The URL can be used to link to this page

Home My WebLink AboutBLD2021-01428 SFR - BLD Application - 7/19/2021 1 MASON COUNTY COMMUNITY SERVICES Permit No: ILA ZZ PERMIT ASSISTANCE CENTER: RECEIVED •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(3W)4279670 ext.352•Fax.(360)427-7798 Phone Belfatr.(360)275-4467•Phone Enna(360)482-5269 ,U I_ 19 2021 BUILDING PERMIT APPLICATION 'M PROPERTY OWNER INFORMATION: CONTRACTOR EWORMATTON: e r Street NAME: LC Ir7Y G i NAME: , 1?p e it'I Q 14-��IN1eS MAILIN AD SS: MAIL G�ib SS: 0s0 CITY: YIF�W�VI'�7s - : ZIP: CTI'Y:�enr11i STATE: 4 ZIP:PHONE#1: __ - o ff/ PHONE _ CELL- PHONE#2: EMAIL:_I EMAIL: L&I REG f P. //b/ , �11m' PRIMA V CONTACTc OWNER CONTRACTOR❑ HER ` NAME QU CP W14 EMAI 5 r , I,I<30 ra- MAILINGADDRESS CITY t STATE Z]P <" PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Numbcr) ZONING LEGAL DESCRIPTTO (Abbrcviaterl) _FIRE DISTRICT SITE ADDRESS �G0 O U/) CITY r) DIRECTIONS TO SITE ADDRESS D 0 e• SL.-zE�A(,� IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO NOW LOAD:P psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkal/thatapp/y): SALTWATER❑ LAKE❑ RWER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW ADDITION❑ AL ERATION❑ REPA,IR`El OTHER [IUSE OF STRUCTURE(Reddence Garage.CommevialBldg,Etc)_ G > C�.SICJL�IIC P IS USE: PRIMARY R'-'� EASONAL❑ NUMBER OF BEDROOMS_NUMBER OF BATHROOMS HEATED STRUCTURE? YES(WhJoleBldgl�YES(—isj of tdi❑ O❑ DESCRIBE WORK & t ll•"I �L-L7 ( ib�'I1� Ne p�j Y 1 lk( ! tj�p SQUARE FOOTAGE:(prop—d) 1ST FLOOR iQ�P sq.ft. 2ND FLOOR sq,ft. 3RD FLOOR ,sq_fi BASEMENT sq.ft. DECK sq.R COVERED DECK sq.R STORAGE sq.ft. OTHER sq.& GARAGE _sq.ft. Attached❑ Detached❑ CARPORT sq.& Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: t �*4 COPIES OF THE FLOOR PLAN REQUIRED- MAKE fr��j^G� � � MODEL CC[` r ,� YEAR W) LENGTH 69 WIDTH ✓lJ BEDROOMS_ BATHS SERIAL NUMBERC'�R '�l� ENVIRONMENTAL HEALTH; SEWAGE/SF,WERSOURCE: SEPTIC[" SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES g-' NO❑ Ujy ,attach completed Water Adequacy Form PERiMETER/FOUNDATION�iDRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT. EXISTING BEDROOMS (T PROPOSED BEDROOMS _ TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate information may result in a stop work older 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.1 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 authorized work or auorized 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 F 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) XQ V`Lb'�f 1 nature of OWNER Mus signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED.. DATE DENIED DATE, TAGSINOTES/CONDITIONS BUILDTNG DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Name Mason County `� artment of Community Development 2021 Sm r Stormwater Management Application/Worksheet ( a e 2 of 2) _ t 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: http//www.co.mason.wa—us/codelcommissioners/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 fatal 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 property for redew and inspection as may be required. X M Owner/Agent/Contractor(circle one)Date_ 1 / —1-4- -� Page 2 of 2 Namc M CO 1 I Parcel# SLD# 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 surf ace2. '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 CRICUIIio/mpervioUs:SUr&CGS Please Complete This Uble Surface Type Length X Width = Area *All dimensions in feet Buildings (G X = D 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 = tf the total impervious a ea of the p"o'sed site X = developmmnt is greater than 1 sgttaite feet a Total 1 Ramat Storn*Mer-Site Plan is Required rrapeniious Surface Aroma(sum+nf®II areas} 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- desc pro for re ' inspection as may be required. X ( Owne �,endContractor(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 I of 2 RECEIVED JUL 19 2021 � PLANNING 615 W. Alder Street -bid 202.1- 61 L4 2-a by � WIAI>V2202 I - PLANN ING: MEASURED ALL SETBACKS ARE (V�. � FROM THE FURTHEST PROJECTION OF THE BUILDING L Io'AI&A now l _ z APPROVEDr MA�O�COUNTY DCD PLAMNING a�TE►(.AMft4VW&D T O BE ON SITE -- s�— sUd,iET TO APPROVAL �