HomeMy WebLinkAboutBLD2022-01561 SFR - BLD Application - 10/26/2022 MASON COUNTY COMMUNITY SERVICES Permit No: Yhd 2C 'L1 '
PERMIT ASSISTANCE CENTER:
.BUILDING a PLANNING a PUBLIC HEALTH a FIRE MARSHAL J/E D
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone
0141WAi�o Beltair:(360)275-4467•Phone Elma:(360)482-5269 L _7
BUILDING PERMIT APPLICATION
C-1— PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Housing Kitsap NAME: Sem r.
�.� MAILING ADDRESS:2244 NW Bucldin Hill Rd MAILING ADDRESS:
CITY:Silverdale STATE:WA ZIP:98383 CITY: STATE: ZIP:
PHONE#1:360-535-6134 PHONE: CELL:
PHONE#2:360-535-6138 EMAIL:
EMAIL:NailD@housingkitsap.org L&I REG# EXP. / /_
PRIMARY CONTACT: OWNER❑ CONTRACTOR[I OTHER I]
NAME JoelKremp EMAIL klempj@housingkitsap.org
,) MAILING ADDRESS 2244 NW Bucklin Hill Rd CITY SbardeN STATE WA ZIp98383
%\ PHONE 360531-6138 CELL 390.609-9209
� PARCEL INFORMATION:
VPARCEL NUMBER(12 Digit Number) a�'(�' 70NING RAP
LEGAL DESCRIPTION(Abbreviated)Lakeland Village 10 LOT:21&VAC PTN Blackwell St adj. FIRE DISTRICT C
SITE ADDRESS CITY Allyn
DIRECTIONS TO SITE ADDRESS �' latcsc� /�f o}� E'(�j,(r.Jnwe( A� OPC =
>_1 lrrT aj ID c d F E Sr 1V. A J!Lf A C I
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO❑ SNOW LOAD:,3apsf
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 Q ADDITION❑ ALTERATION❑ REPAIR❑ OTHER I]
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Erc.)Single Family Residence
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(Whole Bldg)9/YES(Part(s)ofBW❑ NO❑
DESCRIBE WORK /e ,:Jt n
SQUARE FOOTAGE:(proposed)
1 ST FLOOR 13 33 sq.& 2ND FLOOR sq.ft. 3RD FLOOR sq,ft. BASEMENT -� sq.ft.
DECK_ sq.ft. COVERED DECK S sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE !-L sq.ft. Attached Er 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 91 / NEW❑ EXISTING[3
PLUMBING IN STRUCTURE? YES I] NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES El 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
p COUNTY CODE 14.08A2)
Signature of OWNER(Must be ioned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT ��-
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
40 MASON COUNTY COMMUNITY SERVICES Permit No: IL-1 `b-6 L
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL
615 W. Alder St-Shelton, WA 98584
www.co.mason.wa.us I
Phone Shelton:P60)427-9670 ext. 352• Fax:(360)427-7798 LA
Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 0U51,u 67SA-P NAME: ;SAme.
MAII,R;�G ADDRESS:,�agq ht4)�&C/4"oJ klw O MAILING ADDRESS:
CITY: 1cv R,oacE STATE:_ZIP: g8;W3 CITY: STATE: ZIP:
1"PHONE:3G p- 535-w 34 PHONE: CELL:
2nd PHONE:,3/.D-53 S-(-13$ EMAIL :
EMAIL: AJR i/D Q AorAsi:te(ciFsap,n� L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): l a2 6?Q- �-S2D-,t'-'_7ppq Zoning: R- ( P
LEGAL DESCRIPTION(Abbreviated):La k.1,.,,.,1 U.I(a5d- /O LBr' 1/ L L Ae-42rN A/aekwe f( Sf. M ifAT
SITE ADDRESS: CITY: jgl/q
DIRECTIONS TO SITE ADDRESS:
y AlocV-- 1404 �Lakc(avet tJRa� W,�br s/�6 at E 4Jl+.c�lwriS�Fs,^ /Y - 14/!yn
TYPE OF JOB:
NEW[:j�ADD=ALT=REPAIR=OTHER=USE OF BUILDING c5 F
LOCATION OF FIXTURES/UNITS-1 sT FLOOR=2ND FLOOR=BASEMENT=GARAGE bTHERE:=
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:ElectricELDCPG=Natural Gas=DuctlessE�
Toilets a /St,o lD Type of Unit No.of Units Fees
Bathroom Sink t 8e L Furnace
Bath Tubs Q: Heat Pump 1 /g,00
Showers Spot Vent Fan 3 3 0-o d
Water Heater 01,00 Propane Tank
Clothes Washer 1 5 ,06 Gas Outlets
Kitchen Sinks 9.0o Wood/Gas/Pellet Stove
Dishwasher ( q,ao Kitchen Exhaust Hood ( iy.00
Hose bibs a- I $.D a Dryer Vent I o,y p
Other Solar Panel
Other
Base Fee .de7 Base Fee
TOTAL PLUMBING /`Sl.oa TOTAL MECHANICAL f %.6
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 TH,,E APPLICATION.
_ n
Signature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT J�
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN
Michael Matloff 122:�q_-50- 7009
E 92 Allyn Group 1 LOT 7 1333 PLAN
10,
5'
EBERHART LN 102'
_ tclrmwater
run-oft path
15' S'Road Easement
20' \CIS
E 80
r f
95' / 28'
/ 45' f
i 1333 sf SF 3 BDRM 14"
i 2 Bath 2 Car 25' DS �I
20' 46' S DRIVEWAY S /
/
f 1
5' Porch
r FIN.FLR.
/ / Z
f 88.25 24'
f 1 / �yC�
/ O POWER 95 `L
52' GARAGE 1 ___WATER 4i
f r
/E 90 SEWER f
41
0' /
1=20
10,
f /
f
/
102' f/
EH APPROVED
/
Rhonda Thompson 01/06/2023 /
E 80 !
Public water and sewer /`
} 1k
Name MaS/NL 1<�f&p Parcel#1 a21JO— W—1 '?Cog BLD# '?,OZZ- - 614a)
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:
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) VAn 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. p
Owne ge Contractor(circle one)Date: 9hCLXRn—
Page 2 of 2
Name RIDUS/NG f i rS Parcel# ¢y—G B L )-
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 stor nwater 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 =
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections (example:
eaves/gutters)
X =
Driveways L Q X = 5&0
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
QQ _ Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area (sum of all areas) a.pa J
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.
Own ent ontractor(circle one)Date: 5 /
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.
Pagel of 2