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HomeMy WebLinkAboutBLD2018-00703 SFR - BLD Application - 7/3/2013 MASON COUNTY COMMUNITY SERVICES Permit No: �&klb-070 3 PERMIT ASSISTANCE CENTER: if •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 PhoneCO Belfalr(360)275-4467•Phone Elma:(360)482-5269 (J 02 BUILDING PERMIT APPLICATION e1s � PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: er,Qa NAME: L,A)D PF CRAMze j 1 M NAME: ) A 136A M`A00 C !"Set MAILING ADDRESS: MAILING AD RESS: j6-,'L i E', t'ZS S i.b:%Vv CITY: STA LA CITY:C-AC-flAt2C aSTATEN,&4A,ZIP: PHONE#1: HS-►{ - 7 PHONE: CELL: -�44 PHONE#2: EMAIL:0 �;.iA Alta Q eC4kC &- e - EMAIL: L&I REG#r' GAWC.*(K eg- EXP. PRIMARY CONTACT: OWNER❑ CONTRACTOR OTHER NAME ' 4 j XjA, 6' �C� EMAIL �j A L-: Ca MAILING ADDRESS CITY C�,G' Iwif�TATE. N)j^ ZIP PHONE CELL 1�4*k` PARCEL INFORMATION: 4uuko//Vo PARCEL NUMBER(12 Digit Number) 1' 7 C Sd 0GZ� K J _ZONING ,�, . LEGAL DESCRIPTION(Abbreviated);&=_ i C* Lpe,� i Z) FIRE DISTRICT �-� SITE ADDRESS % 6 k F— 'LNk e-L AGSr DIL CITY t44-f 4 U , t.v' . DIRECTIONS TO SITE ADDRESS [:!'t Q r% iii !I VN Ri1.N{ iw� rVizN c 1.3 t.A�ec , D2 I ej�- CrJ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOR 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 E ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Eic.. S Z IS USE: PRIMARY It SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_ HEATED STRUCTURE? YES(WholeBldg)l YES(Parr[s]ojBldg)❑ NO❑ DESCRIBE WORK L-�i✓ to n C±S fCr Cel- " L`C OQ SOUARE FOOTAGE:(propose+existing) I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGELAjG;'—sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Anached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: ,}CAA* Aof I I CCL4 0 9<41J?P- CL SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES■ NO❑ Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS 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 permitlapplication 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 P MIT PLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X Si nature of OWNER( Ust be signed by the OWNER IDate DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT g-S'tfj PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: 20IS '"d6703 PERMIT ASSISTANCE CENTER: •BUILDING •PLANNING •FIRE MARSHAL R�� 615 W.Alder St-Shelton, WA 98584 C:/V www.co.mason.wa.us �D Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 Jtlt 0 Phone Belfair. (360)275-4467• Phone Elma:(360)482-5269 6 3 2018 B ING & MECHANICAL PERMIT APPLICATION 'S�q/der SM OWNER INFORMATION: CONTRACTOR INFORMATION: t NAME: 1_JW'0 R C 1-lriMRrC.id.� NAME: G ai � AaA-feetw CoAST. MAILING ADDRESS: �?n o jjfi c �I l MAILING ADDRESS: i 021� ( �'i4 S ; N LJ CITY: X %4 Q STATE:�A ZIP: CITY:64(r STATE:'Vr'Jt, ZIP: q 8 Q Is'PHONE: qqS- LAg2-0 PHONE:2q�1-elgq CELL2$_3c-(tQA0Lt b 2°d PHONE: EMAIL :I,%pa-5ir— -WSL AmIgz. W�� EMAIL: L&I REG#•Q I(,tfC EXP.JZ)?W_JJ ( PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): i Z22c7 �� 0���., Zoning: LEGAL DESCRIPTION (Abbreviated): 1 ZS OF I p4 eA.A:tsJQ t,I I LC N<7 l SITE ADDRESS: CITY: DIRECTIONS TO SITE ADDRESS: t \)S� y 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 ;C LPG Natural Gas Ductless_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs 2 Heat Pump Showers Z Spot Vent Fan Water Heater 1 Propane Tank —� Clothes Washer 1 Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher \ Kitchen Exhaust Hood �— Hose bibs 'L Dryer Vent 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 WIL INVALIDATE THE APPL CATION. X I[� 9fgrrature of owner DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN LA ti --- t-G of--- j��:t . Lf\v� pl c L--K� N UJ, � �s `�; t�d�� �-- ��l�s 2420 sn RECEIVED JUL 0 3 2013 615 W.Alder Street 0 PLANNING z.Z Lu Q �J Q W F- 0 � W a. a` a. -5 W u c� - V z w 7 . Zaz 0 Lu n� s I C m� --Cf�, L E ALL SETBACKS ARE MEASURED FROM THE FURTHEST PROJECTION OF THE BUILDING 02 t-ZT t2G r;r= 1 f,V,I L Fi ut L L,4- F— N©, k cli ��C�Ll C0\25 VO LUPIN'E e 0E- F.7!-4N A , Pilfer: RECEIVED JUL 0 3 2018 o 615 W.Alder Street 0 I a � ENVIRONMENTAL H HEALTH PPROVE JUL 3 0 2018 MASON COUNTY ENVIRONMENTAL HEALT i C L--..N Vz NNam •� Parcel# t Z,Z Zo —,"�O—CO 12.S BLD# ZO'g '-ao 76 3 Rd I V F—L--� Mason County JUL 0 3 ?n'4 Department of Community Development BV014DIt, Small Parcel Stormwater Management Application/Worksheet (page 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 X Buildings X = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways I X Z = Ecc) 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 � �—G U X � � = d 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) 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- descri ed property for review and inspecti as may be required. t X Owner/Agen(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 I of 2 l 10 Name L11,.1%) Ll k�Parcel# k 2Z2W S a 0 6(25 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: http//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- described property for review and inspection as may be required. X Owner/Age Contracto circle one)Date: Page 2 of 2