HomeMy WebLinkAboutCOM2017-00059 Modular - COM Application - 5/31/2017 MASON COUNTY COMMUNITY SERVICES Permit No:
PERMIT ASSISTANCE CENTER:
Recr'd:
•BUILDING.PLANNING•FIRE MARSHAL
615 Alder St-Shelton,WA98584 RECEIVED
Phone:e:360-427-9670 exf.352 Fax:360-427-7798
ht1n://www.co.mason.wa.us/community dev/
BUILDING BUILDING PERMIT APPLICATION MAY 31 2017
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 615 W. Nder Street
NAMEWASHINGTON STATE DEPARTMENT OF CORRECTIONS NAME: MYLES VIXIE,FORMA CONSTRUCTION
MAILING ADDRESS:7345 LINDERSON WAY SW MAILING ADDRESS:PO BOX 11489
CITY:TUMWATER STATE:WA ZIP:98501 CITY:OLYMPIA STATE: WA ZIP: 98508
PHONE#1:(360)725-8327 PHONE:(360)754-5788 CELL: (206)396-6973
PHONE#2: EMAIL: MYLESV FORMACC.COM
EMAIL: CMHOLIEN(a�DOC1.WA.GOV L&1 REG# FORMACC8780R EXP. �Tt
CONTACT PERSON : OWNER N CONTRACTOR❑ OTHER/BELOW❑
NAME: CORY HOLIEN MAILING ADDRESS:7345 LINDERSON WAY SW
CITY: TUMWATER STATE: WA ZIP: 98501 PHONE:(360)725-8327 CELL: (360)890-0246
EMAIL: cmholien@DOCI.WA.GOV
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 12318-00-60000 ZONING LTCF
LEGAL DESCRIPTION(ABBREVIATED) 67-SERVICES-GOVERNMENTAL FIRE DISTRICTN RD:MAsoN RF
SITE ADDRESS 3420 NE SAND HILL RD CITY BELFAIR
DIRECTIONS TO SITE ADDRESS SOUTHWEST FROM BREMERTON NATIONAL AIRPORT ON NE SANDHILL RD
IS PROPERTY WITHIN 200 FT: what withntnpphd:
SALTWATER❑ LAKE❑ RIVERtCREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
IS THE PROJEC-1'WITHIN 300 PT OF SLOPE(S)GREATER THAN 14% YES❑ NO
TYPE OF WORK: NEW X ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(R e�idcnce,Garage,Owmercial Bldg,Etc.)MOBILE OFFICE
IS USE: PRIMARY X SEASONAL❑ NUMBER OF REPROOMS 4 NUMBER OF BATHROOMS 0
HEATED STRUCTURE? YES(Whole Bldg)X YES(Pan[s]of Bldg)❑ NO❑
DESCRIBE WORK MODULAR BUILDING TO BE PUT IN PLACE ON A FLAT GRADED SITE
SOUARE FOOTAGE:
IST FLOOR 1152 sq.ft. 2ND FLOOR N/A sq.fi. 3RD FLOOR N/A sq.ft. BASEMENT N/A sq.ft.
DECK N/A sq.fl. COVERED DECK N/A sq.ft.STORAGE N/A sq.ft. OTHER N/A sq.ft.
GARAGE N/A sq.ft. ATTACHED❑ DETACHED❑ CARPORT N/A sq.ft. ATTACHED❑ DETACHED❑
NFORMATION: •4 COPIES OF THE FLOOR PLAN REQUIRED
MODULAR BUII.DIN
MAK1{MODERN BUILDING SYSTEMS JNC.MODEL 24'x 46 MOBILE OFFICE YEAR 2006 LENGTH 48'
WIDTH 24'_ _$EBROOMS 4 BATHS_0 SERIAL NUMBER 808-809 2004.01.2A&B
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
/OjFF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42)
X ��6�
_—Si ature of OW ER Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PERMIT SPECIALISTS Intake B ' Appr.,W&Ready for Pick-Up:
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Name CORY HOLIEN Parcel 4 12318-00-60000
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.
Surface Type Length X Width = Area *All dimensions in feet v
Buildings 48 X 24 = 1152
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 X Any paved,gravel or packed area per definition
above table
Patios/Wa s -
A X = Any paved, gravel or packed area per definition
8 _ above table
W(iOthers 61 X
X _ Ifie to W15
X _ Selo=prneht i r a` n ?�O�s uar.. — =
_. tt7alll aXc�1' ormwater4-fiit^� IaPt S eta pet o ; ucfa.sl�} i arl 1152 T
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 Storinwater 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 Iegat 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 f 7 review and inspection as may be required. II/ J
X Owner gent/Contractor(circle one)Date:S!6j
s
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 '
NOT APPLICABLE
Name Parcel# 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 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) 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. l
X Owner gent/Contractor(circle one)Date: 16 I r 7
Page 2 of 2
f
Ct(y) D 0 1 7- 060 5 9
MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST ,
Owner's Name: C� ,A s )C� Date: 6 7 Project description:, I �{,
Documents: BUILDING RECEIVED
✓Building Permit Application Completed. JUN 0 2 2017
_Mechanical/Plumbing Application Completed.
✓ Planning Intake Checklist Completed. 615 W. Alder Street
Site plan includes: Allowable building area, roof overhangs, decks, etc.
Fire Apparatus &Access Road info required? Yes/ No
Stormwater Checklist Completed.
_ Energy Code Application Form - O Electric wall heater O Electric central furnace O LPG Furnace
O Heat 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/engineered calculations & 1 reduced sized set 11X17 min.(no calculation needed )
_ Plans Legible _Recognized Scale _ Elevation Views _Cross Section
j,-Foundation Plan _Roof Framing Plan _ Floor Plan —Use of rooms labeled (all floors)
_Floor Framing Plan -all floor levels including loft, crawlspace, etc.
Deck Framing Plan including covered porch, carports
Plan Details:
_Roof framing details, truss lay-out may be needed (Hip and girder location shown)
_Wall Framing - Does bearing-wall height exceed 10'? (Engineering may be required)
_Floor framing: Floor joists (size & spacing): Floor beams:
Window headers. Typical header: Garage header:
_ Foundation: footing size, reinforcement
_Concrete Walls- Does Concrete Wall Height Exceed 8'? (Engineering may be required, see details)
_ Landings at all exits? Less than 30" above grade?Y/N (must be shown on site plan)
_Water Heater: Location: Type:
_ Heated By Furnace- Location of Furnace Fuel type:
_ Fireplace/Stove Information Shown -Fuel Type? Location(s):
_Window Sizes Marked on Plans.
_ Braced wall p s (shear wal on Plans.
E' Are plans stamped
Man ctur
Foundation Type:
ANSI/Manufacture method Engineered footing/foundation Basement
Decks*: 44 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: /n n.,
O Ceo� �Ir .�S n�0. ; G, IFO" Ce &C ° - 4,t t/();
Intake review(initials): Date:6'-2 7
H:\permit tech building checklist2015.doc Revised 8.5.2016
If any of the items listed below are either indicated or missing within the construction
documents; the plans must be engineered or returned to the applicant for resolution.
ENGINEERING REQUIRED:
Braced wall panels/brace 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 as a 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 BUILDINGS 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 in 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.
8) If a story above grade includes masonry or concrete construction*When this applies the entire story shall be
designed. In accordance with accepted engineering practice. *(exception: fireplaces, chimneys, and veneer as
permitted by the code).
***Applicant must take plans to a design professional to address items indicated above***
Notes/Comments for design professional:
H:\permit tech building checklist2015.doc Revised 8.5.2016
612 Woodland Square Loop SE,Suite 100 Lacey,WA 98503 360.292.7230 kpff.com
LETTER OF TRANSMITTAL iTff
Date: May 17, 2017
Job: # 41700166
Task #
To: Mason County Community Services Project: Mission Creek Correction Center
Permit Assistance Center for Women - Mailroom and
615 W. Alder Street Radio Tower Modular
Shelton, WA 98584
Re: Permit Applications
Attn:
We are sending to you the attached: See Description Below
Via: Courier 2 Hour
Copies Dated # of Shts. Description
1 5/16/17 Building Permit Application
1 5/16/17 Land Modification Permit
1 5/16/17 Small Parcel Stormwater Management Application
1 5/5/17 3 11 x 17 Plan Set
4 Mobile Office Centex Executive Lease Unit
These are transmitted: As Submitted
Remarks:
RECEIVED
/ MAY 3 1 2017
615 W. Alder Street
Copy to: File
Signed: Clinton D. Pierpoint
40DMASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
415 N 6t'Street, Bldg 8, Shelton WA 98584,
Shelton: (360)427-9670 ext 400 ❖ Belfair: (360) 275-4467 ext 400 + Elma: (360)482-5269 ext 400
FAX (360)427-7787
Application for Determination of Adequacy
Instructions
1. Complete Part 1. No determination can be made until Part 1 is fully completed.
2. Complete only the portion of Part 2 applying to the type of water system utilized.
3. Submit completed application, with attachments to the health department for review.
Part 1: Applicant/ Parcel Identification
Name on Applicant: � , ST f�o C, Date: - -
Mailing Address: :1 3 4 5 JJta, hone: ( ,) ) '7 Z5 -- 8?j'2 -7
Parcel Number: ���� � A _ � Arm Cc';'r i_ I�UIi Q✓N
Z3 ► ?- 00 - (v 000 QQ
Type o WMU System Reason for Application
❑ Public/Community Water System (2 or more `; l Building permit fh00LA'10-v- 61b'c� b14_
connections) ❑ Division of land: — /' e ��'S
❑ Individual water source(one connection), #of Parcels? SPL
❑ Well ❑ Boundary line adjustment
❑ Spring/surface water ❑ Other(explain)
❑ Other (explain)
❑ Replacement(please indicate name of water
If you have more than one residence connected system below if applicable-no signature
to this well, check the Public/Community Water required)
System box.
Part 2: Water System Information
Complete the section appropriate for the type of water system being evaluated:
Public Water System
Name of Water System:
Water Facility Inventory (WFI) Number:
(write "none" for two-party)
❑ 1 am the manager of this water system. The water system has been approved for services.
There are presently connection(s) in use. This will be the connection.
❑ 1 am the manager of this system. This connection will be to upgrade or change the use of an existing
connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature
of this change:
-Pais-water-systems ble-and-wiUing-to-provide-wateL-to-Yhis�these)-connections)-without-exceeding-_---- --_---
the limits of the water system or any limits set by state and local regulation.
Signature of Water System Manager Date
J:EH Forms\Drinking Water Revised 1/25MI7
Page I of 2
This form may be scanned and available for public view on the Mason County Web site.
r
Individual Water Well
❑ Water well report (attached to application). Depth ft.
❑ Well capacity Test(attached to application) gpm gpd.
The well driller often performs well capacity tests at the time the well is constructed. Results
from these tests are noted on the water well report. Results from these tests will be accepted.
If the water well report cannot be located by the applicant or if the water well report does not
have a capacity test, a well capacity test, which provides stabilization of draw-down and
recovery data, must be performed by a licensed contractor.
❑ Satisfactory bacteriological test(attach to application).
Individual Spring/Surface Water
❑ WDOE permit (attach to application)
❑ Method of disinfection
❑ I have reason to believe that this water source can provide at least 800 gallons per day; and/or
provides water at a rate of 2 gallons per minute based on the following observations.
Author of Statement Date
Relationship to Applicant
Departmental Use Only: Do not write below this line.
Part 3: Mason County Public Health Evaluation
❑ Satisfactory Determination:
Applicant's water supply does appear adequate to meet the needs of its intended use. This
determination does not address adequacy of the distribution system, guarantee an adequate supply of
water indefinitely in the future, or guarantee compliance with all applicable WDOE water resource
regulations. Recommended approval indicates requirements of Sanitary Code,Title 6, Chapter
6.68.040-Determination of Adequacy for Building Permits are satisfied. Additional Growth Management
requirements may apply. Chapter 36.70A RCW.
❑ Unsatisfactory Determination:
Applicant's water supply does not appear adequate to meet the needs of its intended use for the
following reason(s).
--Reviewer-'s-S.ig.nature: Date
JAFH Forms\Drinking Water Revised 1/25/2017
Paee 2 of 2
This form may be scanned and available for public view on the Mason County Web site.
I
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