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HomeMy WebLinkAboutBLD2022-00838 - BLD Application - 5/26/2022 s MASON COUNTY COMMUNITY SERVICES Pt� 083g PERMIT ASSISTANCE CENTER: , ` •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 MAY 2 6 2022 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone Beltaic(360)275-4467•Phone Elma:(360)482-5269 615 1 C BUILDING PERMIT APPLICATION J W. der Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: b U ®I N NAME: NAME: J C• n _ MAII.IN AD SS: MAILING SS: CITY: S A ZIP-_'&%I CITY: STATE: ZIP: PHONE#1: PHONE: CELL: —1 PHONE 42: EMAIL: SIC EMAIL: L&I REG# PRIMARY CONTACT: OWNER❑ CONTRACTOR H OTHER❑ NAME EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) .3 2.:1. 3;2 c5 O fl O ZONING LEGAL DESCRIPTION(Abbreviated) 2r,9C49 JVS. FIRE DISTWCT SITE ADDRESS n r •e 144 CITY DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO❑ SNOW LOAD:_psf 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❑ ALTERATION ll REPAIR M OTHER ❑ USE OF STRUCTURE(Residence Garage Commercial Bldg,Etc) IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS HEATED STRUCTURE? YES(wholeBldg)jj YES(Pan[,)ofBldg)❑ NO❑ DESCRIBE WORK SQUARE FOOTAGE:(prnpo,ed) `�D 1 IST FLOOR��b1sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.fL BASEMENT sq.ft. DECK Ll C lX sq COVERED DECK i a a sq.ft. STORAGE sq.& OTHER sq.ft. GARAGE 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: SEWAGE/SEWER SOURCE: SEPTIC,® SEWER❑ / NEW❑ EXISTING I PLUMBING IN STRUCTURE? YES f 1 NO❑ If yes,attach completed Water Adequacy Form PERIM[ETER/FOUNDATION DRAINS PROPOSED? YES❑ NO® EXISTING SQ.FT. EXISTING BEDROOMS 1_ PROPOSED BEDROOMS 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 peril 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 8 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 APPLICATI OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X � b G �- Signature (M of OWNER ust be signed by the OWNER) Dat DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: 2 60836 PERMIT ASSISTANCE CENTER: R E C E N E •BUILDING •PLANNING •FIRE MARSHAL 615 W. Alder St- Shelton, WA 98584 1 6 2022 www.co.mason.wa.us Phone Shelton: (360)427-9670 ext. 352• Fax: (360)427-77Qa,5 W. Alder Street Phone Belfair:(360)275-4467• Phone Elma: (360)482-526 PLUMBING & MECHANICAL PERMIT APPLICATIOIB U I L®i N G OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: 1 1 _ NAME: MAILI RESS: 0 MAILING ADDRES $e lob a CITY:� I P 4 ov) STATE: J A ZIP: q2%4 CITY: S TATE: tA ZIP: S Is'PHONE:- -ibU)C 0-,)q2W PHONE. CELL: 3&D- 4;5,. -aal6 2"d PHONE: EMAIL : 4 e,c.-y i kc, IIQ,2® Chic lad�'I• 'yrt EMAIL: L&I REG#e p V e Ag a 3�. EXP I�� 2 PARCEL INFORMATION: PARCEL NUMBER (12 Digit Number): -3a 3 a S O /OS O Zoning: LEGAL DESCRIPTION (Abbreviated): 1 SITE ADDRESS: CITY. DIRECTIONS� T ITE ADDRE �S/ d � -�0-4 4'3JI (Q�t-93 �g (IT aJ -4-=ate TYPE OF JOB: NEW=ADD=ALT=REPAIR®OTHERE=J USE OF BUILDING LOCATION OF FIXTURES/UNITS— 1 ST FLOOR[ 2ND FLOG BASEMENT[:Z:]GARAGED OTHER= PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric=PC>ESE]Natural GasODuctless0 (Toilets 3 Type of Unit No.of Units Fees Bathroom Sink 3 Furnace Bath Tubs / Heat Pump Showers Spot Vent Fan Water Heater / Propane Tank •Clothes Washer Gas Ou s Kitchen Sinks Wood/ as ellet Stove 1 Dishwasher Kitchen xhaust Hood 1 Hose bibs Dryer Vent f 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 T E APPLICATION. X / 1,/i a Signature of Owner ate DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN iCx "'r �,r _ �riv'e IJ�.�� _. _ • i �i 3' pp '1 1 as 1 ©rre Pot(P F,:? 1 j , 1 (\1Y1 EH APPROVED f LD+ <FL a--r, Rhonda Thompson 08,19 2022 EH Setbacks A.) Drainfield/Reserve requires 10'setback from footing/foundations B.)Septic tank(s)requires 5'setback from all footing/foundations C.)No foundatiorVPerimeter Drains within 30f1,downgradient of Drainfield/Reserve area D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within 50ft,down gradient of Drainfield!Reserve area ' Name �1 n);� _ Parcel#�?j�a�j�,`��� f��[�3 BLD# ft Pd6aa_00B3 �± Mason County RECEIVED B u I L r&nt of Community Development INiAY 7 6 2022 Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)_4 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 y8 X = X = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways 0 X I G = VR0 X = Length of drive begins at the right of way X = Parking Areas lco X 3 b = 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) a 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 Storm water 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- de ri a pro erty for rev' and inspection as may be required. y Owner/Agent/ ontractor circle one)Date:,Vy/a7©Z� If he Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read, acknowledge and sign e information provided on page 2 of 2. Page 1 of 2 Name CZ/ 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: hqp//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 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- describe roperty for revie and inspection as may be required. X Owner/Agen Contractor circle one)Date: Pa 2 of 2