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HomeMy WebLinkAboutBLD2024-00331 Pole Bldg - BLD Application - 3/11/2024 4• MASON COUNTY COMMUNITY SERVICES FPer U- OO r 0(/ 3 ✓' PERMIT ASSISTANCE CENTER: Im U L •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL MAR ���� 615 W.AlderM K 11 Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext 352•Fax.,(360)427-7798 Belfair.(360)275-4467•Phone Elma:(360)482-5269�'9('� W. q i d e r Street BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: O vim NAME. MAILt#2: SS: AILING ADDRESS- CITY: STATE ZIP: CIT) TATE: ZIP. PHON I'�/ PHONE CELL: PHON — EMAIL: EMAI L&I REG# EXP. PRIMARY CONTA T- OWNER CONTRACTOR❑ OTHER❑ NAME S�I�I EMAIL MAILING ADDRESS/ CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) - 3T00000 ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRIC SITE ADDRESS Zb D E. M IlZ 46, 12, CITY I/O DIRECTIONS TO SITE ADDRESS NJ 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): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW ADDITION❑ ALTERATIION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)_ CA A�-AIU IS USE: PRIMARY❑ SEASONAL NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg YES(Pan[a]ofBldg)❑ N UA A�1) DESCRIBE WORK Q SQUARE FOOTAGE: (proposed) 1 ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.fL DECK sq.ft. COVERED DECK 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❑ EXISTING❑ PLUMBING IN STRUCTURE? YES/ NO❑ Ifyes,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 dedare 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 v COUNTY CODE 14.08.42) x m4r-m it , Zoz�- Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED I DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Per w�� ~oV 3 PERMIT ASSISTANCE CENTER: 1 \C BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHA 815 W.Alder Street,Shelton,WA 98584 PLANNING Phone Shelton:(350)427-9670 ext.352•Fax:(360)427-7798 P one MAR 11 2024 Belfair.(360)275-4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATIA1 5 W. Alder Street PROPERTY OWNER INFFORMATION: CONTRACTOR INFORMATION: NAME: O vim NAME MAILI A SS: I?.II ING Annu>~cc- CITY: STATE ZIPAVMCITY - SATE: ZIP: PHONE#I: I-I/ PHONI 'CELL: PHONE#2: — EMAIL EMAIL: L&I REG I cXP. PRIMARY CONTA T' OWNER CONTRACTOR❑ OTHER ElNAME . fl W In MI EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) L1.17 71 � — H— 00000 ZONING LEGAL DESCRIPTION FIRErD�ISTRIC SITE ADDRESS Zb 0 6, 01N( a,Q({i V-. CITY >140 DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO14 SNOW LOAD: psf 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 ADDITION❑ ALTERRATIION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) G A�-AV IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg) YES(Part/aI of Bldg)❑ NO❑ DESCRIBE WORK 7 O SQUARE FOOTAGE: (proposed) 1 ST FLOOR2i+QD sq.ft. 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 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❑ EXISTING❑ PLUMBING IN STRUCTURE? YESA NO❑ Ifyes,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 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 Ma�UVt ii , 2oz+ Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT G — •,2 FIRE MARSHAL PUBLIC HEALTH w, ; MASON COUNTY COMMUNITY SERVICES Permit N : PERMIT ASSISTANCE CENTER: RECEIVED ( I •BUILDING •PLANNING •FIRE MARSHAL 615 W. Alder St-Shelton, WA 98584 www.co.mason.wa.us MAR 11 2024 Phone Shelton:(360)427-9670 ext. 352• Fax:(360).,427-7798 Phone Belfair:(360)275-4467• Phone Elma:(360)$$ .Ci12W. Alder Street PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRAC'Tnu IN1v"DMA-r1"N- NAME: NAME. MAILING AD RESS:J00 MAILING ADDRF14C`! CITY: STATE:_ZIP: CITY: 31 ATE: ZIP: 15'PHONE: Ub 'U�� PHONL 2"d PHONE: 0y 5 EMAIL : EMAIL: L L&I REG EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): —J, — 00000 Zoning: LEGAL DESCRIPTION(Abbreviated): SITE ADDRESS: ZOO C. i�ll1�/�G�/ !� 1Z. CITY: e,kaio DIRECTIONS TO SITE ADDRESS: ^' TYPE OF JOB: II,^, NEW ADD= �ALT REPAI OTHER=USE OF BUILDING S Y O p LOCA-601N OF FIXTURES/UNITS—1sT FLOG 21'7D FLOOR=BASEMENT=GARAGED OTHERO PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:El ectric=LPCJ=Natural Gas=Ductles Toilets I Type of Unit No.of Units Fees Bathroom Sink 1 Furnace Bath Tubs Heat Pump _ Showers Spot Vent Fan Water Heater l 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 PLICATION. Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN ■■► wool MIME ■■■■■■■■a-mm HE No IN M, 40 or 11MEME ■E i■■11 ■ ■■■MMMw%mm UNNEWEENIIIII. S■■■■ MEs.I!l�IAM■MM■►%MFA : © M■EM■OEMMEMO■ E■■EEEi�iEMEIIIEErl !t►�' unww'd ■M<<S■■■■ME■Err■ ■EMif r?►'j7©�1E EEu�■■■■mm"RM► EMMMi■M■■M■SO REM 11 Low SENSE KNEMEM MOEN MEN Mini MEN SENSE If PAIUM mkq NO HE MENOMINEE ONMENOMEN No MEN r■i�r■E MEMEMESMEM■ M■MEEM&\EEM■MEM■■■■■I Do , ,a�� lE■■■■M■■■E■■M■■■■■■ME■■MEE■■■S■■■OBI MME■■E■■■MMM■■■EM■E■EMEMEMME■■M&.NEE■SM MEN M 2 !EM .�lilAE:1■M■■■■OEM■■■■■■■■■E■■■MEi �■a■Ee■■ MEN■■■■■■E■■■■■E■EEE■■NEE■■■E■\ \■,MEMO ■ pia NEON \■M■OO■ Esi i " ire►E IO ■■E■■■A��■�EE■■■■■■■EEM■■■fir SEE■■ ENO■■ ■ ■■E� tE� ll ��I� f�►�E a■■E■E■■■■■■EMS■E■ NEON■ ■ ■■■ME■E■EMEME■E■EMME■S■ OEM■■0■M WIN ■s■ Name A1!- J b V 6 mm Parcel# �Zf QQ�� 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 compliieisE€o>�ormwater Management in this jurisdiction.A complete copy of the ordinance can be f u on a ason County website: http//www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". MAR 11 2024 Regulated activities shall be conducted only after Mason County Public W6rkf7a*koAW(9 ort 4.Q9Aite 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) 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