HomeMy WebLinkAboutBLD2020-00468 SFR - BLD Application - 5/26/2020 MASON COUNTY COMMUNITY SERVICES Permit No: iiIKJ
PERMIT ASSISTANCE CENTER: RECEIVE
.BUILDING-PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
• Phone Shelton:(360)427-9670 ext.352-Fax(360)427-7796 Phone M qY 2 6 2020
Bellair.(360)275-4467-Phone Ehna:(360)482-5269
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: L NAME: 1 V
MAILIN MAIL G A DRESS:
CITY: STATE ZIP: CITY: STATE: ZIP:
PHONE - — PHONE- - LL:
PHONE#2: EMAIL:
EMAI k 19A C6 rel L&I REG EXP. / /
PRIMARY CONT w,�1IrWNER CONTRACTOR ElOTHER❑
NAME—( - lJuvO`lU�-- EMAIL
MAILINGADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) V _ZONING 0
LEGAL DESCRIPTION(Abbret t ) I FIRE DISTRICT >. W
SITE ADDRESS CITY
DIRECTIONS TO SITE ADDRESS Gas, Z
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO❑ SNOW LOAD:_psf D
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that uppiy): ♦0♦ ♦
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ V JA
TYPE OF WORK: NEWX ADDITION❑ AWRATIOJ ElREPAIR[IOTHER ElZ
USE OF STRUCTURE(Residence,Garage,Commerrial Bldg,F.tr.) O V
IS USE: PRIMAR SEASONAL❑ NUMBER OF BEDROOMS_ _ NUMBER OF BATHROOMS
DESCRIBE WORK ♦ ♦i
HEATED STRUCTI rY�E (Whale-�j❑ YES(Parris/ajRldg)❑ NO❑ a VO
` Y 1
SOUARE FOOTAGE:(Proposed)
1ST FLOOR_ sq.ft. 2ND FLOOR sq.ft. 3RD FLOOIO sq.ft. BASEMENT sq.ft.
DECK_ sq.ft. COVERED DEC sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE ^ _sq.ft. Attached❑ Detached CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER)4 / NEW v EXISTING❑
PLUMBING IN STRUCTURE? YESX NO❑ V 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 Ore work as proposed.1 have
obtained permission from ail 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 \5.2Le- .2D20
Signature of OWNER(Must be slaved by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
' MASON COUNTY COMMUNITY SERVICES Permit No-Did2bW (YA08
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL
615 W. Alder St-Shelton, WA 98584
www.co.mason.wa.us
Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798
• Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNE INFOHMA I CONTRACTOR INFORMATION:
NAME: NAME:
MAILING DDRESS: MAILINGADDRESS:
CITY: 1 STATE: ZIP: CITY: STATE: ZIP.
1"PHp ; PHONE:
2"d PHONE: EMAIL ( COrYt
EMAILQMie )(',P eS0J 0 .� L&I REG EXP. JJ / LI�XgI
CEL INFORMATION:
WRCEL NUMBER(12 Digit Number): A5�Q 2 Zoning:
GAL DESCRIPTION(Abbreviated):
SITE ADDRESS: CITY:
DIRECTIONS TO SITE ADDRESS:
TYPF,OFJOB:
NEW ADD ALT REPAIR OTHER �SEOF BUILDING � [e
LOCH ION OF FIXTURES/UNITS—1sT FLOOR 2ND FLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_
Toilets Type of Unit No.of Units Fees
Bathroom Sink Furnace
Bath Tubs Heat Pump
Showers Spot Vent Fan
Water Heater 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 acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is
by signature below. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this
permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of
interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of
Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION.
X .,7 ��Z,�/ Zr'Zt>
nature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN
MASON COUNTY COMMUNITY SERVICES Permit No:-f�ld AU.a[') -W+0b
t PERMIT ASSISTANCE CENTER:
.BUILDING.PLANNING.PUBLIC HEALTH.FIRE MARSHAL RECEIVED
615 W.Alder Street,Shelton,WA 985M
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone MAY 2 6 2020
Bellair.(360)275-4467•Phone Elma:(360)482-5269
�e BUILDING PERMIT APPLICATION
Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 1 L NAME: i
MAILIN A D SS: MAIL G A DRESS:
CITY: STATE- ZIP: CITY: STATE: ZIP:
PHONE — PHONE:' - LL:
PHONE#2: EMAIL: _
EMAIL it (Yl L&I REG t EXP. / /
P �j
RIMA Y CON ,ja�jWNER CONTRACTOR❑ OTHER❑
- EMAIL
MAILING ADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) ® L/� ZONING Q
LEGAL DESCRIPTION(Abbreviated) Wn j6IK FIRE DISTRICT W
SITE ADDRESS � CITY
DIRECTIONS TO SITE ADDRESS Z
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO❑ SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check all that apply): ♦0
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ V J
TYPE OF WORK: NEWX ADDITION❑ ❑RATIO REPAIR❑ OTHER ❑ Z 0.
USE OF STRUCTURE(Residence,Garage,Commerctal Bldg.Etc.) O
IS USE: PRIMARI
SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS i` ♦�
HEATED STRUCT Y�ES(whole-B�j❑ YES(Partlsi flildg)❑ NO❑ a vO
DESCRIBE WORK �Yrt� S I F• L
SQUARE FOOTAGE:(proposed) _
I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR5�sq.ft. BASEMENT sq.ft.
DECK sq'
ft. COVERED DEC sq.ft. STORAGE sq.ft. OTHER sq,ft.
�
GARAGE_ sq.ft. Attached❑ Detached CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER) / NEV-V EXISTING❑
PLUMBING IN STRUCTURE? YESX NO 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 1 am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of Interest regarding this project. The owner or legal
representative,represents that the information provided Is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permitlapplication becomes null&void N 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 t5.2[o• '2o2o
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT Jn� IQ•�
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES PermitNo ��Q-(��(�8
PERMIT ASSISTANCE CENTER:
,r ' •BUILDING •PLANNING •FIRE MARSHAL RECEIVED
615 W. Alder St-Shelton, WA 98584
Phone Shelton:(360)427-9670 ext.352• Fax:(360)427-7798 MAY 2 6 2020
Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269
15 W. Alder Street
PLUMBING & MECHANICAL PERMIT APPLICATI6N
OWNER I O I I CONTRACTOR INFORMATION:
NAME: NAME:
MAILING DDRESS: MAIL G DDRESS:
CITY: ' I STATE: ZIP: CITY: STATE: ZIP.
1 gt PHO PHONE: -) LL:
2nd PHONE: EMAIL : - -
EMAIL Ye&40.W L&I REG EXP._/L/S�I
rC
EL INFORMATION: ��rr - 5-j6I DEL NUMBER(I2 Digit Number): OF Zoning:
L DESCRIPTION(Abbreviated):
SITE ADDRESS: 5�, CITY:
DIRECTIONS TO SITE ADDRESS:
TYPF,OFOB:
NEW N ADD ALT REPAIR OTHER USE OF BUILDING 2ffijfOi
LOCH ION OF FIXTURES/UNITS—IST FLOOR 2NDFLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_
Toilets Tyne of Unit No.of Units Fees
Bathroom Sink (D Furnace
Bath Tubs Heat Pump
Showers Spot Vent Fan
Water Heater 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 acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is
by signature below. I declare that 1 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 permittapplication becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION.
X t/Z'1/ 2-eza
nature of Owner Date
DEPARTMENTAL REVIEW APPROVED I DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Ro,v: 1/;17/2016 }BN
MASON COUNTY COMMUNITY SERVICES Permit '�lob S
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
616 W.Alder Street,Shelton,WA 98584
~` Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone MAY 2 6 2020
Bel(air.(360)275-4467•Phone Elma:(360)482-5269
Cz BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
ZNAME: NAME: i T
MAILING A D SS: MAIL G�DRESS:CITY: STATE ZIP: - CITY: E: ZIP:PHONE - PHONE:' LL:
PHONE#2: EMAIL:
J EMAIL ie C (1�1 LBcI REG t EXP. / /
NRIMA Y CONT : g gNER CONTRACTOR❑ OTHER❑
EMAIL
MAILINGADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION: -5-3 D 1 p
PARCEL NUMBER(12 Digit Number) - ax0 ZONING 0
LEGAL DESCRIPTION(Abbreviated) Ke FIRE DISTRICT m
t SITE ADDRESS p CITY �..
DIRECTIONS TO SITE ADDRESS Z
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO❑ SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check aft that apply): O Z
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF ElSTREAM❑ V .<
TYPE OF WORK: NEVX ADDITION❑ RATiO ❑ REPAIR❑ OTHER El a
USE OF STRUCTURE(Residence,Garage,Commercial Bldg.Etc.) i5T.SJ(1,'-2nCC O
IS USE: PRIMAR SEASONAL❑ NUMBER OF BEDROOMS_ _NUMBER OF BATHROOMSCIO
HEATED STRUCT ? YES(Wol I�,ckL[] YES(Parits)oJBidg)❑ NO❑ Q VO
DESCRIBE WORK R \ J-I Imo/
SQUARE FOOTAGE.(proposed)
1ST FLOOR sq.R. 2ND FLOOR sq.ft. 3RD FLOOR,SOL sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DEC sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER) / NEW-V EXISTING❑
PLUMBING IN STRUCTURE? YESX NO❑ yes,attach completed Water Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ L I 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 pennittapplication becomes null&void N work or authorized construction is not commenced within 1 s0
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 ISO DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X \5.2.CP• e'202o
Signature of OWNER(Must be signed by the OWNER I Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
NORTH BAY SEWER
PORT OF ALLYN WATER SANITARY SFVi�R F FlJD ALLYN UCA R.2 POTABLE AIM LEGEND
0 SEWER MAIN CONNECTION WATER METER BOX
CLEANOUT w WATER HOOKUP
LOT STUBOUT WATER MAIN CONNECTION
®SANITARY SEWER MANHOLE Q 4' VALVE
X CROSSOVER X CROSSOVER '�-n -yr
r
Jo A 6A FeF 1" = 30'
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15.
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APPROVED ?o
ASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
CHANGES SUBJECT TO APPROVAL 1ST FLOOR 988 SQ. FT.
y Date 2-'-I-2oz 2 2ND FLOOR 988 SQ, FT.
I 3RD FLOOR 509 SQ. FT
GARAGE 400 SQ, FT,
FRONT PORCH 144 SQ. FT,
REAR PORCH 120 SQ, FT.
r
LEGAL OESCRIPHON ADDRESS >`
LOT 10 BLOCK 53, ✓ 120 E CEOARLAND LANE CEOARLAND HOMES LLC
PLAT OF ALLYN, ALLYN, WA, 98524 P.O. BOX 2269
VOLUME I OF PLATS, PAGE 17 GIG HARBOR, WA 98335
AP No. 12220-50-53010 ,/ CEO 2307 CEO 008 (253) 208-6130
�.BECK SITE PLAN MAP AGATE LAND SURVEYING, PLLC
��,.• 'pF wA '";, PROEESSIOMAL LAND SURVEYOR
FOR 2680 E. AGATE R0. - P.O. BOX 20
CEDARLAND HOMES LLC sf1ELTON, WA 98584 - (360) 426-4172
a IN THE DRAWN BY DATE, 01/10/2022 X6 N0:
20237
�� MJB 4148-5310
'� SWl 4 NEl 4
sZO•..TSTCR. �� 1 SCALE 1 INCH = 30' SHEET. 1 OF 2
^'Ac inN� SEC 20, T22N, RO1 W, W.M. CHECKED BY
SGB FILE NO: 4148-5310-JJ_SITEPLAN,DWG
N
IW - L &
LANNI G RECEIVED
POTABLE WATER AND '1 26 2020 �- n
SWTARY SD"PROV10E0
BY TOM OF Aam
b I b W. Alder Street
1" = 30'
A 46
Zor 3
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20
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PLANNING:
ALL SETBACKS ARE MEASUR
FROM THE FURTHEST
( (/ " PRQJECT10N OF THE BU DING
LEGAL DESCR TaY ADDIM
LOT 2 BLOCK 46, E CMAR"LANE J k J DEVELOPMENT
PUT OF ALLM, ALLIK WA- 98524 P.O. BOX 2264
VMUME 1 Of PUTS: PACE 17 2307 GIG HAROW, WA 98335
AP No. 1 2220-50-4 60 02 CfD 2307100 (253)208-8136
Bic SITE PLAN MAP AGATE LAND SURVEYING, PLLC
"lr G- *� . PRQ�ESSCWAL LA►@ SW ?U?
°F J, FOR 2680 E.AGAIE RD. -P.a BOX 246
J & J DEVELOPMENT SFRMN, WA 9&%4-(360)426-4172
b`. a
IN THE DRAYS BY DATE 04/13/2020 NO.
4118-4602
s+ . 28237 -w tl W1/4 NE114 MJB/RLe
�ssj���IsreR`°v SCALE 1 1NGF1= 30' SffEtT 1 OF 1
L b SEC 20, T22N, R01 W, WY. CNECKED BY
$( FILE MU. 41
p iId 2o2.o --c-0409 - *ac4V -AI I
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NNING
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LOT 2 BLOCK 46, f CEDARLA D LANE J h J DEM30PMENT
PLAT OF AU)W, ALLIX WA. 98524 P.O. Box 2264
VMW 1 OF PLATS, PACE 17 2307 CIG HAR9M WA 9833.5
AP Na 12220-50-46002 LED 2307 (253)208-8136
SI TE PLAN MAP AGATE LAND SURVEYING, PLLC
ry.BE PRVESSIQYAL LARD S1A WWR
FOR 2680 E AGA1E A'J). -P.a wx 246
SHIM. WA 90584-(JW)426-4172
_ J & J DEVELOPMENT
1N THE DRAW BY DATE 04/13/2020 4148-W
N*714 IYE1 f4 MJB/RL B
SslO y AR$ SCALE 110 30' 9W. 1 OF 1
EC 20, T2N, R01 W, W.M. 000,11
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RE EIVED �
M Y 2 6 2020
POTA6LE WATER ANO
SMTARY SB"PRONOM 615 Alder Street ���
BY Tom OF m YN
1" = 30'
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ENVIRONMENTAL
HEALTH
LEGAL DfS47UPlM ADDRESS
E LANE
LOT 2 BLO(X 46, J k J OEVELOPa IDU
PLAT OF ALL A, ALLIN, Wit 98524 P.O. BOX 2264
KXUUE I OF RAT% PAGE 17 2307 (C HARBO.R, WA 98335
AP No. 12220-50-46002 CfD 2307 (253)206-8136
r,.sEc
SITE PLAN MAP AGATE LAND SURVEYING, PLW
PRLFE59CWAL LAND SURVEILR
FOR 26W E AGAIE RD. -P.Q BOX 246
J & JDEVELOPMENT SHELTON WA 98564-(360)426-4172
s
b o
1N THE DRANK BY DATE 04/13/2020 X8 NO.,
4148-4602
26237 w NW114 NE114 MJB RIB
`ass E�rsrER�°J~ SCALE 1 M= 30' SHEET. 1 OF 1
rO�AL LA AA 2U SEC 20, T2A, R01 W, W.M. C1 CKED BY
y
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MASON COUNTY EP<;`;''' -NTAL HEALTH
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MAY 2 6 2020
POTmff e SAM�W MVM �r,+8Y IONN OF ALLYN.P� hhketr
1 = 30$
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PLANNING. Qv
ALL SETBACKS ARE MEASURED
FROM THE FUI47HEST
PRQ,JECTION OF THE BUILDING
LEGAL DES"INN E LANE
LOT 2 BLOCK 46, J k J DEVELOPMENT
PLAT Of ALLM, ALLMX !bl 96524 P.O. BOX 2264
KXUME 1 OF PLAM PAGE 17 2307 aG HARBOR, WA 98335
AP No. 1222 0-50-4 60 02 CEO 2307 (253)206-8136
G_BEC
SITE PLAN MAP AGATE LAND SURVEYING, PlW
li" FOR 268oso E. AG 7E-Rv. D.a YVR
BOX 246
4`F� 1•=. C�A J & J DEVELOPMENT 9CW WA 9&M-(360)426-4172
moo,
IN THE DRAWN BY DA7E: 04/13/2020 N0
b. ,o
NW1/4 NE1 f4 MJB/RLB 4148 4fi02
SCALE t UV(,r`!= 30' SHEET• 1 OF 1
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$(„� FIZ£Nk 4118-4bQ2�_STFS�(.AlI.D1YG
p Ltd 2OZO -t'nOL4U S - ��e. I l Ue�i A
o�A I Lv1 f-v,, W A+-t-r'- 'lam_ 2o' wY,,Q.," A b o+5
IMA8ON Ct�UNN DCD p AWNING
SITE PLA
w REOUIRED TO
CHA4 ES SU'g,IET 7ir Ai
Name M foil ad, Parcel# BLD#2Q 2Q
kfbC5 Mason Coui�t�yb to � ILDING
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements fot�tI VE D
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County Vabtie:
http//www.co.mason.wa—us/code/commissioners/index.htm MAY 2 6
Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". 2020
Regulated activities shall be conducted only after Mason County Public Works approves a stogy teWitA I 4 rr Street
(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
yov in preparing the necessary information and plans for Public Works to review and approve. Per Department of
40plic Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT. 450
Mail: P 0 Box 1850, Shelton WA 98584
Physical: 415 N 6th St, Shelton WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other, parcel. You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical:426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.1
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspec 'on as may be requi d00,
X Own /Agent/Contractor(circle one)Date:
Page 2 of 2
;jJ-Name Parcel# BLD#
rnCs
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 2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
urface 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
X
above table
=
Patios/Walks 0 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
Total Impervious Surface Area (sum of all areas) Small Parcel Stormwater Site Plan is Required
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 1 of 2