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HomeMy WebLinkAboutBLD2024-00924 Pole Bldg - BLD Application - 7/30/2024 MASON COUNTY Permit No:b i t E IVE D, COMMUNITY DEVELOPMENT JUL 3 0 2024 Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION 615 W. Aicier Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: MAILING ADDRESS: MAILING ADDRESS: CITY:A G STATE: uJ A ZIP:g S S2 Z CITY: STATE: ZIP: PHONE#1: 2 '93- L'S = 33A6. PHONE: CELL: PHONE#2: EMAIL: EMAIL: L&I REG# EXP. PRIMARY CONTACT: OWNER.r CONTRACTOR fPTPER 'J NAME /1J�/� L� EMAIL s 4 f-'r`. —tyt�G ��& MAILING ADDRESS CITY STATE. � '� PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) LZ & CS- 2(�p(� y ZONING LEGAL DESCRIPTION(Abbreviated)C k Cki •r e% 1',t'J 9 L 07' 41/ FIRE DpISTRICT SITE ADDRESS q7() At. S fA0t0 S 4f14 `Dd? . S b CITY 4-0-W5 A7'7. DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO "NOW LO :�sf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check an that appty): SALTWATER❑ LAKE g-R1VER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ �3REAM[❑ TYPE OF WORK: NEW.f ADDITION❑ ALTERATION❑ REPAIR[] OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc f ('2 A-'*A-'*f.,e —VTV 1P IS USE: PRIMARY❑ SEASONAL,.Er NUMBER OF BEDROO S_d NUMBER OF BATHROOMS_ HEATED STRUCTURE? YES(whole B)dg)❑ YES(Part[s]ofBldgl NO❑ DESCRIBE WORK .PO L E rS SQUARE FOOTAGE:(propased) Lo 'I 1 ST FLOOR; =sq.ft. 2ND FLOOR sq.fL 3RD FLOOR /� BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE<, -1� sq.ft. OTHER sq.ft O GARAGE_ _sq.ft. Attached❑ Detached CARPORT sq.fL Attached❑ :Detached❑ MANUFACTURE ON: *4 COPIES OF THE FLOOR PLAN REQUIRED* MODEL LENGTH ZTH A P7 BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH:. SEWAGE/SEWER SOURCE: SEPTICP' SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES„ NO❑ Ifyes,attach completed WaterAdequacy.Form PERIIv1ETER/FOUNDATION DRAINS PROPOSED? YES❑ N90' EXISTING SQ.FT. EXISTING BEDROOMS_ PROPOSED BEDROOMS TOTAL BEDROOMS _ OWNER acknowledges that submission of inaccurate information may result in astop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT'IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PER R APPLICATION OF 1 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08A2) s X S' ER u si ned by the OWNER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Permit No: MASON COUNTY COMMUNITY DEVELOPMENT ON C' Permit Assistance Center, Building,Planning PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFO TION: I CONTRACTOR INFORMATION: NAME: 0, 17 �4-6,94 K &-AA q IM NAME: MAILING DDRESS: P. 0 S MAILING ADDRESS: CITY: Ad ki (, STATE: CAJ # ZIP:9?16-�7 CITY: STATE: ZIP: Is`PHONE: 2-5-3- C, $ - 33 e-/(e PHONE: CELL: 2n1 PHONE: 5 3-c1 - 3 EMAIL : EMAIL: L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Mumber): 2 Z 0 53— Z io-a� y Zoning: LEGAL DESCRIPTION(Abbreviated): ZQ&? T0,14 M Lor-411 SITE ADDRESS: �(7 U 4 Sfem R-r-. So . CITY: DIRECTIONS TO SITE ADDRESS: Z-e/C f --A Z,y v Ci,h R D /{v✓y TYPE OF JOB: NEW=ADD=ALTO REPAIR =OTHER=USE OF BUILDING LOCATION OF FIXTURES/UNITS—IST FLOOR=2ND FLOOR=BASEMENT=GARAGED OTHERO PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:ElectricGKJL.PG=Natural Gas=Ductless= Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace O Bath Tubs Heat Pump Showers Spot Vent Fan _ Water Heater r 7A M�iC1a Propane Tank d Clothes Washer Gas Outlets O Kitchen Sinks Wood/Gas/Pellet Stove 0 Dishwasher Kitchen Exhaust Hood O Hose bibs Dryer Vent d Other b�� Solar Panel Q2 Other _$' Base Fee Ct4't-JJ-f5 L � Base Fee TOTAL PLUMBING t�6}ru CAL OWNER acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or contractor.I further declare that 1 am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INV LI T THE APPLIC ON. 3 X I/ Si wne Date DEPARTMENTAL VIE APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 1BN • , , MOM a one AMW m El Mmilfmm m I ON, 'Wit" momMOM mmr�1 �l�l�C�II M ON to Now m���InagIIm M-.. MISIMMISM m ■1!�! . it m 0111 - �m wrl Mot Mol MOB �K1 MINIM� �!R m MI m I� M i m l�alrml mm i�mmmm � 0 !- �Elm� El m �1 �ME! mm MOM IMMI��� ON mm MIMMISI rt:��n USE THIS SHEET TO "J Lessee Nam oki/1 e: DRAW YOUR PLOT PLAN t d (see sample) 1 d Division&Lot No: d Par r 11 � r � 1 r O W Po G i 0 4 G I 5 GL qt Me M OD AZ 1 Building Permit Sample Plot Plan �-1► Property Line 120' H 5'Utility Easement(10' in Divisions 9 thru 12, 14,and 16 thru 19) ............_....................................._._......................................._..................... ................................ ..........__........_ ....... 150' to stream Septic Sys 60' 30' Structure o c t= 030' r. C � IF CO a� 45%Slope - Drice- 5'Utility Easement(10'in Divisions 9 thru 12,14,and 16 thru 19) �♦` Property Line 120' C Ivert 2W - -- -- ------- ------ - ---------- STREETNAME------ ------- ------- --------- Name LCIvIC Building Permit Pkt 03/04/16 Divisi©n&Lot(s) Page 7 Name Parcel# �jC'lLd��'d'Q'O BLD# .� ' Q� I Z. 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 surface2. '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. 2Common 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 = X = Measurements for buildings are taken at the perimeter of the farthest projections(example: X = eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parkinq Areas X = 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) (� 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 ac nowled a that the information provided is accurate and employees of Mason County are granted access to the above- describe r e f review and ins ec' as a required. X Owner/ gent/Contractor(circle one)Date: If the Total erviou urface re is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page f 2. Page 1 of 2 Name Parcel# L11ZPd_ s 2-0_PV q/1 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 knowledge th t th 'ntormation p ded is accurate and employees of Mason County are granted access to the above- describ property fo vi w and' sp on s be required. ZXOwner/ gent/Contractor(circle one)Date: Page 2 of 2