HomeMy WebLinkAboutBLD2017-00145 MFG Home - BLD Permit / Conditions - 4/10/2017 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
y 615 W Alder St
Shelton, WA 98584
W4 RESIDENTIAL BUILDING PERMIT
BLD2017-00145
OWNER: WILLIAM EMERY RECEIVED: 3/6/2017
CONTRACTOR: LICENSE: EXP: ISSUED: 4/10/2017
SITE ADDRESS: 1301 E VICTOR RD BELFAIR EXPIRES: 10/10/2017
PARCEL NUMBER: 122217500030
LEGAL DESCRIPTION: LOT 3 OF SURVEY 5/31
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
INSTALLATION OF MANUFACTURED HOME WA-3 N, CONT ON TO E NORTH BAY RD, CONT ON WA 302, L ON NE
VICTOR RD, FOLLOW TO SITE
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: 2 Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,512
Valuation: Building Height: 16 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make:FLEETWOC Length: 56 Ft. Front: E 189.0 Ft. Shoreline: Ft. Water Body:
Rear: W 220.0 Ft. Slope: Ft. SEPA?:
Model: Width: 27 Ft. Shoreline Desig.:
Side 1: N 183.0 Ft.
Year:1981 Serial No.: WAFL2AB05 Side 2: S 80.0 Ft. Comp. Plan Desig.:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Manufact. Home Issuance AMP 3/6/2017 $264.25 S3201700000001
Planning Review Fee AMP 3/6/2017 $205.00 S3201700000001
EH Plan Review AMP 3/6/2017 $210.00 S3201700000001
Manufact. Home Submittal SLC 3/31/2017 $264.25 S3201700000001
Total $943.50
BLD2017-00145 Please refer to the following pages for conditions of this permit. Page 1 of 6
CASE NOTES FOR
BLD2017-00145
CONDITIONS FOR
BLD2017-00145
1) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X
2) Prior to final approval, all upland areas disturbed or newly reated by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
3) Application cknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is RR-5.
X
4) Property is zoned residential zoning(RR-5 . Per MCC 17.04, only one single family residence is allowed per lot. Please verify prior to final
inspection and occupancy. X
5) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-6 - 9 2. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
6) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Depa t nor to any further inspections being performed or approvals granted.
X
7) OwneV_// 'gpn responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X
8) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal oyed documents will result in failure of required building inspections.
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9) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the "approved" site plan is not on site, then
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Buildi D ent prior to any further inspections being performed or approvals granted.
X
BLD2017-00145 v Please refer to the following pages for conditions of this permit. Page 2 of 6
10) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State
Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present
to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified
installer responsible for each major part of the installation. RCW43-63B.090
An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily
located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each
installer performed Ain tal certification number and signature of the certified installer responsible for each major part of the installation.
WAC365-210 X
11) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American
National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you
znt c ce of Manufacturing Housing (360) 725-2800.
12) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the
manufacturer's installation instructions.
A drip edge shall be provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5)
X (/v
13) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X
14) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer specifications and in accordance with IRC
Section R315.
Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level of the dwelling.
EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances),
repairs, or additions requiring a permit occur, or when one or more sleeping rooms are added or created.
X
15) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such roads aonnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
X
16) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit o ati
X
BLD2017-00145 Please refer to the following pages for conditions of this permit. Page 3 of 6
17) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all
responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the
inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason
County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been
discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy (Final
Inspection)will be granted for the residence.
OWN ER/CO NTRACTOR(indicate which) Signature X
18) This permit is for the placem nt nd installation of the manufactured home only and does not imply approval or review for any other items indidcated on
the plot plan. X
19) Permanent Address must be posted and visible from the road
Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails
must be in good condition and meet code for year built or current code if replaced.
Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit
Gutters and downspouts must be installed with splash blocks provided
All exterior penetrations must be sealed
HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24" above grade.
The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4
panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection.
All conditions on the original or issued permit must be met
If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available
It shall be the responsibility of the person requesting the inspection to provide the
manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection.
Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an
inspection is requested and required items are not completed prior to the inspection being performed
ENFORCEMENT PROVISION:
Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action
and subsequent violation and penalties pursuant to the Mason County Code.
X 101,
BLD2017-00145 Please refer to the following pages for conditions of this permit. Page 4 of 6
20) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact
adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the
stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further
information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access
connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which
is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may
affect your project.
X
21) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance ore I � n, must be reviewed and approved by Mason County prior to construction.
X
22) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspecto s I made prior to requesting additional inspections.
X
23) MOBILE HOME PARK SETBACKS SHALL BE 15' FROM NEIGHBORING ACCESSORY STRUCTURES, 10' FROM PROPERTY LINES AND 5' FROM
RIGHT-OF-WAY EPER MASON COUNTY ORDINANCE#118-91.
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24) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including
installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be
clearly marked i the installation instructions.
X
25) All property lines shall be clearly identified at the time of foundation inspection. X
26) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason Co nt o nces and building regulations.
X
VT
27) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prev nt d action from being taken. No more than one extension may be granted.
X
28) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connect rs, a X�!hing. Install metal connectors approved for contact with the new types of pressure treated material.
17
BLD2017-00145 Please refer to the following pages for conditions of this permit. Page 5 of 6
29) Retaining walls needed to support a surch ge,s 1 as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X
30) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approv ite I "to ensure these structures are shown and meet the setback conditions listed.
X
31) ALL SUR ACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD WA .
X
32) On-site septic system final installation required prior to temporary/final occupancy SWG2014-00158.
X 14
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.
Signature Date
OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2017-00145 Please refer to the following pages for conditions of this permit. Page 6 of 6
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REVIEW CHECKLIST
for important code information and details that pertain to this MAR 0 6 2017
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REVIEWED FOR FILE PocumentS to approved plans:
CODE COMPLIANCE Coj3y Siteplan:
MASON COUNTY Plan revie.r
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'VLA-SO'N COLT NTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST
Owner's Name: I 10llh Date: 3 Project description N W Al F�
Documents:
3IdZOf7 - 60PIS
_Building Permit Application Completed.
_Mechanical/Plumbing Application Completed.
_Planning Intake Checklist Completed.
_Site plan includes:Allowable buildin verhangs, decks, etc.
_Fire Apparatus &Access quired? Yes/No
_Stormwater Ch pleted.
Ener pplication Form- O Electric wall heater O Electric central furnace O LPG Furnace
eat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type )
O Ductless Heat Pump O Other. Specify:
Construction Plans:
_3 Sets (2 full size sets w/enginee ns & 1 reduced sized set 11 X1 7 min.(no calculation needed )
_Plans Legible Scale _ Elevation Views _Cross Section
_Foundation _Roof Framing Plan _Floor Plan—Use of rooms labeled(all floors)
_FI g Plan -all floor levels including loft, crawispace, etc. BUILDING
ck Framing Plan including covered porch, carports
Plan Details:
_Roof framing details, truss lay-out may be needed (Hip and girder location s
_Wall Framing - Does bearing-wall height exceed 10'? (Engineeri required)
_Floor framing: Floor joists (size&spacing): Floor beams:
_Window headers. Typical header. Garage header-
Foundation: footing size, reinforcemen g (Engineering
g g y g p C 'O ED
_Concrete Walls- Does Concrete eight Exceed 8'? En ineerin may be re u-IRIEC il�lJ
_Landings at all exits? Le 0° above grade? Y/N (must be shown on site plan)
_Water Heater. L Type: MAR 0 6 2017
_Heated By F - Location of Furnace Fuel type:
_Firepl ove Information Shown -Fuel Type? Location(s):
_ w Sizes Marked on Plans. 15 W. Alder Street
raced wall panels (shear walls) MUST be markedfindicated on plans.
_Engineered Yes/ No Snow load: Seismic: D2 Design Code: Are plans stamped
Manufacture Homes:
XFloor Plans (rooms&areas must be labeled)
Foundation Type:
ANSI/Man facture method Engineered footing/foundation Basement
Decks": �// 4x4 min. landings required at each entrance (must be shown on site/plot plan)
*Covered decks and/or any decks greater than a 4'x4' (that exceed 30'from grade) requires a permit and
construction plans.
COMMENTS:
Intake review (initials). Date: 3 ��
H:\permit tech building checldist2015.doc Revised 8.52016
If any of the items fisted below are either indicated or missing within the construction
documents; the plans must be engineered or returned to the applicant for resolution.
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ENGINEERING REQUIRED:
Braced vreall paneWbrace wall lines are not marked on plans (R602.10)
Amount and location of bracing does not meet minimum required in Table R602.10.1
DESIGN CRITERIA:
All notes and details required are result of the engineered analysis shall be transferred onto proposed building plans.
Wind 85 MPH, Exposure B (unless proven otherwise). Seismic Zone: D2, Snow_psf.
IRREGULAR BUI LDINGS R301.2.2.2.5 Irregular portions of structures shall be designed in accordance with accepted
engineering practice. A portion of a building shall be considered to be irregular when one or more of the following
conditions occur.
1) Exterior shear wall or braced wall line are not in one plane vertically from the foundation to the uppermost
story ij which they are required. See exceptions.
2) Roof or floor is not laterally supported by shear walls or brace walls lines on all edges.
3) Portion of roof or floor extend more than 6 ft. beyond the braced wall line.
4) End of BWP extends more than 1 ft over an opening more than 8 ft in width below.
5) Opening in a floor or roof exceed the lesser of 12 ft. or 50% of the least floor or roof dimension.
6) Portions of floor level are offset vertically
7) Shear wall lines do not occur in two perpendicular directions. z
8) If a story above grade includes masonry or concrete construction*When this applies the entire story shall b�
designed. In accordance with accepted engineering practice. *(exception: fireplaces, chimneys, and veneer as
permitted by the code).
'Applicant must take plar s to a design professional to address items indicated above-"
Notes/Comments for design professional:
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Name Parcel# I Z 221 - ? -00 0 0 BLD#61 A W I 1— 00 45
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
iri th it 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
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and i spection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
Name lJ Parcel# QT ZI - 15 Q66✓6) BLD# 9I a to 1-7—0(7`YS
Mason County BUILDING
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'.
'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 5 X ! _
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways 250 X -2566
X = Length of drive begins at the right of way
X =
Parking Areas X = 760
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) 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 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
r
MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
RE
ENVIRONMENTAL CE/Vpr.)
6 February 2017 HEALTH MAR
o 6 Z01�
Mason County Addresses Exempt Wells BIV�.S
The Washington Supreme Court decision on Whatcom County v. Hirst, a Growth Man gdii ls9wbt
(GMA)case,has had a profound impact on the way many counties throughout the state address water
resources.Under the Hirst decision,counties have the responsibility to make determinations of water
availability for development permit approval and cannot defer to Ecology. While this decision affects all
water withdrawal, it greatly affects the legal availability of water from Permit Exempt Wells.This
handout explains the Mason County position on Hirst implementation.
• At this time we are in compliance with the current comprehensive plan
• The comp plan is being updated and that process will take another few months to complete
• The legislature is working on legislative changes that will impact implementation of the decision
and we're waiting to see how that will effect state wide policy
• We're working with stakeholders to address current and future water use issues,and to match
population growth with available water as required by Hirst. Through the comprehensive plan,
we are updating forecasts for population growth,buildable lands,capital facilities and water use.
We will use county-wide groundwater studies to estimate development's impact on streams that
have instream flow regulations, and create county-wide solutions to mitigate for development's
impacts on stream flows.
• At this point in time,we are proceeding under our current policy as outlined in our current
development code and our current comprehensive plan. However,we are currently engaged in
the process of updating both our code and our comprehensive plan. The updated comprehensive
plan and code may be more restrictive than the current plan and code, as required by the Hirst
decision. Even if our current plan and code allow you to install an exempt well,we have no
control over judicial interpretations of State law or how State law may affect your project;
therefore,our willingness to permit your project or allow your exempt well is not a guarantee,
promise,or warranty that you will have legal or actual access or right to water. We cannot
promise,guarantee,or warranty that your permit will not be invalidated,or your exempt well
prohibited,by a court or hearing board. Notwithstanding our issuance of a permit at the County
level,you proceed at your own risk
By signing this,I declare that I have read and understand the policy for Permit Exempt Wells in Mason
County when applying f r an A plication of Water Adequacy.
" W�&� Date: MC. 4 6 �� 7
Signature �-
Parcel 12 2Z ( - 75 - p o D 3a
Public Health Community Development
(Community Health/Environmental Health) (Permit Assistance Center/Building/Planning)
415 N.611 Street—Shelton,WA 98584 615 W.Alder Street—Shelton,WA 98584
Shelton:360-427-9670,Ext.400 Shelton:360-427-9670,Ext.352
Belfair:360-275-4467,Ext.400 Belfair:360-275-4467,Ext.352
Elma:360-482-5269,Ext.400 Elma:360-482-5269,Ext.352
�oN coU�r� MASON COUNTY COMMUNITY SERVICES ] (d Z�1-7 --O o�qS PERMIT ASSISTANCE CENTER: Permit No:
•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
LDINlw
360)275-4467•Phone Elma:(360)482-5269 RECEIVED
E+ ` VED
BUILDING PERMIT APPLICATION
IV 4ult
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: �t I / NAME: 615 W Alder Street
MAILING ADDRESS: R2 MAILING ADDRESS:
CITY: h STATE: ez�lp: CITY: STATE: ZIP:
PHONE#1: lob k0/ 'S�o!mob PHONE: CELL:
PHONE#2: EMAIL
EMAIL: ' e 4 e L&I REG# EXP.
PRIMARY CONTACT: OWNER CONTRACTOR❑ _ OTHER❑
NAME Orv% EMAIL W e
MAILING ADDRESS f b 13 1 CITY Alf STAt E ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) )23 -? 1 — 7 S-00b 3Q ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS 1301 UI e_4V( Rd CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOV
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 [K ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) 12es t A g(►tee
IS USE: PRIMARY 4 SEASONAL ❑ NUMBER OF BEDROOMS � NUMBER OF BATHROOMS
HEATED STRUCTURE? YES (Whole Bldg)X YES (Part[s]of Bldg) ❑ NO ❑
DESCRIBE WORK_ I ns�-o.\\ ,ra�tXlnu Fc���-uT2d Inome.
SQUARE FOOTAGE: (propose+existing)
I ST FLOOR h S sq.ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT-- sq. ft.
DECK b 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 JJQ Lk)QQ(J MODEL YEAR LENGTH S
WIDTH BEDROOMS BATHS [ 3�� SERIAL NUMBER�,JPr fL 7 A W'3 f�3f
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES:4 NO ❑ 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 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 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 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)
Signature o NER(Mu ned by the OWNER) T Date
DEPARTMENTA REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH