HomeMy WebLinkAboutBLD2019-01276 FDPO - BLD Application - 11/7/2019 MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES FLD RECEIVED
615 W.Alder Street—Bldg.8,Shelton,WA 98584 Date Rcvd NOV 13 2019
Phone:(360)421-*70 Ext.352♦Fax:(360)427-7798
' 'Fee: $300.00
No fee if w/other permits
FDPO Development Permit Application
Applicant: Contractor: 6.,B,Ce n 54rU c: i vN
�onfr'ac�
►�l S�" Ic L l� LL c
Mailing Address: Mailing Address:
Plot X 1109 N w A/o// ,?6A61
City, State, Zip City, State, Zip
Phone: (310) qq3-b<37 Phone: (-10) a 07
Email: Email: -a 5fJa/`e ¢� 11na1 6o,10
Parcel Number: Property Address:
I a a 36 -J I z��io ;-ed 4,a- ,ddre
I understand I am making application for a permit to develop in a designated flood hazard area. The
undersigned agrees that all such work shall be done in accordance with the requirements of the County Flood
Damage Prevention Ordinance, building codes and all other applicable Local, State and Federal regulations.
This application does not create liability on the part of the County or any officer or employee thereof for any
flood damage that results from reliance on this application or any administrative decision made lawfully
thereunder. ty"
Applicants Signature: 0 0 '�T -RAIL Date:
Official Use: `
A. Description of Work (complete for all work):
1. Proposed Development Description:
ANew building/Addition ❑ Manufactured home ❑ Fill/grade ❑ Other:
❑ Commercial (see section D)
❑ Remodel/repair to existing building (see section C)
2. The parcel has been identified in the following Flood Hazard Area:
X A ❑ AE ❑ AO ❑ VE
3. Are any other Federal, State or local permits required? Must attach copies of permits.
Yes ❑ No If yes, list type: h lWt 09 k-'A(`5
4. Is the proposed development in an identified floodway?
❑Yes N No
5. If yes to#4, a No Rise Certification must be attached.
❑ Yes No
B. Complete for New Structures and Building Sites:
='1��Etma- nn Certificate isr�-guired must be completed by a Washington State licensee!-Surveyor:-
Elevation Certificate must be attached.
2. Base Flood Elevation at the building site: feet NAVD 88
3. Required lowest floor elevation (including basement floor): feet NAVD88
4. In flood hazard areas without a base flood elevation (BFE), what is the highest adjacent
Grade? (HAG)
Structure must be a minimum of two (2) feet above the HAG.
The required finish floor height is
C. Complete for Alterations, Additions, or Improvements to Existing Structures:
******(See attached Substantial Improvement & Substantial Repair) *******
1. What is the estimated market value of the existing structure? $
Attached:
Assessor's Parcel Detail Report OR
Appraisal from a Washington State Licensed Appraiser
2. What is the cost/valuation of the proposed construction? $ Percentage
Attached:
Contractors Bid (FEMA Criteria) OR
County Valuation per Mason County Ordinance
3. If the cost or valuation of the proposed construction equals or exceeds 50 percent of the market value
of the structure, then the substantial improvement/repair provisions shall apply.
Is the proposed work a substantial repair/improvement ❑ Yes ❑ No
D. Complete for Non-Residential Floodproofed Construction:
1. Type of floodproofing method:
2. The required floodproofing elevation is: feet NAVD88
3. Floodproofing certification by a registered engineer is attached:
❑ Yes ❑ No
E. Complete for Subdivisions and Planned Unit Developments:
1. Will the subdivision or other development contain 50 lots or 5 acres?
❑ Yes ❑ No
2. If yes, does the plat or proposal clearly identify base flood elevations?
❑ Yes ❑ No
3. Are the 100 Year Floodplain and Floodway delineated on the site plan?
❑ Yes ❑ No
J
Administrative
1. Approved: eme :
Planning Staff Signature: Date:
Building Staff Signature: Date:
3. As-built lowest floor elevation: feet NAVD88
Comments/Conditions:
Mason County Flood Damage Prevention Ordinance #41-17 & International Building Codes