HomeMy WebLinkAboutBLD2009-00010 SFR - BLD Permit / Conditions - 2/2/2009 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 186
Shelton,WA 98584
too
RESIDENTIAL BUILDING PERMIT BLD2009-00010
OWNER: GLENN EKOES RECEIVED: 1/8/2009
CONTRACTOR: DOUBLE DIAMOND CONSTRUCTION 425-508-7422 LICENSE: DOUBLDC016PS EXP: ISSUED: 2/2/2009
SITE ADDRESS: 101 E PINE ST UNION EXPIRES: 2/11/2010
PARCEL NUMBER: 322325220012
LEGAL DESCRIPTION: UNION-GRAYS HARBOR & UCRR ADD PCL 2 OF BLA#07-61 PTN BLK 20
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
New SFR McReavy Rd. to 5th St. to left to Pt. Townsend turn left to top of hill to tee(Pine
Rd) lot is straight ahead and drainfield site is to the right up exsisting driveway.
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 2 Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck:
Type of Work: NEW Fire Dist.: No. of Stories: 2 Occ. Load: Building:1,022
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: N 50.0 Ft. Shoreline: Ft. Water Body:
Rear: S 20.0 Ft. Slope: 15.0 Ft. SEPA?: No i
Model: Width: Ft. Shoreline Desig.:
Side 1: E 5.0 Ft.
Year: Serial No.: Side 2. W 5.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 1/8/2009 $614.09 S22009000
Hosebibs 2 Furnace<100K 1 EH Plan Review KKK 1/8/2009 $41.00 S22009000
Kitchen Sink 1 Gas Outlets 2 Water Adequacy Plan Review KKK 1/8/2009 $41.00 S22009000
Lavatories 2 Propane Tank 1 Planning Review Fee KKK 1/8/2009 $205.00 S22009000
Showers 1 Ventilation Fan 3 Fire Warden Review KKK 1/8/2009 $73.00 S22009000
Water Closets (Toilets) 3 Heat Pump 1 EH Plan Review AMH 1/12/2009 $62.00 S22009000
Water Heaters 1 Dryer Vent 1 Additional Plan Check Fee RTB 1/26/2009 $36.50 522009000
Bath Tubs 1 Building State Fee RTB 1/26/2009 $4.50 S22009000
Clothes Washer 1 Building Permit Fee RTB 1/26/2009 $986.75 S22009000
ADJUST--Plan Check Fee RTB 1/26/2009 $27.30 S22009000
Mechanical Permit Fee RTB 1/26/2009 $85.70 S22009000
Mechanical Base Fee RTB 1/26/2009 $28.50 S22009000
Plumbing Permit Fee RTB 1/26/2009 $103.14 S22009000
Plumbing Base Fee RTB 1/26/2009 $24.70 S22009000
Total $2,333.18
BLD2009-00010 Please referto the following pages for conditions of this permit. 1 of 5
• CASE NOTES FOR
BLD2009-00010
CONDITIONS FOR
BLD2009-00010
1) ApprovMtpeqdimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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2) 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- 098g The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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3) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such roay nec ith a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
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4) Water qua {s t to be degraded to the detriment of the aquatic environment as a result of this project.
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5) Prior to final approval, all upland areas disturbed or new
a by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
6) Temporary erosion control measures must be implemented to prevent water q ion of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established. X
7) Appro�d per imensions and setbacks on submitted site plan. Setbacks are measured m the furthest projection of the structure.
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8) Site is located within an unstable Landslide Hazard Area. Adequate drainage/siltation control/stormwater plan must be submitted for review prior to
development, clearing, grading, or construction on the site. Plan must be approved by Mason County Planning, Building, and Public Works prior to
development. Development should be designed to preserve the natural drainage courses in the area. Surface drainage, including downspouts, shall not
be directed onto or within 50 feet above or onto the face of a Landslide Hazard Area or it's associated buffer. If drainage must be discharged from the top
of a Landslide Hazard Area to below it's toe, it shall be collected above the top and directed to below the toe by tight-line drain and provided with an
energ pat device at the toe.
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BLD2009-00010 Please referto the following pages for conditions of this permit. 2 of 5
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9) The Mason County Resource Lands and Critical Areas Ordinance requires vegetative management of the site. There shall be a minimum disturbance of
trees and vegetation in order to minimize erosion and stabilize Landslide Hazard Areas. Limbing trees for view purposes is preferred over tree removal.
Vegetation rerua
y@1 on the slopes of banks between the ordinary high water mark and the top of the bank shall be minimized due to the potential for
erosion.X
10) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. All
applicable recommendations and specifications shall be applied to the development on this site. Any deviation requires stamped written approval from the
registered design professional responsible for the report/assessment, and may require special inspection by same. Structures and /or land modifications
(grading, cuts, fills, etc.) required in the geotechnical report/assessment, may require a separate permit. The geotechnical report/assessment shall
remaja4* hed to the approved building plans.
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11) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. All
applicable recommendations and specifications shall be applied to the development on this site. Any deviation requires stamped written approval from the
registered design professional responsible for the report/assessment, and may require special inspection by same. Structures and/or land modifications
(grading, cuts, fills, etc.) required in the geotechnical report/assessment, may require a separate permit. The geotechnical report/assessment shall
remain to the approved building plans. As per page 3 of geo report Engineer of record is to witness compaction of footing subgrade.
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12) All other n cessary permits from Mason County, Washington State and/or Federal Agencies that ajeleq ire for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
13) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and 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
Departrr pri to any further inspections being performed or approvals granted.
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14) Owner/Agen s nsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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15) The plan review Qck 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
removal o pr documents will result in failure of required building inspections.
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16) THE FOUND ON SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
17) The"approved"site plan is required to be on-site for inspection purposes. If an inspection is requ d 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
Build zg,P rtment prior to any further inspections being performed or approvals granted.
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BLD2009-00010 Please refer to the following pages for conditions of this permit. 3 of 5
18) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors
(Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab
Insulation R-10.
Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the
underside of44,r, a, p sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation.
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19) A Mason County ormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/age nt/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting 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. By calling for a final inspection of
the building permit the owner/agent/contractoJ,s.a kn edging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
20) Concrete used for basement walls, foundation walls, rior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concre"ork exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
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21) Any changes in��ed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
charged F be collected by the Building Department prior to any further inspections being performed or approvals granted.
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22) 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 revoca
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23) Provisions for su a /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 pro .
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BLD2009-00010 Please referto the following pages for conditions of this permit. 4 of 5
24) Psll changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance o �3ion, must be reviewed and approved by Mason County prior to construction.
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25) CONSTRUCTIQ 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 internatio I codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspecto b e prior to requesting additional inspections.
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26) All property lines shall be clearly identified at the time of foundation inspection. X
27) 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
Masons o inances and building regulations.
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28) 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 periocLnot exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have ted action from being taken. No more than one extension may be granted.
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29) Pressure treat wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
con nectorg,-�n sh\ng. Install metal connectors approved for contact with the new types of pressure treated material.
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30) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure
these stru res the setback conditions listed.
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31) Landings ar�_stai must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approved Si I "to ensure these structures are shown and meet the setback conditions listed.
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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 Mason County access to
the above described property:a�hdd_strcture fQueview in tion.
OWNER OR AGENT: DATE. b 2��
BLD2009-00010 Please referto the following pages for conditions of this permit. 5 of 5
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MASON COUNTY PERMIT NO.
BUILDING PERMIT APPLICATION '�!!Ir_L AJWLtq
426 W. Cedar• P.O. Box 186, Shelton, WA 98584 �� �
Shelton (360) 427-9670• Belfair (360) 275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us '= _5 (_Qr4(ti'1
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner. Company Name fin: EL-C n u A►' c);-,;n CeOJ`>t.
Mailing Address - = PiNe Mailing Address 215 SCLAR lA y
City_ State.A A Zip Code q City4.r-fl %r)r. i,' State h)r.; Zip Code 1�5�52
Phone 2L O ;ES i i l ( Other Ph. Phone`t),. )b'S 7`il_d, Other Ph.
Lien/Title Holder Contractor Reg. #
E mail address E Mail Address ?en7, i5rn a-i ,, C2:;t mac. i < <3
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC/WATER SYSTEM jNFORMATION - Connect to New Se-ptir Existing Septic
Connect to Water System ✓ Name of Water System U C;rJ
Well Water System Name of Water System
PARCEL INFORMATION - 12 Digit Parcel No, '2 Fire District
Legal Description 0-thc',n - 0 6a-,4S Rcx t nc Y l.C&6 Acicli, P<< c,1� 1[3 �0 7 • 6-.1 Pto E)LK
Site Address(Please include street name, street number and city) iC t- P Ft v\,) is)eJ
Directions to site
Will timber be cut and sold in parcel preparation? Yes/
Is property within 200' of Saltwater N6 Lake C River/Creek i1J C- Pond '
Wetland ty U Seasonal Runoff sL(1 Stream U Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o
TYPE OF JOB - New.. Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Describe Work Oe,.i C0 ne_ JrL)CA-1rm
No. of Bedrooms X No. of Bathrooms 2_Square Footage- 1 st Floor bag 2nd Floor
3rd Floor Basement e_ Deck fi Covered Deck a4 9�—Other Sq. ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/No
Installer Name Certification No.
CWNER/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.
PROOrFNn OF RK IS BY MEANS OF A PROGRESS INSPECTION.
X Date'
Owner/O7wne rese ative7 Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by; Date t
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department ( y
Planning Department , 0C CL-
Environmental Health Department rl.
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee lv y1- 3 EH Review Fee
Plumbing& Base Fee 02 IV a 20 Planning Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee S
Violation Fee •Z C Pre-Paid at Submittal
Valuation $ TOTAL FEES
MASON COUNTY PERMIT NO.
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.Cedar•P.O. Box 186, Shelton,WA 98584
Shelton(360)427-9670•Belfair(360)275-4467•Elma(360)482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailing Addres t we Mailing Address
City V State Lk. Zip Code City State Zip Code
Ph R i 1! 1 Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION-Connect to New Septic Existing Septic. Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION- 12 Digit Parcel No 3 29, 3 5 Fire District
Legal Description
Site Address(Please include street name,street number and city)tC - i J6'J(G►v
Directions to site c 7C-
Clc ` E fr r-ii Tip
- ,
Lei -c- _ — tc , Sc� �� )? — �'tf /L( i�/7 C LErT
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% C '
TYPE OF JOB- New V Add Alt Repair Other Use of Building
I.Location of Fixtures/Units- 1 st Floor 21 nd Floor 3 S( Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric_LPG—Natural Gas_Heat Purnp_
Toilets 3 Type of Unit No.of Units Fees
Bathroom Sink Furnace
Bath Tubs �_ Heatpumps
Showers Spot Vent Fan
Water Heater I Propane Tank
Clothes Washer r Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove
Dishwasher KAchen Exhaust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base 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 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 penission 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 Mas n County access to the above described property and structure for review and inspection.
PROOF OF COMINUATION OF WOK IS 70M OF A PROGRESS INSPECTION.
X i Date:
Owner F6wners Representativ�y Contr r (indicate which one)
FOR OFFICIAL USE BEYON THIS POINT
Accepted by ^ anning Pd Ck# Date i •Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Departmept
Occ Group Constr.
Planning Depart 1
Environmental He th Repartment
FEES
Plumbing& Base Fee Site Inspection
Mechanical&Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
RECEIVED
jh': 0 8 2009
-----MASON COUNTY
0
14 � /Z! PLANNING
! ,u t}-.e&- Po re,p
PLANNING:
5' ?� {�ousG ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
67Z'`/yrP '� PROJECTICN OF THE BUILDING
to •
10
. a 0
APPROVED
s* Pe-- MASON COUNTY DCD PLANNING
/ram SITE PLAN FYI ;"tJIRIED TO BE ON SITE
O ff/ CHANGES SUSjET TO APPROVAL
if LOD! sy Date1 �D
); EAaa
Roy C-
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TOPOGRAPHY PROFILE:
Direction: Scale: roval: for office use
Building Permit number: UJ n-� Building: _
Owner/Applicant: ate f 1 'Planning:
Parcel Number: .3Z 2 3 2��2 bG/Z
ap tcation: Env. Health:
` Name -i 1,&A Parcel#
�Ltld-L� &;;a3a- rJa' lmla BLD#
WJ-.7 Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page I 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.
ZCommon 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.
�-
Surface Type Length X Width = Area *All dimensions in feet
Buildings X = 41
X = Measurements for buildings are taken at the
X = perimeter of the farthest projections(example:
eaves/gutters)
X =
—Driveways X = OD
X = Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved, gravel or packed area per definition
—d above table
X =
Patios/Walks X =
X = Any paved, gravel or packed area per definition
X _ above table
Others X =
a
X = If the total:impervious area of the proposed site
X = develo6iient is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area(sum of all'areas) a�9
_..._ �a
If the Total Impervious Surfac rea is LESS THAN 2000 Square Feet, pleas rea , cknowledge and sign below.
Based Upon the information you have r Site P I d 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 1 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-
descri perry for review�and inspection as may be required.
X OUP, wn Agend ontractor(circle one)Date: j� �aq
If the Total Impervio 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:
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/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-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
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