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BLD2011-00135 Cancelled SFR - BLD Permit / Conditions - 3/21/2011
f 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 ` RESIDENTIAL BUILDING PERMIT BLD2011-00135 OWNER: DREW DAVIES RECEIVED: 2/22/2011 CONTRACTOR: DBC CONSTRUCTION LLC 1.360.509.0657 LICENSE: DBCCOCL945K4 EXP: 12/1/2012 ISSUED: 3/21/2011 SITE ADDRESS: 301 E BLACKWELL ST ALLYN EXPIRES: 9/21/ 011'� PARCEL NUMBER: 122205028004 LEGAL DESCRIPTION: ALLYN BLK: 28 LOT: 4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR (WILL BE STOCKING THIS PLAN)STOCK PLAN 2009-0008 ST RT 3 TO ALLYN, L ON WADE ST, ON BLACKWELL ST TO SITE D ADDRESS ON TH LEFT SIDE General Information Construction&Occupancy Informatipin X Squ re Footage Information No. of Bedrooms: 3 Type of Constr.: qPri Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: Lotong:1 Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 2 Occ. Load: B Garage-Attached 420 Valuation: Building Height: 27 Occ. Status: Ba COV PORCH 20 Manufactured Home Info on Setback Inf tion Shoreline&Planning Information Make: Lengt AF : E 4 Ft. horelin Ft. Water Body: : W 0 t. Slo Ft. SEPA?: Model: Widt Ft. : N 0Shoreline Desig.: Not Applicable Year: Serial N S .0 Ft. Comp. Plan Desig.: Urban Growth Area Plumbing Fixtur echanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee GMM 2/22/2011 $838.86 S12011000 Hosebibs 2 Ventilation Fan 4 Planning Review Fee GMM 2/22/2011 $205.00 S12011000 Kitchen Sink 1 Dryer Vent 1 Address Fee GMM 2/22/2011 $173.50 S12011000 Lavatories 3 Fire Warden Review GMM 2/2 212 0 1 1 $73.00 S12011000 Water Closets(Toilets) 3 EH Plan Review KKK 2/25/2011 $103.00 S62011000 Water Heaters 1 Water Adequacy Plan Review KKK 2/25/2011 $103.00 S62011000 Bath Tubs 2 Building State Fee LDK 3/14/2011 $4.50 S12011000 Clothes Washer 1 Building Permit Fee LDK 3/14/2011 $1,290.55 S12011000 Mechanical Permit Fee LDK 3/14/2011 $58.20 S12011000 Mechanical Base Fee LDK 3/14/2011 $28.50 S12011000 Plumbing Permit Fee LDK 3/14/2011 $110.60 S12011000 fF-� Plumbing Base Fee LDK 3/14/2011 $24.70 S12011000 Additional Plan Check Fee LDK 3/14/2011 $73.00 S12011000 j�11 Total $3,086.41 BLD2011-00135 Please referto the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2011-00135 CONDITIONS FOR BLD2011-00135 1) 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 grantgd, In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Departme pri �tol to further inspections being performed or approvals granted. X // 2) Owner/ ge�isp sible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X S< 3) 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 per it holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or remo o v d documents will result in failure of required building inspections. X 4) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X� 5) 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 De nt rior to any further inspections being performed or approvals granted. 6) Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric or other than electric, Compliance Method: Prescriptive option III, Window(Max U-Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38 advanced or R-49 standard, Vault Insulation R-38, and Slab Insulation R-10. In 770 n the f loa►�ing credit from Table 9-1 shall be completed: 6 HEATED SPACE UNDER 1500 SQ FT X BLD2011-00135 Please referto the following pages for conditions of this permit. 2 of 6 ?'j • A permanent certificate, completed by the builder or registered design professional, shall be posted within three feet of the electrical distribution panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there is more than one value for each component, the certificate shall list1he value covering the largest area. The certificate shall list the type and efficiency of heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 503.10.2, and air leakage results if a blower door test was conducted. Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 0.00030 Specific Leakage Area (SLA) when tested with a blower door at a press of 50 Pascals (0.2 inch w.g.). Testing shall occur at any time after rough in and after installation of penetrations of the building envelope, including penetrations for utilities, plumbing, electrical, ventilation, and combustion appliances and sealing thereof. The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is not required for additions less than 750 square feet. Reference WSEC 105.4 Certificate and 502.4.5 Building Air Leakage Testing. Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2009 Certificate" and are available in '/4 or'/z sheets. The Mason C Ser7enter will also have some available. X v . r 8) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or installed inok aroun swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps). Referenc 0�. X�;�S� J,/ 9) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufactt�e ' instal7ain instructions.X 46 10) 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 acknovol�-rl i ;I"all components of the stormwater management system have been installed as approved on the stormwater site plan. X 4 1 1 c/ . 11) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/ Reserve requires a 10ft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. No foundptrorfslwithin 30ft, down gradient of drainfield/reserve area. X �� x BLD2011-00135 Please referto the following pages for conditions of this permit. 3 of 6 12) In buildings of unusually tight construction, fuel-burning appliances (excluding cooking appliances and domestic clothes dryers) shall obtain combustion air from outside in.. r tli:e,� with the international codes. x � J 13) 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. RRads arp_�equired to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads nn � Jt�al county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 14) Stock Plan Identification number: 2009-0008 This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department, original buil i plans nd all attachments approved by the Mason County Building Department shall be available for the Mason County Building Inspector t e, it d inspection. X 15) Any changes in proposed 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. lf,�[ cume is are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged�nd�h�tl�e�ollected by the Building Department prior to any further inspections being performed or approvals granted. X `� c✓✓` 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 rn2f X 17) Provisions for surface/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,project. X k 18) Placement Lln( must comply with standards set forth per the international codes regarding descending and/or ascending slopes. x 11,� � 19) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Masora County ordinance r r . io , must be reviewed and approved by Mason County prior to construction. X BLD2011-00135 Please referto the following pages for conditions of this permit. 4 of 6 20} CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMEN-f AND THE ADOP I EU ` 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 a ,��{7(fp/I�'�J�for to requesting additional inspections. 21) All property lines shall be clearly identified at the time of foundation inspection. X 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 Couirta�s and building regulations. X ✓, 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 holder have ventedction from being taken. No more than one extension may be granted. X ��/� 24) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connector41= Install metal connectors approved for contact with the new types of pressure treated material. X 25) Retaining walls needed to support a surcharge suds s tures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 26) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures —meet the setback conditions listed. X .,i 27) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv� n' to ensure these structures are shown and meet the setback conditions listed. X 28) 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 att, ) e pproved building plans. X BLD2011-00135 Please referto the following pages for conditions of this permit. 5 Of 6 29) 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 1-800-647-0982. per igning this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 30) Approved r l-imeGstqns and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 31) Temporary erosion control measures must be implemented to prevent water quality de a Lqf adjacent waters or properties. Silt fencing must be installed and maintained until upland vegetation has become established. X 32) All construction and demolition debris must be removed from the site after project completion. PropDe . nosa o construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X 33) Prior to final approval, all upland areas disturbed or newlyM cor struction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X �f �/�. This permit becomes null and void if work orconstruction 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 i o o ne 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 d stru t e f r view and inspection. OWNER OR AGENT: _ DATE: BLD2011-00135 Please refer to the following pages for conditions of this permit. 6 of 6 X Insulation Northwest LLC ZY81\� IF, a\- NORTHWEST Insulation Certificate/ Blower Door 'Vest Forge Batts and Blankets Thermal Performance(Attic Application) When installed in accordance with the manufacturer's The stated thermal resistance(R-value)is provided by installing in accordance with the manufactuer's instructions,the required number of recommendations,Knauf batts and blankets will provide bags per 1,000 sq.ft.of net area,at not less than the labeled minimum thickness. Failure to install both the required number of bags and at the full R-value. least the minimum thickness will result in lower insulation R-value. R-Value' Minimum Thickness R-Value` Ba s/1 000 s .ft. Maximum Coverage Minimum Weigh! Minimum Thickness To Obtain An insulation Installed insulation should To Obtain an insulation The number of Contents of this bag should not The weight/SF of installed Installed insulation should resistance(R-Value)of: not be less than: resistance(R-Value)of: bags/1,000 SF of net cover more than: insulation should not be not be less than: area should not be less less than: R-38HD 10.25" R-60 31.7 31.5 SF .952 LBS 19.75" R-38HD 12.00" R-49 25.8 38.7 SF .774 LBS 16.75" R-30HD 8.25" R-44 22.1 45.3 SF .663 LBS 14.75" R-30 10.00" R-38 19.0 52.7 SF .569 LBS 13.00" R-26 9.00" R-30 14.4 69.7 SF .431 LBS 10.25" R-22 6.50" R-26 12.4 80.9 SF .371 LBS 9.00" R-21HD 5.50" R-22 10.4 95.8 SF .313 LBS 7.75" R-19 6.25"' R-19 8.9 111.8 SF .268 LBS 6.75" R-15HD 3.50" R-13 6.1 164.3 SF .183 LBS 4.75" R-13 3.50" R-11 1 5.1 197.6 SF .152 LBS 4.00" R-11 3.50" Bag Weight-Nominal 30lbs.,Minimum 29lbs. This product comforms to the performance requirements of ASTM C 764,Type I,and R-8 2.50" cancelled Federal Specification HH-1-10308,Type I,Class B. R-Values are determined in accordance with C 687 and C 518. -R"means "R-18 in a 5.5"cavity.Conforms to ASTM C665 and resistance to heat flow. The higher the R-value,the greater the insulation power. To get the marked R-value,it is eseential that the insulatiofi Federal Specification HH-1-521 F. be installed properly. If you do it yourself,get instructions and follow them carefully. Blower Door Test Building Airtightness Test Form Building&Test Condition Comments Equipment Required To achieve labeled R-value,this product must be applied with a pneumatic blowing machine and a Date: B /0 1/ corrugated hose with a minimum.25"internal corrugation,a minimum length of 150 ft.and a diameter Time: of at least 3". Coils in the hose should not be less than 36"in diameter.Acceptable material feed rate Indoor Temperature: is 5-35lbs./minute. Recommended feed rate is 15-25 lbs./minute. Outdoor Temmperature: Volume(fh) Builders Insulation Statement Floor Area(ftx) /�Pp Batts and/or blankets have been installed in conformance with the above recommendations to provide Surface Area(%) a thermal resistance of... Wind Shielding: R-Value Standard Attic Area R- R-49 Test#1 Sloped Ceilings R- c R-38 Depress._ Press._ �'0 3 Walls R- R-21 Pretest Baseline Pressure._(Pa) Floors(over an unheated crawls ace) R- C--) R-30 Bldg Press.(Pa) Flow Ring Fan Press. Flow(cfm) Completed as of: f3 /v Post-Test Pressure:10 L.(Pa) Site Address: Fan Model/SN: Results: L-�L Home Builder SLA(Specific Leakage Area): Signature: Test#2 Home Builder 'L-�-BC S? Depress._Press Address: Pretest Baseline Pressure:_(Pa) Bldg Press.(Pa) Flow Ring Fan Press. Flow(cfm) Insulation Contractor: Insulation Northwest LLC Post-Test Pressure: (Pa) P.O.Box 732069 Fan Model/SN: Puyallup,WA 98373 Phone: (253)846-0121 Results: Fax: (253)846-8096 SLA(Specific Leakage Area): bo �.. c1 CONCRETE MECHANICAL 4Unt7 MANUFACTURED HOME D NO Date r Footings I Setbacks Gas Piping By C Ribbons o Interior Date By Interior-Date By Date By y 0 W Fxterw Date y',' �y By Exterior-Rate B Set_up "' INSULATION m Point Load I Isolated Footings Date By BG 1 SLAB INSULATION __.-�..____. ..__�..___ Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By DateV' `Z a �� By� Data By DECKS FRAMING wall Date By Date s-/6'/1 ByM Data By PROPANE TANKS PLUMBING vault Date _ - By Date By OTHER Groundwork Attic Type Date By Date By Date By D.W.v �o Z DRYWALL Type- Date By / Int.Brace Wail Date — R> Date By FINAL INSPECTION m Water Line I Fire Seperation N Date By Date By Date By O Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Done By Comments w .1�1.a�GS 1� .� -l/ LL-// - - �3- 0 ti.�. CD s� sS ill / y� g p V V ;G itc CD 0 J Permit# a MASON COUNTY BUILDING Ill 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location - ax VF-C.L This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain compliance , /a / CC - c�c - .L 'cri s: d .1 o vy You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Cell for re-inspection when corrections are made before continuing ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural 0 OK to damage incurred by recent �j'i-•�i "natural/man made" ❑This is not a complete inspection -disasters.This is NOTa CORRECTION NOTICP. Date Department Inspector 'r f' GoGry � , ' �� 1� OT , �� F irm T J*MW Permit# �kb)15`-'__ MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360)' 427-9670 CORRECTiON NOTICE Job Location 361 43 11 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain compliance )00 Acmes ce.- 1 7 YZ'i- �'S t'e --t i� G., - -c"s S e-r, n p CA You are hereby notified that the-above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ please contact_our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOT a Date �5�1 1 Department CORRECTION NOTICE. Inspector NOT IoV ' TH1 ,1, T,"-- * -w Permit# o MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain compliance yJi c LOcd O v 1�ri ..�- �cT.ra,v = t' d �S o 04d vide �-�cr� •i ov .Sco v L - C O ©mot/ cc o Lf ov v� G"e,94W 6c o ii y d'. v g4da�rZ:- r cAvc,� ,v cS d r O r 0 - r G GP A, -S e You reliereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WOK &74❑ 8 n cor all for re-inspection wherections are m�fore continuing ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOT Date �� Department.h r CORRECTION NOTICE. Inspector -7-�(� • O* $ N* ,0T , I r 1* 01 ' THI , Ti--' -* Mw PLA. I.-- ING 0 ALL SETBACKS ARE MEASURED I N bA6A FROM THE FURTHEST I PROJECTION OF THE BUILDING :d T � I J I J I 3 i S ir-� i J APPROVED MASON COUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE _t CHANGYES SUBJET TO APPROVAL By Date 3 l 1 ' .0 C( i I - �C� l L22b S U e2_ Y `/ 14 -2-9 p 44- e;*/71 c A6. l 1�v✓,�e- A6A r I � r J i v 3 I �• r ► ADS* op A r 5 . A I I6Lu,tcL L�,•r S �3 l/c �$ F lam' 8��l17� ACCESS & GRADE INSPECTION BLD % I ADDRESS: INSPECTOR: DRIVEWAY ACCESS (7 need post at access of driveway with reflective address numbers Length: / Width: /D Surface: Size of turn-around: n! 1 S_j Condition of shoulders: Vertical clearance: GRADE OF DRIVEWAY OF ROAD Z % ROAD ACCESS Length: n Width: 2 Surface: �� �lC Condition of Shoulders: a Vertical clearance: /V f ( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. ( � LOT INSIDE UGA—NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4 X 4 FIRES 2X3FIRES PASSED ( FAILED ( ) ON HOLD ( ) REMARKS: Name J a / 1 iS Parcel# / 2-2-Zy 5� z 0 Uc) BLD# �� '�� ( ✓ 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 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. F '. . To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X 2 y`'S .� X .2 z— = y e Z Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways p X Z = X = Length of drive begins at the right of way X = Parking Areas G2 X 'Zc.� _ -3 2� 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 total impervious area of the proposed site X _ development is greater than'2000 square feet a mail Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) , Z If the Total Impervious Surface Area is LESS 2000 S uare Feet, ease read,acknowledge and sign below. Based Upon the information you have provided aZAN rm► t r e P1 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 7pr a for re spection 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 I of 2 Name r .cc/ a-:f 5 Parcel# 7 ZZ Z O J O d a Y BLD# Mason County Department of Community Development Small Parcel Stormwater Management Applieation/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 Stormivater 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: Phonc: (360)-427-5670 E::T. 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/d ra infield 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: Page 2 of 2 MASON COUNTY PERMIT NO.:h I. 20� �- oo ►3 5 BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 ]An Shelton (360) 427-9670 • Belfair (360) 275-4467• Elma (360) 482-5269 �I ��+ _�_1 On the web www.co.mason.wa.us �l APPLICANTINFORMATIO CONTRACTOR INFO MATION Owner 4✓ e /�a,�"� 1 c Company Name /)/�C Mailing Address 5 Mailing Address S ZZ f 0/y.^ ��< <•^ r City State w� Zp C e �;_S Z y City �G� State�Zip Code Phon c �� O�r'Ph 3Cu �c'� S S5'Z- Phon"cr - ` O G�7 Other Pt .36cf y3 yecc I Lien/Title Holder -✓ ��� �'s Contrg. # << ���9n��!#xp. E mail address L E Mail Address �'t ��C C<<^5 T�✓: �� �cc. <_� Drivers Lic.# w1 rJs 3SGv DOB z� �� Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic!5]!f 'L_ Existing Septic Connect to Water System _ < Name of Water Systemc- Well Water System Name of Water System PARCEL INFORMATION- 12 Di it Parcel No 2Z 0 --0- 2- - 0v y Fire District Legal Description z£i Site Address (Please include street name, street number and city) x -Al X- /e .-�2 l srr�e .� Gv ntionsto ite v ,<; reel ttiesr )« [vr Lc T? i i s lC i.0 ( 1"v l L 0✓y Z Will timber be cut and sold in parcel preparation?Yes/. o Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs ] 15% Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement action?Yes/9 TYPE OF JOB -New, Add—Alt—Repair Other PRIMARY RESIDENCE aSEASONAL ❑ Use of Building S4-9 Describe Work Alegi 1Y0�-se- No. of Bedrooms 3 No. of Bathrooms 2,3 Square Footage- 1 st Floor s 2nd Floor 7-?5 3rd Floor Basement Deck Covered Deck Other «t Sq.ft. _Z 12 Garage 20 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. 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 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 a to and ran ployees of Mason County access to the above described property and structure for review and inspection. PROOF 0 CO INU I O WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner/Ow rs Representative/Contractor (indicate which one ` FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date 2- 2.2 l DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department �t V✓J Planning Department Environmental Health Department _ - Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES