Loading...
HomeMy WebLinkAboutBLD2017-00333 SFR - BLD Application - 4/21/2017 MASON COUNTY COMMUNITY SERVICES �lC� C�t7l �J 0)0 PERMIT ASSISTANCE CENTER: Permit No: BUILDING•PLANNING•PUBLIC HEALTH.FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 —-' Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone - Belfair.,(360)275-4467•Phone Elma:(360)482-5269 s DlrqG BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: 1 Q fYl 0_ 11M 4 A NAME: S MAILING ADDRESS: VO Box 17.7�( MAILING ADDRESS: CITY: Ally r'i STATE: tv/4 ZIP: CITY: STATE: ZIP: PHONE#I: n b b I` I PHONE: CELL: PHONE#2: EMAIL : EMAIL: PI U M j' 14 .,'e 1 Q 4 e ' L&I REG # EXP. PRIMARY CONTACT: OWNERK CONTRACTOR❑ OTHER NAME_ '�OIM �i(1Mk✓� EMAIL PjtJ/06 Ye v>' l � (�t1 coy-, MAILING ADDRESS P 0 1-7 32 CITY 411,�� STATES_ ZIP PHONE-16Qo-hki;q'z CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Nuinbeie '' aaao " �V 0 O ZONING J'' LEGAL DESCRIPTION(Abbreviated) Ltike grlj V'6 kykt t �TR \�Q FIRE DISTRICT 5 SITE ADDRESS L1 CITY 11 yr� DIRECTIONS TO SITE ADDRESS up hw� 0") k 1C e )44d I l— lie De, a'c 0� � vrn l�e;� On MT R pobpk/�j -S On ?�►� R; ►. -I �' IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOX 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 K ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) ze'J " kt✓1 C e IS USE: PRIMARY SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES (Whole Bldg) X YES (Part[sj of Bldg) ❑ NO ❑ DESCRIBE WORK 11I-Cw CQnS+f )6A)V� SQUARE FOOTAGE: (propose+existing) I ST FLOORo O b O sq.& 2ND FLOOR sq.ft. 3RD FLOOR sq,f}. BASEMENT sq. ft. DECK sq. ft. COVERED DECK sq. ft. STORAGE sq.ft. OTHER sq. It. GARAGE�(�sq. ft. Attached Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAIL, MODEL I WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER❑ / NEW ❑ EXISTING4 PLUMBING IN STRUCTURE? YES D NO ❑ Ifyes, attach completed Water Adequac)h Form PERIMETER&OUNDATION 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 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 OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.00.42) C-7 ig attire of (Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH \\ MASON COUNTY RECEIVED COMMUNITY SERVICES APR 2 4 2017 . / Building,Planning,Environmental Health,Community Health BUILDINGww. Alder street Physical and Mailing Address: 615 W Alder St., Bldg 8, Shelton, WA 98584 Shelton Phone: (360)427-9670 ext 352 + Fax (360)427-7798 -7 ? PLUMBING & MECHANICAL PERMIT APPLICATION Permit#: �/ 4W) / ' OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: ='p,v\ 70\y\nt11n NAME: MAILING ADDRESS: MAILING ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: 1st PHONE: PHONE: CELL: 2nd PHONE: EMAIL : EMAIL: L&I REG# EXP. 1 I PARCEL INFORMATION: -/ 44 PARCEL NUMBER (12 Digit Number): w I Zoning: LEGAL DESCRIPTION (Abbreviated: SITE ADDRESS: CITY: DIRECTIONS TO SITE ADDRESS: TYPE OF JOB/WORK: NEW t/ ADD ALT REPAIR OTHER USE OF BUILDING PLUMBING FIXTURES MECHANICAL UNITS [] Electric in-wall heaters(no fee) Type of Fixture No. of Fixtures Fuel Type Fees Type of Unit No. of Units Fuel Type Fees Toilet(s) Furnace DG/LPG] Bathroom Sink(s) Heat Pump / G/LPG] Bath Tub(s) o Ductless H.P. [E/G/LPG] Shower(s) �_ Spot Vent Fan 3 Water Heater(s) [E/G/LPG] Propane Tank gal.] Clothes Washer(s) r [E/G/LPG] Gas Outlet(s) Kitchen Sink(s) I Heat Stove [E/G/LPG/W] Dishwashers) j Kitchen Exhaust Hood Hose bib(s) I Dryer Vent Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee Final Inspection Fee Final InslDection 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 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 const ction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY MIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X - - � 1-1 � Sign ur of Applicant Daw X I brv'1 --r-k i 1# tuff Ownerr)0wners Representative/Contractor Print Name (Circle one) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS O Building O Fire Marshal O Permit Tech (OTC permit only) Permit number BLD Mechanical Permit Checklist • Name of owner: Name of Installer: • Fuel Type? LPG Nat Gas Electric Other • If propane, what is the proposed size of tank(s)? • What type of mechanical unit will be installed? (i.e.freestanding stove,forced air furnace, etc.) • If the unit is a wood stove,provide: Make Model Year Label Number • What is the use of the structure? (Circle one) Residential Commercial (A permit application for a commercial mechanical permit will be issued upon satisfactory review by staff. Include a floor plan showing the location of unit(s)and layout of duct work with the permit application) • Type of structure: (Circle one) Site Built Home Manufactured Home Other • What room will the mechanical unit be located? • Will the unit be located in a basement?(circle one) Yes No • How will combustion air be supplied to the mechanical unit? (Describe, i.e. direct vent, air inlets, etc.) • How will the mechanical unit be exhausted to the outside? Applies to appliances using gas, oil or wood fuel. (Indicate B-vent, direct vent,L-vent,etc.) • What year was the structure constructed? Was this structure part of a PUD upgrade? • What type of controls will be installed? (i.e. thermostat, etc.) • Will the proposed mechanical unit be a heat source?(circle one) Yes No • Additional information: Signature of Applicant Date Typical mechanical fees: Forced air furnace $ 18.30 Heat pump 18.20 Propane tank 73..00 Gas Outlets 6.20 additional outlets over 1-5 ($1.20 each after 5) Mechanical base fee 28.50 or $ 9.00 if base fee was paid on an active building or mechanical permit Freestanding unit, fireplace,pellet stove or wood stove$73.00 Final Inspection fee 73.00 MASON COUNTY C� Sewer J Water Permit Permit No. 61uv— Date Owner iNwivi— Contractor Job Description Job Location O �/ y + Inspection By Approved for Cover Date Remarks Applicant Must Call Utilities & Waste Management Issued By For Required Inspection 360-427-9670 Ext. 652 Post this card in a conspicuous place at Front of Premises DATE RECEIPT 371767 RECEIVED FROM ADDRE�- f D RS FOR tW 1 L ? ACCOUNT HOW PAID1.1 BEGINNING CASH BALANCE a AMOUNT PAID J g BALANCE MONEY DUE ORDER ©2001 REDIFORM® 51657N-CL APPLICATION FOR SEWER UTILITY SERVICE � HAD MASON COUNTY UTILITIES & WASTE MANAGEMENT - 1=00 W PUBLIC WORKS DRIVE- SHELTON, WASHINGTON 98584 (360) 427-9670 ext 207, 283, 566 DATE MM I PARCEL# SITE ADDRES S i� "U� � qMW BILLING ADDRESS RIAX [M ANTICIPATED DATE FOR. SERVICE TO BEGIN I -agree to-the terms and conditions of the Mason County Codes and/or ->: Resolutions. (Copy available upon r quest.) _ SIGNATURE A COPY OF CONSTRUCTION SITE PLAN MUST ACCOMPANY THIS APPLICATION. ) � J1 "` ------------------------------------------- ! �r�.0 ----- ,-- ------------------------------ FOR OFFICE USE: F' "�✓, �'`�C� � Connect Fee„T3 W Dat !- Grinder Pum 1 J4 Date Receipt# Vacant Lot Fee Effective TOT— Monthly Sewer Rate Effective Building Permit# Date Issued Date Final Name OM I Sho,,Jh Parcel# 1,2 9o� — S4 u 0/40 BLD# JJ�� 17 "— �3-3� Mason County s U11 Department of Community Development ma a c Pormwater 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 surface2. '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 Buildings X = 3JC L X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways X © _ 700 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 Q) X IQ C) 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) Vq 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- described property for review and inspection as may be required. X Owner/Agent/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 ] of 2 Name_ �'1 �L��/ f � Parcel#T � J�%"_L�U BLD# �1 7-'Q�� Mason County BUILDING Department of Community Development Small Parcel Stormwater Management Application/ vorksheet (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: hgR//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 the r 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 450 100 W. Public Works Dr 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 400 415 N.6th St—Bldg#8 lower level 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 rope iew and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 RECEIVED APR 21 2017 615 W.Alder street ALLYN UGA RAP SIDE YARD SETBACK 5' + A Z'FOOT ROOF EVE OVERHANG IS ALLOWED IN SETBACK J ENVIRONMENTAL VSl v� HE ALTH JC 0 -� Poi r^ 0 rn ' N � 00 o > z3 i v, r C m > D am' ic oNrnz p BLD2017-00333 n 0 !Z. o nC� �O A s RECEIVED APR 21 2017 815 W.Alder Stet IV©4 T9 4 ^� ALLYN UGA R-iP SIDE YARD SETBACK 5' + .A 2'FOOT ROOF EVE OVERHANG IS ALLOWED IN SETBACK /1y i PLANDIUNG �v C\ .>, r i APPROVED MASON COUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE C PNGES SUBJECT TO APP V L PLANNING: Bye Date ALL SETBACK ARE MEASURED FROM T E FURTHEST ' PROJECT IL t 0 - m Ncn0O q N D C $ � m D Q1eZ3 CD •' mz 0 Y .... _ X BLD2017-00333