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HomeMy WebLinkAboutBLD2019-00391 Addition, Remodel - BLD Application - 4/22/2019 coo-�A MASON COUNTY COMMUNITY SERVICES 1C t0� ' PERMIT ASSISTANCE CENTER: Permit No: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 / 2 1 i — Phone Iton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone J ir. (360)275-4467•Phone Elma:(360)482-5269 AM A( 2019 18.54 �� BUILDING PERMIT APPLICATION PROMTY OWNER INFORMATION: CONTRACTOR INFORMATI :Z 2 20I9 NAME: ,9.e°�l� E:y/1lll� NAME: si MAILING AD SS: �'n,e !� MAILING ADD SS:O l yr r CITY: STATE: ZIP: CITY: STATE _ZIP:Q�� PHONE#1: �?&j2_ Z,77. 7,7,aA PHONE- --=n��CELL: PHONE#2:_.�l to 5 0�Qr� EMAIL : fL�.� (- EMAIL: L&I REG# EXP. PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAME _ EMAIL MAILINt ADD ESS CITY STAT _ ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) /4,;� !^r2 r�«�C9 ZONING���� — LEGAL DESCRIPTION(Abbreviated) � � L?—S C���� FIRE DISTRICT SITE ADDRESS I 16 &aST J;� CITY DIRECTIONS TO SITE ADDRESS�a,2Z&- A�1�f �3 2- �, T 7- IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO 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 ❑ ADDITIONJ& ALTERATION X REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) IS USE: PRIMARY g SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES (Whole Bldg) (I YES (Part[sl of Bldg) ❑ NO ❑ DESCRIBE WORK,4Vn,���� , SQUARE FOOT A C-v• 3pose+existing) 1ST FLOORo�I rj sq:ff. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. ft. DECK sq. ft. COVERED DECK sq. ft. STORAGE sq. ft. OTHER sq. ft. GARAGE_ sq. ft. Attached Detached❑ CARPORT sq. ft. Attached❑ Detached❑ MANUFACTURED *4 COPIES OF THE FLOOR PLAN REQUIRED* MAK MODEL YEAR W TH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER'[ ' / NE ❑ EXISTING ❑ PLUMBING IN STRUCTURE? YES ❑ NO ❑ Ifyes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NON EXISTING SQ.FT. EXISTING BEDROOMS ] PROPOSED BEDROOMS 4V 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 14.08.42) X_ &441Z z2z=� 4 — Signatur of OWNER( ust be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH 11011MASON COUNTY D COMMUNITY SERVICES /�p�} , Building,Planning Environmental Health,Community Health APR I- I- �Ui3 Rr, APR 2 2 2019 Physical and Mailing Address: 615 W Alder St., Bldg 8, Shelton, WA 98584 615 W• Alder$tr190t Shelton Phone: (360)427-9670 ext352 t• Fax (360)427-7798 615 W. Aluji -4; o PLUMBING & MECHANICAL PERMIT APPLICATION Permit#:3IdZbl l -6031 OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: MAILIN ADDR SS: MAILING ADDRESS: CITY:Ac&d (/ ATE: /} ZIP:. __ CITY: STATE: ZIP: V PHONE: - ., PHONE: CELL: 2,d PHONE:. 1/212­ EMAIL: EMAIL: Av_k�Aiz L&I REG# EXP. / I PARCEL INFORMATION: PARCEL NUMBER (12 Digit Number): Zoning:��� LEGAL DESCRIPTION (Abbreviated:4i11(`/ '�C -�; �23i7'9 /y SITE ADDRESS: z"/ i'l�5`� T�' /� 7�z �� CITY: DIRECTIONS TO SITE ADDRESS: "� TYPE OF JOB/WORK: NEW ADD ALTO REPAIR OTHER USE OF BUILDING PLUMBING FIXTURES MECHANICAL UNITS [] Electric in-wall heaters(notee) Type of Fixture No. of Fixtures Fuel Type Fees Type of Unit No. of Units Fuel Tyne Fees Toilet(s) / Furnace [E/G/LPG] Bathroom Sink(s) Heat Pump [E/G/LPG] Bath Tub(s) / o Ductless H.P. _� [E/G/LPG] Shower(s) Spot Vent Fan Water Heater(s) [E/G/LPG] Propane Tank a[.] Clothes Washer(s) [E/G/LPG] Gas Outlet(s) Kitchen Sink(s) --- Heat Stove _[E/Gg)W] Dishwasher(s) Kitchen Exhaust Hood 1 Hose bib(s) Dryer Vent Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee Final Inspection Fee Final Inspection 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. x - s�� �'2� /C� Si ature pplic�nt Dates x �.� 5-/,y/�7 lrown�riowners Representative/Contractor Pri"ht Name a one) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSINOTES/CONDITIONS O , Building O Fire Marshal O Permit Tech (OTC permit only) \"tsil Us on-lim- litTp //www.CO.iilnsoil.wa.Us/conll»unity_dev/ Rev:3/08/2017 Name- i cel C"L(Ld BLD#,:aa Il-l '0Q 3, Mason County P.yVtOC Department of Community Development APR 2 2 2019 rnaVd arcel Stormwater Management ApplicatioWWorksheet (pag�J�o )e1i1gr r t s- 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 = X = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: 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/1Nalks 31.7 X = X = Any paved, gravel or packed area per definition above table X = Others X = i X _ If the total impervious area of the proposed site X 5 i = 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- described property for review and inspection as may be required. X Owner/ gent/Contractor(circle one)Date: ! (' If the Total Impeir ious 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 ApplicatioWWorksbeet (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: htI 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 TMS SPTE 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 finther 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 20'-3" 00 "' ———————————————————— -- 14� PLANNING I C I I L APR 2 2 2019 � 615 W. Alder Street a Vws Gfrage�and Grans01 �+ ! T I I I I I I I I 144" �------- a T I I RecydC '- a Gabirtet Glebinet -- — 5epgc °ivid�i mm� \ I I / � III b 1 1!8`_ b- I. � T //I r-10 4 5/8" — 4'9` F-3" 13-5 1!7 / Master Bath( it I '010 �_-7 1!4" 3' '-Y 3l4" 1T-5 1l2` c / / ———— —— ——� I• / , xzw mm / p bresser moire / o File ® / I ------ A Main p Bedroom i —T— Master Bedroom Bath uul b Room A // F( \ / Gloset / Bedroom#3 I ` \\ L�antr45torage / / Hutch -Tea Cart Hut ch ' pO / \ � s waxy .wne xwbxc :o / o � Propane Fireplace / \ o s exhaust Wng Room O �, I / O \,— o I // Dining I � Kitchen ? I / Plant Cart `�T, / maw maw. mm mwo" maw. -5Lafe -- b' Living Area _g• 51'-B 1 &1flyn County WA GIS Web Map --- APR 2 2 2019 18512 ESTATE ROUTE- ---I15 W. Alder Str a 0500 122A5 00 9001 122200060010 122205007 10 18510E STATE ROUTE 3 122205 070 8 122205006009 18518 E STATE 222M 2205 12P205 07007 18514E STATE ROUTE 3 122205000007 -- 18516ESTA 2205 122205007005 1�450 E STATE ROUTE 3 12 • 122205006003 1 - - 2220 122205006001 8430 E STATE ROUTE 3 • 4/22/2019 11:00:51 AM 1:765 0 0.01 0.01 0.02 mi County Boundary AE 0 0.01 0.02 0.04 km • Site Address (Zoom in to 1:5,000) AE FLOODWAY Tax Parcels (Zoom into 1:30,000) ® AO Sources.Esri,HERE,Garmin,Intermap,increment P Corp.,GEBCO,USGS, FEMA FIRM Map 1 FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri OPEN WATER Japan, METI, Esri China (Hong Kong), swisstopo, © OpenStreetMap contributors,and the GIS User Community A VE Mason County WA GIS Web Map Application Richard Diaz I Bureau of Land Management,Esri Canada,Esri,HERE,Garmin,USGS,NGA,EPA,USDA,NIPS) PLANNING MASON COUNTY APR 2 2 2019 TITLE COMPANY --� 615 W. Alder Street Part of the Aegis Land Title Group •, 1 w « J Ail Jc r � ,. - r �� .:A tea' •.�.. . • This is not a survey. It is provided as a convenience to locate the land indicate hereon with reference to streets and other land. It is not intended to show all matters related to the property including,but not limited to,areas,dimensions,assessments,encroachments,or location boundaries. It is not a part of,nor does it modify the commitment or policy to which it is attached. The company assumes no liability for any matter related to this sketch. Reference should be made to an accurate survey for further information. LO 130 W Railroad Ave, Shelton,WA 98584 Phone: (360)426-9713 /(360)426-0716 Web Site: www.MasonCountyTitle.com J � • • • I „ X,' r I �71 • i • i • C Q: f l _ r • • i ' AX l, I : : i .6D7 -o0 � I I y ; S xt4 n6 • APR 2 2 2019 615 W Alder Street I ; P - : , ENVIRONMENTAL HEALTH A16 • • 1* i QVE ,P pR UN 2 7 2019 MASON COUNTY • ENVIRONMENTAL.-HEALTH WLi )owls JGPIV M s L s 61OZ Z Z ddd I ' ��' � ti re- I I ' I � I i Y I � i i t : � ` 6D - L _.AW-V lid - 4 .�� ;c r�: boo (,i r-f ./f✓ � T/�.Ti,�i�Cdr�r���/ram _ _ ___ R►p�' I oN P S S a I / rip S� ES Lup - PLiNNINJI P LAN N 1-N G: ALL SETBACKS ARE + 7 � E MEASURED i . FROM THE FURTHEST PRQJECTION OF THE BUILDING