND JODY ("'R,I.�;.:� ADDRESS: ss•A r ,� 110 E STERLING DR 53 ALLYN, WA rA964 N M1 91" PARCEL NUMBER: 122175300009 F ' ° MIn LAKE LAN D VILLAGE #'j Itoion . o ar CVA 801 - PHASE I LOT: 9 ALL SFTP.Acik t f .,.. M F" Pao; . �dG 0 10 feet 20 fest Scale:1 in=20 feet IF .... ----------------------------------------------- Gripp Re irei if 17! 1' :I1.4, ®wa,» SCALE REV 06101r2017 srt:e'i