HomeMy WebLinkAboutBLD2017-00141 Garage - BLD Permit / Conditions - 4/13/2017 Inspection Line(360)427-7262
�PSoq cot, MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2017-00141
OWNER: FRED BADER RECEIVED: 3/3/2017
CONTRACTOR: LICENSE: EXP: ISSUED: 4/13/2017
SITEADDRESS: 90 E UNION HEIGHTS PL NORTH UNION EXPIRES: 10/13/2017
PARCEL NUMBER: 322327590123
LEGAL DESCRIPTION: TR 12-C OF SURVEY 5/59 TR 4 OF SP#610
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW GARAGE WITH HEATED HOBBY ROOM AND HALF BATH TAKE E BROCKDALE RD TO E McREAVY RD, FOLLOW E McREAVY RD TO
E UNION HEIGHTS PL S IN UNION
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 1 Occ. Group: R3 Lot Size: Deck:
Type of Work: ACC Fire Dist.: 6 No. of Stories: 1 Occ. Load: Building: Garage-Detached 960
Valuation: $ 42,844.80 Building Height: Occ. Status: Seasonal Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W Ft. Shoreline: Ft. Water Body:
Rear: E 5.0 Ft. Slope: Ft. SEPA?: Unkn
Model: Width: Ft. Side 1: IN 175.0 Ft. Shoreline Desig.: DlaltlApplicable
Year: Serial No.: Side 2: S 50.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 1 Ventilation Fan 1 Plan Check Fee JBN 3/3/2017 $372.48 S2201700000001
Lavatories 1 EH Minor Plan Review JBN 3/3/2017 $ 105.00 S2201700000001
Water Heaters 1 Planning Review Fee JBN 3/3/2017 $205.00 S2201700000001
Building State Fee MPB 4/12/2017 $4.50 S1201700000001
Building Permit Fee MPB 4/12/2017 $573.05 S1201700000001
Mechanical Permit Fee MPB 4/12/2017 $9.00 S1201700000001
Mechanical Base Fee MPB 4/12/2017 $28.50 S1201700000001
Plumbing Permit Fee MPB 4/12/2017 $26.10 S1201700000001
Plumbing Base Fee MPB 4/12/2017 $24.70 S1201700000001
Total $ 1,348.33
BLD2017-00141 Please refer to the following pages for conditions of this permit. Page 1 of 5
CASE NOTES FOR
BLD2017-00141
CONDITIONS FOR
BLD2017-00141
1) Prior to final approval, all upland areas disturbed or newt geated by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
2) Approve ,p�r dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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3) Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is RR-5.
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4) Proposed structure or portions thereof, � maintain a 5' separation distance between adjacent structures. Separation is measured from furthest
projection to furthest projection. X
5) 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-W-0982. 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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6) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans 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
Department Xior to any further inspections being performed or approvals granted.
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7) Owner Lfipynt is responsible 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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8) The plan review check 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 approved documents will result in failure of required building inspections.
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9) THE FO�N ATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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BLD2017-00141 Please refer to the following pages for conditions of this permit. Page 2 of 5
10) The "approved" site plan is required to be on-site for inspection purposes. If an inspection is requested 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
Building Department prior to any further inspections being performed or approvals granted.
11) 2012 IECC/Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C, Window(Max U-Factor):0.30, Skylight(Max
U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation min. R-49, Vault Insulation R-38,
and Slab Insulation R-10.
In addition the following credits from R406.2 shall be completed as follows:
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12) A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section
R404.1.
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13) A Mason County Stormwater 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/agent/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/contractor is acknowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
14) A concrete encased grounding electrode must be installed and used at each new building or structure that is built upon a permanent concrete foundation.
In Mason County the electrical code is regulated by Washington State Department of Labor& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-4000.
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15) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer specifications and in accordance with IRC
Section R315.
Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level of the dwelling.
EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances),
repairs,,or additions requiring a permit occur, or when one or more sleeping rooms are added or created.
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BLD2017-00141 Please refer to the following pages for conditions of this permit. Page 3 of 5
16) 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 revocation.
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17) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency (ORCAA).
It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos containing materials have been
identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or
operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623 www.orcaa.org
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18) Proposed structure or portions thereof, must maintain a 5' separation distance between adjacent structures. Separation is measured from furthest
projection to furthest projection. X f:::�5
19) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
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20) CONSTRUCTION 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 international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector shall t egnade prior to requesting additional inspections.
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21) All property lines shall be clearly identified at the time of foundation inspection. X l�
22) 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
Mason C.flarl�v ordinances and building regulations.
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23) 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 period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
j holder a prevented action from being taken. No more than one extension may be granted.
24) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connecto nd flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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BLD2017-00141 Please refer to the following pages for conditions of this permit. Page 4 of 5
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
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
/ -
Signature ] R Date
f5k&D ✓ A DE ` OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2017-00141 Please refer to the following pages for conditions of this permit. Page 5 of 5
MASON COUNTY COMMUNITY SERVICES LW O
PERMIT ASSISTANCE CENTER: Permit No:
• 7
_a_
BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
815 W.Alder Street,Shelton,WA 98584 RECEIVED
Phone She (360)427-9670 ext.352•Fax:(360)427-7798 Phone
-" Belfair.(360)275- MAR•Phone Elma:(360)482-5269 0 3 2017
834
B U 1LDING BUILDING PERMIT APPLICATION e15 W fier Sbeet
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: fl?6 D A aZ`� NAME:
MAILING ADDRESS: 07t MAILING ADDRESS:
CITY: Ori (�V-tJ STATE: ZIP: CITY: STATE: ZIP:
PHONE#1: tloj - "0 - -7 16> 6 C PHONE: CELL-
PHONE#2: 3bo - $ 8 - Lcri l EMAIL :
EMAIL: e_R A 0 r-R J5 TOND, C-'4 M L&I REG# EXP.
PRIMARYCONTACT: OWNER CONTRACTOR❑ OTHER❑
NAME EMAIL C D rRF,D Q :Tywo C om
MAILING ADDRESS ?.C)- L CITY STATE ZIP
PHONE 3LCt . G 4�`[�9!1_ CELL 3/"0— qe® ._
PARCEL INFORMATION: n r1 P r
PARCEL NUMBER(12 Digit Number) 3_;? oZ 3 o?, — 75 (? L Z 1iO2 ZONING e,C
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS Qn G - Uh t� , COL CITY � /()
DIRECTIONS TO 3 ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO k
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�f ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)
IS USE: PRIMARY❑ SEASONAL K NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Partft]of Bldg) ® NO ❑
DESCRIBE WORK
SOUARE FOOTAGE: (propose+existing)
1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq. ft.
D s COVE CK sq.% STORAGE sq. ft. OTHER sq. ft.
GARAGE sq. ttached❑ Detached CARPORT sq. ft. Attached❑ Detached❑
UFA E INFO TION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODE YEAR LENGTH
WIDT4== ROOMS ATHS RIAL NUMB
ENVIR'NTqfNTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC, SEWER❑ / NEW ❑ EXISTING.90-
PLUMBING IN STRUCTURE? YES�9- NO❑ If yes, 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 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
1COUNTY CODE 14.08.42)
S-4.10X3 -3 -
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
co&`= MASON COUNTY COMMUNITY SERVICES Permit No: o20) —_ 6V)
' A5 �T "
PERMIT ASSISTANCE CENTER: RECEIVED
t
•BUILDING•PLANNING•FIRE MARSHAL
615 W. Alder St-Shelton, WA 98584
-- Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798 MAR 0 3 2017
Phone Belfair. (360)275-4467 Phone Elma:(360)482-5269
17e54 `''` 6'!5 W. Alder Street
B r I N GPLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INF RMATION:
NAME: r—ITED BAQ NAME: ,J y c— rA47 E 2 A
MAILING, ADDRESS: ?,0• D k 1 -4, MAILING ADDRESS:
CITY: vNipw STATE: ZIP: L CITY: STATE: ZIP:
I s'PHONE: _ -1 1 O ff- G PHONE: CELL:
2nd PHONE: )(9G EMAIL :
EMAIL: L&I REG# EXP.
PARCEL INFORMATION: ^
PARCEL NUMBER(12 Digit Number):�3 oL;1-7 -- -75' Z Zoning:
LEGAL DESCRIPTION(Abbreviated):
SITE ADDRESS: qD 5� CITY:
DIRECTIONS TO SITE ADD SS:
TYPE OF JOB
NEW :2!�,-ADD ALT REPAIR OTHER USE OF BUILDING L/I ��C
LOCATION OF FIXTURES/UNITS- 1 IT FLOOR 2ND FLOOR BASEMENT GARAGE L�OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric_�(___LPG Natural Gas Ductless_
Toilets I Tyne of Unit No.of Units Fees
Bathroom Sink 1 Furnace
Bath Tubs Heat Pump
Showers Spot Vent Fan
Water Heater eO) Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hose bibs Dryer Vent
Other Solar Panel
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 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 OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature of Applicant Date
x rR'5 6 8 Owner/Owners Representative/Contractor
Print Name (Circle one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev:,1/27/2016 )BN
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
Name Parcel# v>2 Z 32— —/Yi—, �� BLD#`7 — M _ C
BUILDING Mason County MAR 0 3 2011
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (pe)l.ofkAr Street
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 X = O
X = Measurements for buildings are taken at the
perimeter of the farthest projections(example:
X = 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 = 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) I �w I
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 prorty for review and'inspection as may be required.
X obj� - 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 1 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 Stormx,ater 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
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-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
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