HomeMy WebLinkAboutBLD2016-00186 Final SFR with Attached Garage - BLD Permit / Conditions - 7/15/2021 Inspection Line (360)427-7262
�P5007 cot, MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT
BLD2016-00186
OWNER: PATRICIA MOORE RECEIVED: 3/15/2016
CONTRACTOR: REO RESTORE EQUITY OPRTN/MAINT (360) 265-0242 LICENSE: REORERE9000T EXP: E ISSUED: 5/17/2016
SITEADDRESS: 1010 NE OLD BELFAIR HWY BELFAIR EXPIRES: 11/17/2016
PARCEL NUMBER: 123204100090
LEGAL DESCRIPTION: TR 9 OF NE SE
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR WITH ATTACHED GARAGE TAKE OLD BELFAIR HWY TO MILE MARKER 1, PROPERTY ON RIGHT
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 3 Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,992 Garage-Attached 488
Valuation: $ 251,171.34 Building Height: 20 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W 330.0 Ft. Shoreline: Ft. Water Body:
Rear: E 250.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: N 10.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: S 10.0 Ft. Comp. Plan Desig.: Urban Growth Area
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 3 Furnace<100K 1 Plan Check Fee JBN 3/15/2016 $ 1,199.22 S2201600000001
Lavatories 3 Heat Pump 1 Address Fee JBN 3/15/2016 $ 173.50 S2201600000001
Bath Tubs 1 Ventilation Fan 3 Planning Review Fee JBN 3/15/2016 $205.00 S2201600000001
Showers 1 Propane Tank 1 EH Plan Review JBN 3/15/2016 $205.00 S2201600000001
Water Heaters 1 Gas Outlets 5 Building Permit Fee JBN 3/15/2016 $717.28 S2201600000001
Clothes Washer 1 Propane Stove 1 Building Permit Fee JBN 3/15/2016 $ 1,127.67 S2201600000001
Kitchen Sink 1 Exhaust Hood 1 Building State Fee SLC 4/1/2016 $4.50 S2201600000001
Dishwasher 1 Dryer Vent 1 Mechanical Permit Fee SLC 4/1/2016 $237.90 S2201600000001
Hosebibs 3 Mechanical Base Fee SLC 4/1/2016 $28.50 S2201600000001
Plumbing Permit Fee SLC 4/1/2016 $ 110.60 S2201600000001
Plumbing Base Fee SLC 4/1/2016 $24.70 S2201600000001
Total $4,033.87
BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 1 of 7
CASE NOTES FOR
BLD2016-00186
CONDITIONS FOR
BLD2016-00186
1) 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
1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) 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
Depart prior to any further inspections being performed or approvals granted.
3) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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4) 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 of approved documents will result in failure of required building inspections.
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5) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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6) 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
Building Department prior to any further inspections being performed or approvals granted.
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BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 2 of 7
7) 2012 IECC/Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C, Window(Max U-Factor):0.30, Skylight (Max
U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation min. R-49, Vault Insulation R-38,
and Slab Insulation R-10.
In addition the following credits from R406.2 shall be completed as follows:
1A- EFFICIENT BUILDING ENVELOPE (0.5 CREDITS)
3A- HIGH EFICIENCY HVAC EQUIPMENT, PROPANE WITH A MINIMUM AFUE OF 95% (0.5 CREDITS)
5A- PROPANE WTAER HEATER WITH A MINIMUM EF OF 0.82 (0.5 CREDITS)
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8) A permanent certificate, completed by the owner, builder or registered design professional, shall be posted within three feet of the electrical distribution
panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall
and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there
is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of
heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 105.4, and air leakage
results if a blower door test was conducted.
Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 5 air changes per hour when tested
with a blower door in accordanve with IECC/.WSEC Section R402.4.
The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is
not required for additions less than 750 square feet. Reference IECC/WSEC R401.3 & R101.4.3
Compliance certificates are available online at the WSU Energy program website titled, 'WSEC 2012 Certificate"and are available in /<or /z sheets. The
Mason County Permit Center will also have some available.
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9) A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section
R404.1.
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10) 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)
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BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 3 of 7
11) A concrete encased grounding electrode must be installed and used at each new building or structure that is built upon a permanent concrete foundation.
In Mason County the electrical code is regulated by Washington State Department of Labor& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-4000.
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12) In buildings of unusually tight construction, fuel-burning appliances (excluding cooking appliances and domestic clothes dryers) shall obtain combustion
air from outside in accordance with the international codes.
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13) A separate inspection in addition to the inspections required in IBC, Section 110 shall be required in accordance with the 2012 IBC, Section 1707.11.2.
The additional inspection is required when shear wall fastener spacing is required to be less than 4-inches.
The shear wall schedule shown on sheet S3 designate walls type SW3 with fastener spacing less than 4-inches.
The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified to inspect lateral
connections, the engineer of record (EOR), or an authorized representative of the EOR. The special inspectors duties & responsibilities shall be as
specified in Chapter 17. When a third party inspector is used to perform the inspection special inspection reports shall be submitted to the Mason
County Building Department, 426 West Cedar St, Shelton WA 98584 and also available for inspection. Ins c on reports shall be completed and
submitted to the dept. in a timely manner and shall be submitted prior to the framing inspections. XL
14) 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).
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15) 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.
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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.
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16) 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 roags connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
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17) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, 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 Building Department prior to any further inspections being performed or approvals granted.
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BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 4 of 7
18) 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 revocation.
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19) Installation of heating equipment in a single-family residence shall meet the requirements of the current IECC/WSEC R403, applicable sections of the
IRC, and IMC.
Heating equipment shall be sized in accordance to ICC/WSEC, Section R403.6. Heating and design load calculations for the purpose of sizing HVAC
systems are required and shall be calculated in accordance with accepted practice, including infiltration and ventilation. Design calculations shall be
available for inspection during inspection.
Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made
substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous
glass ducts shall comply with UL181Aand shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape.
Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive
tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened.
Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal ducts
shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or rivets
equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation
instructions.
Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8
DUCT TIGHTNESS TESTING shall be conducted by person(s) trained to perform such testing. A signed affidavit documenting test results in accordance
to IECC/WSEC Section R403.2.2 shall be provided to the Mason County Building Department prior to the final occupancy inspection. Affidavit forms are
available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit" or"Duct Leakage Testing Results (Existing Construction)." Duct
tightness testing is not required if the air handler and all ducts are located within the heated space.
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20) The placement of buildings and structures on or adjacent to slopes steeper than one unit vertical in three units horizontal (33.3% slopes) shall conform to
the International Residential Code Section R403.1.7 for descending or ascending slopes.
Alternate setbacks may be approved subject to approval of the building official based upon the investigation and recommendations of a qualified engineer
licensed in the State of Washington. Such an investigation shall include consideration of material, height of slope, slope gradient, load intensity, and
erosion characteristics of slope material.
21) Proposed structure(s) must maintain a minimum of a 5' setback from all property lines, easements and 25'from all County and State Road right of ways.
Setbacks are measured from the furthest projection of the structure.
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BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 5 of 7
22) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinanc��gulation, must be reviewed and approved by Mason County prior to construction.
23) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND 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
Inspector shall be made prior to requesting additional inspections.
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24) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks filled
on site must be located a minimum of 10'from any possible source of ignition (electrical outlets, electrical fixtures, compressors, etc), mechanical system
air intake (direct vent appliance, ventilation air intake, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. Propane
tanks less than 125 gallons must also be located a minimum of 5'from any building opening (foundation vents, windows, doors etc). Setback to the public
way, or access easements shall be the greater of 25-ft or as specified in the Mason County Development Regulations. Setback to property lines shall be
the greater of 5-ft or as specified in the Mason County Development Regulations. If a propane tank is exposed to probable vehicular damage, protective
bollards must be installed.
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25) Fuel piping shall be inspected after the installation of fuel piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the
time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall
not be u d until the final inspection has been performed and approved by a Mason County building inspector.
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26) The placement of small propane tanks are not normally subject to a permit review by the Planning Department; however, propane tanks are subject to
Planning Department regulations. Such regulations primarily consist of setbacks from shorelines and features considered to be critical areas (streams,
wetlands, slopes, etc.) If you think such featlires exist on or nearby your property, please contact the Planning Department so that exact setback
requirements can be determined. X
27) All property lines shall be clearly identified at the time of foundation inspection. X
28) 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 CoLinty ordinances and building regulations.
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29) 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
ho
lder prevented action from being taken. No more than one extension may be granted.
30) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 6 of 7
31) Landings and stairs must meet the same setback conditions as any permitted structure, and, must be shown on your site plan. Please check your
"ApprovV Site Plan"to ensure these structures are shown and meet the setback conditions listed.
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32) On-site holding tank final installation approval required prior to temporary/final occupancy. SWG2016-00091
33) 1. Owners agree to decommission the holding tank and connect to public sewer within 90 days of the public sewer system extending to within
500 feet of the subject's property's nearest property line.
2. Owners agree to payment of monthly fees as established by Mason County Department of Utilities and Waste Management.
3. Owners must allow needed pumping services to be provided by Mason County Department of Utilities and Waste Management.
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34) Applicant must provide a satisfactory Bact sample and well log or capacity test prior to final or temporary occupancy.
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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.
Signatu Date
OWNER - REPRESENTATIVE - CONTRACTOR
Prin Name (Circle one to indicate)
BLD2016-00186 Please refer to the following pages for conditions of this permit. Page 7 of 7
PLANNING 6LD206 - 0))X9
4--- RECEIVED
ts MAR 152016
615 W.Alder Street
t46 4
me d u w- De ne;it ) as id Qn-ba,L R -S
D�� side to
to r
Rear 10,
ay
lo,�y�
APPROVED
MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
CHANGES SUBJET TO APPR07AL
kLp�DaW4 J 17-6 I(Q
PLANN! Irk!G:
y ALL SETBACKS ARE IvIlEASURED
FROM THE FURTHEST
PROJECTION OF THE BUILDING
14
pQ[c9-k 123e;20- 41) Wo' 0
EXHIBIT"A"
LEGAL DESCRIPTION
A tract of land in the Northeast quarter(NE 1/4)of the Southeast qua (SE 1/4)in Section twenty(20),
Township twentythree(23)North,Range one(1)West,W.M.,pa described as follows:
COMMENCING art the Northeast corner of said NortheastRh
1/4) the Southeast quarter
(SE 1/4);thence South 1°50'30"West,along the East line feet to the POINT OF
BEGINNING of the tract of land hereby described;thence '17"West,150 feet;thence North
1°50'30"East,50 feet;thence North 88'53'17"West, 1290or less,to the Easterly right-of-
way line of Old Belfair Highway,County Road No.9825 - herly,along said Easterly right-of-
way line,250 feet;thence South 88°53'17"East,340 1°50'30"East,75 feet;thence
South 88°53'17"East,990 feet,more or less,to the st line o id Southeast quarter(SE 114);thence
Northerly,along said East line ROI T OF BE ING.
Parcel No. 12320 410009 �f
LPB 10-05(i)
Page 2 of 2
2053361 Page 2 of 2 03/07/2016 03:43:47 PM Mason County,WA
BUILDING
MASON COUNTY COMMUNITY SERVICES DEPARTMENT
WSEC/ Ventilation Code Compliance Application
Submit with heating/cooling system size worksheet (see instructions #4)
Owner: Parcel#: Type of project:
Total Sq. Ft. 1 Floor: 2" floor. Heated Basement:
of heated area:: Z
Yem-�� lectric wall heater O Electric Central Furnace O LPG Furnace
t it rn c p w s ce Ductless Heat Pump
55ier, specs ue y er. pec
Prescriptive Option Table R402.1.1
Compliance Method ❑ Component Performance, R402.1.3 — Calculation worksheets required
Check one::
❑ Other (Specify):
Check one µ Whole House Ventilation system • Whole House Ventilation µ Other,
Ventilation using exhaust fans&window or Integrated with a Forced Air describe:
System wall fresh air vents(M1507.3.4) System (M1507.3.5)
Referencing Table R406.2, "Additional Residential Energy Efficiency Requirements," all residential units
must develop credits as specified in Table 406.2. Identify and describe which option(s)will be used to
comply. If the table is not attached to this form you can access the table on our website at:
http://www.co.mason.wa.us/forms/Community Dev/index.php.
Additional
Energy a) Description: Small dwelling units with less than 1500 sq. feet of heated or cooled
Efficiency space and less than 300 sq. ft fenestration (see definition below) or additions to.an
Requirements existing building that is less than 750 sq. ft. of heated area. To use this option
Energy credits complete a window schedule in order to verify that the fenestration area does not
exceed 300 sq. ft. Fenestration is defined in the /ECC as skylights, roof windows,
required: vertical windows, opaque doors, glazed-doors that include products with glass and
non-glass glazing materials. - 0.5 points
1 Cb:))Medium dwelling units not includes in a) above, or b) below- 1.5 points
c) Large dwelling unit is a dwelling unit that exceeds 5000 sq. ft. of heated or cooled floor
area. -2.5 points.
Describe Energy Credit Option(s):
Using Option number(s):
3a
RECEIVED
MAR 15 2016
615 W. Alder Street
FENESTRATION SCHEDULE
USE FOR ENERGY CREDIT,a) SMALL DWELLING OPTION & COMPONENT PERFORMANCE COMPLIANCE
List all windows, doors, skylights. (If needed, attach an additional sheet)
'Fenestration is defined in IECC Chapter 2 as skylights, roof windows, vertical windows, opaque doors, glazed-doors that
include products with glass and non-glass glazing materials.
Manufacturer Location U-Factor Size Quantity Total
(rough opening) Square Feet
_ 1
Total Fenestration: windows, skylights and door area
Name I �U�dn Parcel# C Z 3 Z (� C���U BLD#
Mason County BUILDING
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 St� V C
Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason Coun
htto//www.co.mason.wa--us/code/commissioners/index.htm
Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". MAR 15 2016
Regulated activities shall be conducted only after Mason County Public Works approves a stormwaW WAdder Street
(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 Lois, 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 pro rty for review and inspection as may be required. /
X Owner/Agen Contractor(ci le one)Date:__ ✓[ ,� ���
Page 2 of 2
Name A Parcel# Z 3 0 ` "1 I d / BLD#
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 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 X = Z
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X = _
X = Length of drive begins at the right of way
X =
Parking Areas Z X "� U = (P('(1�
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) ��3 ,
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 4keq�� Owner/Agen ontracto (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
APPROVED
MC PUBLIC HEALTH �
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r ,r°n 'cop�r ,MASON COUNTY COMMUNITY SERVICES
` , PERMITA5515TANCECENTER: Permit No: I�1,D2o)b --DOI
' • BUILDING• PLANNING• FIRE MARSHAL Recv'd:
' 615 W. Alder St - Shelton, WA 98584 RECEI
VED
Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798
1854 Phone Belfair:(360)275-4467 Phone Elma:(360)482-5269 MAR 15 2016
B U I L D I N G BUILDING PERMIT APPLICATION615 W.
PROPERTY OWNER INFORMATION: CONT OR INFORMATION:
NAME: Akt L« cam(�g, NAME: , S
MAILING ADDRESS: CID I&J I rG1r + MAILING ADDRES: S
CITY: STATE: ZIP: CITY: VcC 4 7S E: L�J ZIP:Afis
PHONE#1: PHONE:3 Go R 7 T
PHONE#2: EMAIL CeA 3) 0-1
EMAIL: L&I REG# c L mo EXP. to /73
CONTACT PERSON : OWNER ❑ CONTRAC OR [ i *OTHER/See Below ❑
*NAM�: 010 7 MAILING ADDRESS:
CITY: STATE: W SL ZIP: F3J-3 PHONE: 3�C,Z77 (q-nELL:
EMAIL: 6o c(o a
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) _C '-3 2-0 4/ o(Z)o2 c) ZONING ,'r
LEGAL DESCRIPTION (Abbreviated) FIRE DISTRICT_
SITE ADDRESS CITY
DIRECTIONS TO SITE ADDR1 S r w ♦k G
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO Qr
IS PROPERTY WITHIN 200 FT: (check ali that apply):
SALTWATER❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑
TYPE OF WORK: NEW ,0 ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE( esidence Garage,Commercial Bldg,Etc.) r✓' F
IS USE: PRIMARY,C SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS Z k/Z—
HEATED STRUCTURE? YES (lVh e Bldg) d' YES (Partfsj of Bldg) ❑ NO ❑
DESCRIBE WORK r�,�l/ �� L,) N6— 'e
(Valuation/Project Bid Amount: $ )
SQUARE FOOTAGE:
IST FLOOR If2—sq.ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. ft.
DECK sq. ft. COVERED DE IC �.�{5 sq. ft. STORAGE sq. ft. OTHER sq. ft.
GARAGE sq.ft. Attached DE
❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
M E MODEL YEAR
W BEDROOMS BATHS SERIAL NUMBER
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 or owner's legal representative. 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 IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42)
Signature of OWNER 'Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
PTIM L
PERMIT SPECIALISTS Inta I(f Approved&Ready for Pick- -, 5'—�-7
Visit us on-line: http://www.co.i-nason.wa.us/community_dev/ Rev. 1/27/2016byJBN
40 co MASON COUNTY COMMUNITY SERVICES '�(�� D �
ter''
.., PERMITASSISTANCE CENTER: Permit No:
i4D•BUILDING•PLANNING•FIRE MARSHAL
615 W. Alder St- Shelton, WA 98584 RECEIVED
Phone Shelton;(360)427-9670 ext. 352 Fax:(360)427-7798 r
Phone Belfair. (360)275-4467 Phone Elma:(360)482-5269 MAR 15 2016
1R�4
B U I D I N GPLUMBING & MECHANICAL PERMIT APPLICAT101615 W.Alder Street
OWNER INFORMATION: CONTRA TOR INFORMATION:
NAME: r6 '1 L(z- / 4[,n(-� NAME: ACQ a
MAILING ADDRESS: MAILING ADDPE S: 111a S
CITY: STATE: ZIP: CITY:S L r of STATE: ZIP:
Is'PHONE: PHONE:Win 2-7) It (43.7 CELL:
2"'PHONE: EMAIL : U l S5 KCA:t Q
EMAIL: L&I REG# EXP.
PARCEL INFORMATION: X
PARCEL NUMBER(12 Digit Number): Z w " � g
( 'dw' "l 0 Zoning- �S
LEGAL DESCRIPT ON(Abbreviated):
SITE ADDRESS: Q-144) CITY:
DIRECTIONS TO SITE ADDRESS: 1�{ C� s C h1��'� k41,c
TYPE OF JOB SF74z'
NEW ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS— 1 IT FLOOR 2'''D FLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Tyne of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_
Toilets Type of Unit No. of is Fees
Bathroom Sink � Furnace
Bath Tubs Heat Pump
Showers i Spot Vent Fan
Water Heater GA5 Propane Tank 6 zo.?1) I—
Clothes Washer Gas Outlets ---�----��
Kitchen Sinks Woo Gas ellet Stove
Dishwasher Kitchen Exhaust Hood
Hose bibs 3 Dryer Vent
Other Solar Panel
Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
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.
X � � _:� -( S - ( G
Signature of Applicant Date
X f 4 ( 2C_�o F Owner/Owners Representative/Contractor
Print Name (Circle one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev:!/2,7!2116 1BN