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Home My WebLink AboutBLD2018-00706 SFR - BLD Application - 7/5/2018 MASON COUNTY COMMUNITY SERVICES Permit No: I� o 76 PERWT ASSISTANCE CENTER: BUILDING•PLANNING•PUBLIC HEALTH.FIRE MARSHAL • 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone Bedair.(360)275-4467•Pion Elma:(360)4a2-5269 4 BUILDING PERMIT APPLICATION ✓641 O ' PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: eY� �(.�� L✓� NAME: MAILING ADDRESS: PO Px)tC 17a Q MAILING ADD 3 CITY: ANA STATE: ZIP: a9':;2 CITY: STA ZIP: �7 PHONE#1: Zbo 1ca0 , lob 1 y PHONE: CELL: jl PHONE 142: EM n IL: EMAIL: 1 UM e der\ �� Gnr►'� L&I REG# EXP. PRIMARY CONTACT: OWNER®, CONTRACTOR❑ OTHER❑ NAME 'T-*c✓h 'i c, ' EMAIL MAILING ADDRESS P c ' v_ 1 7;Z:R CITY 411ge\ STATE 7r"E ZIP PHONE 3 0[1-1g a y —6ini ice— CELL PARCEL INFORMATION: i ^� PARCEL NUMBER(12 Digit Number) 1 �{ d �( — o O L —3 ZONING LEGAL DESCRIPTION(Abbrevtated) d�r11 � a 7' r Z FIRE DISTRICT SITE ADDRESS— a Ti x f,CAu � � crrY Ali y el DIRECTIONS TO SITE ADDRESS r v/ k L,T tn a,i r�'m* Yew ► Q IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14*: YES❑ NOX IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITIONZ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Remdmce,Garage,Commercial Bldg,Etc.) r R .+Ct,('e IS USE: PRIMARY Ok SEASONAL❑ NUMBER OF BEDROOMS_NUMBE OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part(sI Bldg) NO❑ ?M DESCRIBE WORK /// W SQUARE FOOTAGE:(propose+emsttnr) 1ST FLOOR J�9Z_sq.ft. 2ND FLOOR sq.ft 3RD FLOOD sq.ft BASEMENT sq.ft. DECK- sq.ft COVERED DECK—N.ft STORAGE sq.ft OTHER sq.ft GARAGE6VL/ _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` J / NEW❑ EXISTING PLUMBING IN STRUCTURE? YESA NO❑ If yes,attach completed Water Adequacy Farm PERIMETER/FOUNDATION DRAINS PROPOSED? YES)< NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS_ 3 OWNER acknowledges that submission of inaccurate information may result in a stop work order or pern-A 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 I 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 1 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON /+ COUNTY CODE 14.08.42) Q Signature of OWNER(Must be siarmd by the OWNER I Date DEPARTMENTAL REVIEW APPROVED D E DENIED DATE I TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT 67 PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: eb7& PERMIT ASSISTANCE CENTER: .BUILDING •PLANNING •FIRE MARSHAL 615 W. Alder St-Shelton, WA 98584 /�A r www.co.mason.wa.us ``4 Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 �/� / *^ • Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269 -'PLUMBING & MECHANICAL PERMIT APPLICATIGN l' tq OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: 77Rm ' NAME: MAILING ADDRESS: PO 0>pA 1-7a ;RMAILING ADDRESS: CITY: \ STATE: �JA_ZIP: �) CITY: ZIP: V PHONE: y -Na u PHONE' CELL: 2°d PHONE: EMAIL: L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): 0 �5,— DQ Zoning: LEGAL DESCRIPTION(Abbreviated): i SITE ADDRESS: a\O a. 'nq CITY: 'hi I DIRECTIONS TO SITE ADDRESS: _ GU lCflls TYPE OF JOB: NEW ADD_ ALT REPAIR OTHER USE OF BUILDING e�t LOCATION OF FIXTURES/UNITS- IST FLOOR ) 2ND FLOOR V _BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:ElectricN�LPG Natural Gas Ductless_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump Showers T Spot Vent Fan Z. 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 W Other 4✓N� l 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 pernut 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 CONTINU FTHI Y MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WIL IDATE T PLICATI X -- --- -- -- -- -- -- 7---5 - - ---- - - - - Signature of her Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT ()&-r PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN Name I f m f n Parcel# I a aZ a 0 BLD# Z_o 0 - 00 7 C)<p Mason County Department of Community Development Small Pnrrel Stormwater Management Annlicntion/Workclteet Inage 1 of 21 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 liatural 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 Z X Z0 = O X = 1 Measurements for buildings are taken at the perimeter of the farthest projections(example: Z! X cy.to = eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parkinq 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) (op - -7 - - — 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 ovTer,owner's legal representative, or the contractor.I further acknowledge that the i ormation provided is accurate and employees of Mason County are granted access to the above- described pro rty for and ins ion 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 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 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: hi!RL/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 INTTIAL 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.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 RECEIVED UL 0 5 2018 W.Alder Street a APPRO ED .� MASON COUNTY DC D PLANNING P L NING SITE PLAN REQUIRED :0 BE ON SITE CHANGES SUBJECT TO A'DPR ")10 By A.,) IS `Ba�eo - PL NING: ALL SETBACK ARE MEASURED FROM T E FURTHEST e 0�4 pROJEC'1"IAN QF THE BUILDING s - F(\ ff ri \ , CO V) bgvt -ba 0(P 1 N r RECEIVED UL 0 5 2018 W.Alder Street x ENVI RD MENTAL c HE LTH y+p�a-r 1 IU 5 A, r - is a t�• „ co i J .. _ --_ - J z ve w . s 2f o� LLJ a. o V) Z o , 1