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HomeMy WebLinkAboutBLD2013-00399 Addition - BLD Permit / Conditions - 7/24/2013 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 279 Shelton, WA 98584 it RESIDENTIAL BUILDING PERMIT BLD2013-00399 OWNER: DIANA HOLMLUND RECEIVED: 5/31/2013 CONTRACTOR: HARPER FAMILY HOMES 360-394-2211 LICENSE: HARPEFH953N6 EXP: 9/15/2013 ISSUED: 7/24/2013 SITE ADDRESS: 800 E LAKESHORE DR ALLYN EXPIRES: 1/24/2014 PARCEL NUMBER: 122195000003 LEGAL DESCRIPTION: LAKELAND VILLAGE 7 LOTS: 3 &4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: ADDITION TO SFR ST RT 3 TO ALLYN, L ON LAKELAND DR, FOLLOW TO LAKESHORE DR TO SITE ADDRESS ON THE RIGHT SIDE General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: R-3 Lot Size: Deck: Type of Work: ADD Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:168 Valuation: $ 19,067.40 Building Height: 12 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: W Ft. Shoreline: Ft. Water Body: ANDERSON LAKE Rear: E Ft. Slope: Ft. SEPA?: Model: Width: Ft. Side 1: N Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: S 20.0 Ft. Comp. Plan Desig.: Urban Growth Area Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee GMM 5/31/2013 $208.81 S120130000000i Planning Review Fee GMM 5/31/2013 $205.00 S1201300000001 EH Plan Review KKK 5/31/2013 $ 103.00 S620130000000i Building State Fee LDK 6/26/2013 $4.50 S1201300000001 Building Permit Fee LDK 6/26/2013 $321.25 S120130000000i Total $842.56 BLD2013-00399 Please refer to the following pages for conditions of this permit. Page 1 of 5 CASE NOTES FOR BLD2013-00399 CONDITIONS FOR BLD2013-00399 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800- -098 . The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Dep( t pripr to any further inspections being performed or approvals granted. XT 3) Owne t is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 4) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or remov ppr v d documents will result in failure of required building inspections. X 5) All slabs within the heated space shall be insul to a minimum R-10 for at least 24". Monolithic slabs shall be insulated around the perimeter from the top of the slab to the bottom of the footing X 6) TH=FATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL. X � 7) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building,�spa tm nt prior to any further inspections being performed or approvals granted. -o BLD2013-00399 Please refer to the following pages for conditions of this permit. Page 2 of 5 8) Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric or other than electric, Compliance Method: Prescriptive option III, Window(Max U-Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38 advanced or R-49 standard, Vault Insulation R-38, and Slab Insulation R-10. In addition the following credit from Table 9-1 shall be completed: 6 X -s! i� 9) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or installed in or around swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps). Refererr SEC 505. X 10) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufa rer's installation instructions. X IX 11) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/ Reserve requires a 10ft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. No2Lation drains within 30ft, down gradient of drainfield/reserve area. X 12) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 13) Carbon monoxide alarms, listed as complying with UL 2034 shall be installed in accordance with manufacturer specifications and in accordance with IRC Section R315. New an existing dwellings within which fuel-fired appliances are installed, and new dwellings with an attached garage shall be equipped with carbon monoxid larm . Carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms. X 14) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit.'re 0 X BLD2013-00399 Please refer to the following pages for conditions of this permit. Page 3 of 5 15) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 16) Place of str cture must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X 17) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinane regul tion, must be reviewed and approved by Mason County prior to construction. X 18) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspec rshall b made prior to requesting additional inspections. X 19) All property lines shall be clearly identified at the time of foundation inspection. X 20) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mas9 minty o finances and building regulations. X 21) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder, a eve ted action from being taken. No more than one extension may be granted. X 22) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connecto f hing. Install metal connectors approved for contact with the new types of pressure treated material. X 23) Retaining walls needed to support a surchar ch asstructures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X BLD2013-00399 Please refer to the following pages for conditions of this permit. Page 4 of 5 24) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure these structures meet the setback conditions listed. X 25) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv i#ee 21a to ensure these structures are shown and meet the setback conditions listed. X 26) Approve dim nsions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X2f`, 27) The proposed project must be consistent it�pplicable policies and other provisions of the Shoreline Management Act, its rules, and the Mason County Shoreline Master Program.X 28) All construction and demolition debris must be removed from the site after project completion. Pr s os of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X 29) Temporary erosion control measures must be implemented to prevent water quality degradation o cent waters or properties. Silt fencing or straw/ matting must be installed and maintained until upland vegetation has become established. X 30) Prior to final approval, all upland areas disturbed or ne d y construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 31) Must meet North Bay Sewer requirements. X z�/" This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Ma on Cou7tcess to the a ve described property and structure for review and inspection. OWNER OR AGENT: Gig/ DATE: o BLD2013-00399 Please refer to the following pages for conditions of this permit. Page 5 of 5 o CONCRETE MECHANICAL MANUFACTURED HOME .O R Date By r- w Footings I Setbacks Ribbons ?_a Gas Piping V7 r o Interior Date By Interior-Date By Date By C Exterior Date By Exterior-Date By Set-up Z Point Load!Isolated Footings INSULATION Date By � BG 1 SLAB INSULATION Date By Data By FIRE DEPARTMENT z Foundation Walls Floors Date By D Date By Data By DECKS FRAMING Walls Date By Date By Data q-ZC - / By C J PROPANE TANKS PLUMBING vault Date By Date -zz _ By L OTHER Groundwork Attic Type- Date By Date By Date By D.w.)/ / DRYWALL Type- By/ Int.Brace Wall Date By W Date I ' ( Date By v FINAL INSPECTION 0 (n Water Line Fin Separation N CD Date By Date By Date By CD CD m W s Pass or Request Inspect c 5 Type of Insp. Fail Date Date Dane By Comments w v _ J 4 5 - b- -Z L c J 0 o ,n �` s _a o' c _ E CA m ,v 0 Contractors or Tradespeople Printer Friendly Page Page 1 of 1 Generat/Specialty Contractor A business registered as a construction contractor with LEtl to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name HARPER FAMILY HOMES UBI No. 601556272 Phone 3603942211 Status Active Address Po Box 4042 License No. HARPEFH953N6 Suite/Apt. License Type Construction Contractor City Silverdale Effective Date 8/26/2005 State WA Expiration Date 9/15/2013 Zip 98383 Suspend Date County Kitsap Specialty 1 General Business Type Individual Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date HARPER, BRIAN lowner 08/26/2005 Bond Information Bond Bond Company Name Bond Account Numbe Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 INDEM CO DEVELOPERS SURETY 548149C 08/19/2005 Until Cancelled $12,000.0008/26/2005 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date Capitol 7 Specialty Ins CS00311720 08/18/2012 08/18/2013 $1,000,000.0008/17/2012 Corp Capitol 6 Specialty Ins CS00311720 08/18/2011 08/18/2012 $1,000,000.0008/09/2011 Corp CAPITOL 4 SPECIALTY INS CS00311720 08/18/2009 08/18/2011 $1,000,000.0008/13/2010 CORP CAPITOL 3 SPECIALTY INS CS00311720 08/18/2008 08/18/2009 $1,000,000.0008/18/2008 CORP CAPITOL 2 SPECIALTY INS CS00311720 08/18/2006 08/18/2008 $1,000,000.0007/16/2007 CORP Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period Infractions/Citations Information No records found for the previous 6 year period https:Hfortress.wa.gov/lni/bbip/Print.aspx 7/8/2013 . . ,CEIIVET-) R 1 1 ! LD' N &SON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT °Y 3 1202 WSEC/Ventilation Code Compliance Application 197n,fta QT Owner: ANA HOLMLvcv J3 I Parcel#:061,9-5c" Type of project: Aoj2;-n eti Total Sq. Ft. 1" Floor: 2" floor: Heated Basement: of heated area.. 1 a Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace *Heat Pump with electric furnace O Heat pump with gas furnace O Ductless Heat Pump O Boiler, specify fuel type: O Other: Specify: Glazing Compliance 9 Prescriptive Option see reverse side circle one: 1 II II Percentage: Method V Component Performance , Chapter 5— Calculation worksheets required % Check one:: —�- Other (specify): Check one µ Whole House Ventilation system µ Whole House Ventilation µ Other, Ventilation using exhaust fans&window or Integrated with a Forced fir describe: System wall fresh air vents(M1508.4) System (141508.5) Referencing WSEC Section 901, "Additional Residential Energy Efficiency Requirements,"all NEW )residential units must develop 1 credit from Table 9-1. Identify and describe which option(s)will be used ENERGY to comply. If the table is not attached to this form you can access the table on our website at: CREDITS hftr)://www.co.mason.wa.us/forms/Community Dev/index. h . Option: Description: ,, /� I r-�Table 9-1Lo .CYJC /1 Q_ CA UJeL Jl�l'1 � ( h J 1� � &L LL✓J Window & Door Schedule (If needed, ach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Windows: Windows: Total Sq. ft. b 57 S Doors: Doors: Total Sq. Ft Total window and door area &S, ,S Total window& door area /(divided by) total sq. ft of heated area I D U = (O %of glazing MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Permit Assistance Center SHELTON (360)427-9670 BELFAIR (360)275-4467 Elma (360)482-5269 FAx: (360)427-7798 WEB SITE: www.co.mason.wa.us P.O. Box 186, SHELTON 98584 2009 Washington State Energy Code (WSEC) Effective January 1, 2011. Ventilation & Indoor Quality Ventilation code provisions are now located in the 2009 International Residential Code (IRC), 2009 International Mechanical Code (IMC), & 2009 International Building Code The following information will be required for the WSEC and ventilation code plan review: 1. Complete the Washington State Energy Code/Ventilation code application located on the reverse side including information about the project, proposed compliance methods and proposed energy credit(s) listed in Table 9-1attached to this form. All dwelling units are required to develop at least one credit from Table 9-1. 2. Include all windows, skylights, sliding glass doors, french doors and any other door with 50% glass or more on the window and door schedule. Use rough opening dimensions to calculate size. It is always helpful to list the u-factors of windows and doors, if known. If you do not know u-factors, the plan reviewer will assume that all window & door glazing will have the required u-factor of the compliance option. When using the area weighted average methods to comply with prescriptive-path include calculations with submittal documents. 3. Identify the location and fuel type of the heating system, water heater, location of exhaust fans (bathroom, laundry, kitchen, etc.) and R-factor of proposed insulation for walls, floors, ceilings, and slabs on the building plans. Indoor and outdoor lighting shall be high efficacy luminaires that comply with WSEC section 505. To verify compliance, provide lighting information on plans. 4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. WSEC compliance information and code text is also available on the WSU-Energy Program website at: http.-I www.energy.wsu.edu/code/ Prescriptive Requirements 0,' for Group R Occupancy Climate Zone 1, Table 6-1 Glazing Glazing U-factor 12 Wall Wall 6 Area% Vaulted Wall int o ext' Slab Option of Floor Factors oor Vertical Overhead DoorU- Ceiling2 Ceiling3 on Grade Above below Below Floor 5 on grade Grade R-49 or R-21 R-21 1 13% .34 .50 .20 R-38 R-38 int7 TB R-10 R-30 R-10 adv R-49 or R-21 R-21 11* 25% .32 .50 .20 R-38 R-38 int' TB R-10 R-30 R-10 adv R-49 or R-21 R-21 III Unlimited 30 .50 .20 R-38 R-38 int 7 TB R-10 R-30 R-10 adv *Reference Case/Call(360)427-9670 ext. 352 for footnote information. Log&solid timber wall with a min. avg.thickness of 3.5"are exempt from the above grade wall insulation requirements. job ME -a■ ■.n 'if■O[a .•■■.MI•.al■ .Inn .�■ .I,. -• •• ■■a..■■na rn. • �] «n !.( .�r=ac=� «n ran n.■.. • nnr.. 01. iJ-.e.■:n■.r -t..n•,n�'�" ■.i w.■i■. `t �rl:• it ��' r • • •t■t•. ■1 ■- \ •OIatK•,■tt - tt'tt•■ .■•Jn►�..• ■■■n •in.■.■■•i■ ■r nn .n i=«. .m n- .n n •• .u .a ■ .nun � ■■ ■ d■a•.' • C ■ . • •■i n.• • ■__ _a i n -n• ya •� •r=t■ul .••-t ` �. ■•m■.n■n n■w- s. -+nnu.gin an V • (/ MIA .•. -■ . _ "� I = i , I I I, I - /:.,) .■nn x .. .1 .■.t■ ■.... 1 ..■• fir. ARE i•i lull - .�■ 1 ■.n • I all . as n • .e■nu•-n. •rn u. •` n• ■•.. • n to.nnanau �■m�■ a .. .1/ 1 Y C, .1' 71' ! a•.� ..• •.na -.au ■ .i • n �a m" • .n.'° . r.1 • ■-n tca�■ unn u ■..��a •• ■n- ■ .n "n. JI': NA■• ■ u■ u.-as •u �••_ •n • ••c n•••■ .• • ■ . n ■.1 ■ • ��■�. n .rra •. ^m .■�■ �t�[t fin_ u •«• •u ■■■ • .n un_ • • r■ny■ A. r■n n •. a .y m, •• aa• • n ■�..--n mnnrn •r«n ' •• u i••I i• .■ice .i• r:..•: �■ ■n :1 �.■•�.. 'n ■u. • •a c i•• Wlm• ■.• u.. ■ •••• u . .r-a 1 ua .*a• • :`■- t�!..1 n• l• • t ■ .n •.++•na- [a■1 n.t■ I. ^ ■t[. . • 1 � ��■.n Y.■I - •a• �.■. n t.a.., a •m • rtga« -� an�■ ...■.. � • - . .■nm =n a •a- •�■.� n ..■.a u a■n ■ -■r 1 r ■ �a�. n ..ru■..■. ^m {�• •.■man_ ■- "r■ a n un- � • Planner: Grace Allan ebecca _ MASON COUNTY PLANNING INTAKE CHECKLIST Owners Name: ala-Aga ) �nlwLj )ncl Date: 5- 31- 2L13 Project: ILI X I '�,`>Qdj1-fi0 r-�-) Commercial ?: yes no Sit Plan• North Arrow property Dimensions: x Irregular Shape . yes no ,2'"Streets and Driveways shown �Road Frontage Name: LJ4 KE �r E_ — �Q All Existing Structures Shown with setbacks and use. ,2''Identified Surface water(streams,ponds, shoreline.wetlands,natural/historic drainage, defined drainage) ,,En'ropography (slopes) I I k-+ �,O fLa, X_G- ' —�o EAs f' ,,E � inimum Structure Setb2 (direction/setback): F:_W/ &- R:__/-.0- S 1 I') /_ - S2 / Qn ,.e'Utility and Drainage Easements: yes no (if yes enter condition 45022) ther Easements A Accessory Appurtenances: propaXtank Heayump Does site plan show landings at all exits ? ❑ Variance applied for: yes no Parking spaces allotted: yes no County Access Permit Needed (add condition #0010) E x I5-h ,,2r State Access Permit needed (add condition #0020) 'Standard Planning conditions: #5019 and #700 ,a'Are there any impediments (dogs/gates) that may restrict access to your site? yes no If yes, do we need appoin yes no ❑ Is site clearly marked? ddress Name Other NING UGA'S (A IL7I ELFAIR/SHELTON Rural LAND DESIGNATIONS GC PF R-1 R-1P RC 1 RR 2.5 AGRICULTURAL POS FR R-2 R-1R RC 2 RR 5 LTCFL BI GC-CI R-3 RI RC 3 RR 10 IN-HOLDING HC LTA R-5 RT _TRW_ RR 20 TRIBAL T A U -10 RT/RTC RNR Ng1P BP RAC NR Critical Areas: (streams,ponds, shoreline,wetlands&steep slopes) 426 W. CEDAR S i Shoreline Designation: ❑ N/A Urban ❑ Rural ❑ Conservancy ❑ Natural Water Body: r -) C —) SEPA: yes no n Flood Plain: yes no unto Map # Aquifer Recharge: no ur, o vn Map# Tags/Cases RLC/SPI: r)on ('z 6 year Reforestati s Ono Eagle Nest Tag: yes no Other orth Bay Sewer !yes) no e Name HbL.M i_v r-3 a Parcel # i c3od 19 50- OOGO 3 BLD## PLANV i Nf' Mason County Department of Community Development MAY 3 4 fin, 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 Buildin s X = 1. 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 i pervious area of the proposed site X _ development is greater than 2000 square feet a Small Parce Stormwater Site Plan is Required Total Impervious Surface Area(sum fall areas) I�� If the Total Impervious Surface Are is LL HAN 2000 Square Feet, please rea ,acknowledge and sign below. Based Upon the information you have pro ' ormwater Site Plan IS OT re fired for this development activity. Owner/Builder/Agent Acknowledges that submisinacc r e informati may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. r at I am a 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:cam-A7A�t c9 Q t 3 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 ] of 2 Name IlOL-m t_v N t7 Parcel# I01 000CIR 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: httpHwww.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 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/d ra infield 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_ DILL lc��e►� Owner/ gent/Contractor(circle one)Date: oZo1 M a 0/3 Page 2 of 2 MASON COUNTY PERMIT NO. I"2 1 AL,I IDI C G PERMIT APPLICATION I,a n 426 W. Cedar P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 f ✓� On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner_Djtz K�az Hcp_z4 i i. IU LC Company Name Mailing Address 113 n . 7�jx i of i,-_i Mailing Address �.O, ©,< 4e��►Z City A,L--!v State\Nl A Zip Code S R`4 City Si L,; State NV P\_Zip Code Phone 1pO-37a- Other Ph. :3 73, -o,4 i Phone 3t s✓- x3LA-zz i i Other Ph. 3�o-z71-2 zo1 Lien/Title Holder Contractor Reg. # HARPEFJa953ntL. Exp. II1.7!2G.3 E mail address 0@010L t_c�C i C ,c_�>;y E Mail Address 4ARPER- %L: -to i - 0 ' ,rj Drivers Lic.# LM t_DL5T4 R..ii DOB 1'2. - tGtA-3 Drivers Lic.# DOB ;i✓i 13 1 is i,6 i SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System x Name of Water System PARCEL INFORMATION- 12 Digit Parcel No. Fire District Legal Description Lg-, 3-%-i•-t Q i v. 7 LA kc L_a r.�0 V i LL,ac G Site Address (Please include street name,street number and city) 43c;c; z. . :fig- ALI_-�Aj Directions to site Will timber be cut and sold in parcel preparation? Yes/ 1� Is property within 200'of Saltwater Lake +r River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB- New Add ✓ Alt Repair Other PRIMARY RESIDENCE [a SEASONAL ❑ Use of Building 11'_�7-N Describe Work Iti x i/AcL•>--o —ram /D._ No. of Bedrooms_I:.—No. of Bathrooms CA Square Footage- 1 st Floor 150' 2nd Floor 3rd Floor _ Basement — Deck Covered Deck Other Sq. ft. c Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. �� i No. of Bedrooms No. of Bathrooms Type of Heat Purchase Pri $ Replacement Unit? Yes/No Installer Name Certification No. 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 the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date:,;"),MA-I aCGl 3 Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by 1 Date .`� I -Z G 1 DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department ` /3G10k Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbinq & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES