HomeMy WebLinkAboutBLD2012-00639 Final SFR with Garage - BLD Permit / Conditions - 8/15/2014 t • Inspection Line(3W)142/-1262
toMASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 279
too Shelton, WA 98584
o RESIDENTIAL BUILDING PERMIT BLD2012-00639
OWNER: CLINTON SHUMAKER RECEIVED: 8/24/2012
CONTRACTOR: LICENSE: EXP: ISSUED: 3/7/2014
SITEADDRESS: 531 NE OLD BELFAIR HWY BELFAIR EXPIRES: 9/7/2014
PARCEL NUMBER: 12329129009'1'IS
LEGAL DESCRIPTION: LOT: 1 SP#2501 OF TR 9 OF NW NE S 1/131
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
RESIDENCE WITH GARAGE
General Information Construction&Occupancy Information Square Footage Information
o. of Bedrooms: 3 Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3/U Lot Size: Deck: 348
Type of Work: NEW Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:2,423 Garage-Attached 2,537
Valuation: $ 370,278.22 Building Height: 28 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: S 110.0 Ft. Shoreline: Ft. Water Body:
Rear: N 45.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Shoreline Desig.:
Side 1: E 2 1.0 Ft.
Year: Serial No.: Side 2: W 45.0 Ft. Comp. Plan Desig.: Rural
BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 1 of 7
s Plumbing Fixtures Mechanical Fixtures rtts
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 3 Furnace<100K 1 Plan Check Fee TW 8/24/2012 $ 1,454.02 S2201200000001
Lavatories 4 Heat Pump 1 Planning Review Fee TW 8/24/2012 $205.00 S2201200000001
Bath Tubs 1 Ventilation Fan 4 Fire Warden Review TW 8/24/2012 $73.00 S2201200000001
Showers 2 Gas Outlets 4 EH Plan Review KKK 8/24/2012 $ 103.00 S6201200000001
Water Heaters 1 Dryer Vent 1 Water Adequacy Plan Revi KKK 8/24/2012 $ 103.00 S6201200000001
Clothes Washer 1 Exhaust Hood 1 Building State Fee LDK 9/18/2012 $4.50 S2201200000001
Kitchen Sink 1 Gas Outlets 4 Additional Plan Check Fee LDK 9/18/2012 $ 149.24 S2201200000001
Dishwasher 1 Building Permit Fee LDK 9/18/2012 $2,466.55 S220120000000(
Hosebibs 4 Mechanical Permit Fee LDK 9/18/2012 $ 100.90 S220120000000(
Mechanical Base Fee LDK 9/18/2012 $28.50 S2201200000001
Plumbing Permit Fee LDK 9/18/2012 $ 128.00 S2201200000001
Plumbing Base Fee LDK 9/18/2012 $24.70 S2201200000001
Additional Plan Check Fee DLC 3/7/2014 $73.00 S1201400000001
ADJUST--Building Permit F DLC 3/7/2014 $44.80 S1201400000001
ADJUST--Mechanical Pern DLC 3/7/2014 $3.60 S1201400000001
Total $4,961.81
CASE NOTES FOR
BLD2012-00639
CONDITIONS FOR
BLD2012-00639
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
X800-647-� T� person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
2) Owner/Agent is responsibleto post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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3) Approved er dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
4) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands. Silt fencing or straw
matting must be installed and maintained until upland vegetation has become established. X tr-11 S.
5) 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
BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 2 of 7
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6) All construction and demolition debris must be removed from the site after project completion. Proper dis osal of construction debris must be on land in
such a manner that debris cannot enter or cause water quality degradation of State waters. X
7) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approve�t Site Ian"to ensure these structures are shown and meet the setback conditions listed.
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8) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure
these structures meet the setback conditions listed.
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9) ALL SURFACE 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 VYAY.t S 10) 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
Departmentprigr to any further inspections being performed or approvals granted.
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11) 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 aAprQ d documents will result in failure of required building inspections.
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12) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
13) 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 Depa/ment prior to any further inspections being performed or approvals granted.
14) Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option III, Window (Max U-Factor):0.30, Skylight(Max U-Factor):0.50, Doors
(Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38 advanced or R-49 standard, Vault Insulation R-38,
and Slab Insulation R-10.
In addition the following credit from Table 9-1 shall be completed: 1A- HEAT PUMP WITH MIN 8.5 HSPF
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BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 3 of 7
'IS) .A permanent certificate, completed by the builder or registered design professional, snail De posted wimin tnree reet or the eiectncai aistnDutuon panei.
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 503.10.2, 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 0.00030 Specific Leakage Area (SLA)
when tested with a blower door at a press of 50 Pascals (0.2 inch w.g.). Testing shall occur at any time after rough in and after installation of penetrations
of the building envelope, including penetrations for utilities, plumbing, electrical, ventilation, and combustion appliances and sealing thereof. 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 WSEC 105.4 Certificate and 502.4.5 Building Air Leakage Testing.
Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2009 Certificate" and are available in %4 or'/z sheets. The
Mason County Permit Center will also have some available.
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16) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC
Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall
be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or
installed in or around swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps).
Reference W C 505.
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17) 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.
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18) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. `NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting 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. By calling for a final inspection of
the building permit the owner/agent/contractor is a�lcnywl�.dging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
19) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/ Reserve requires a 10ft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. No foundatiq!Zins within 30ft, down gradient of drainfield/reserve area.X �'�
BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 4 of 7
20) 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 rn� ct 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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21) 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 h II be collected by the Building Department prior to any further inspections being performed or approvals granted.
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22) 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 revo ati n
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23) 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.
24) Placement of structure ust comply with standards set forth per the international codes regarding descending and/or ascending slopes.
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25) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
26) CONSTRUCTION PROCESS TO BE FIELD CORRECTEDAS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND THEADOPTED
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 sh�m a prior to requesting additional inspections.
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27) 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 used until pection has been performed and approved by a Mason County building inspector.
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BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 5 of 7
' 28) All property lines shall be clearly identified at the time of foundation inspection. X / j�;r!z
29) 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
X ason County Vir�n�es and building regulations.
30) 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 preyon ed action from being taken. No more than one extension may be granted.
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31) 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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32) Retaining walls needed to support a surcharge such as Vuctures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X
33) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at
(360)427-9670, ext. 450. The building permit will not be"finaled" until the permit holder can show proof that the access permit from Public Works has
been "finale d" and 210proved.
34) RIGHT TO MANAGE RESOURCES AND RESOURCE USE NOTICE
This property is within or near designated agricultural resource lands on which
a variety of commercial activities may occur at times and that are not compatible with residential development. Residents of this property may
be subject to inconvenience or discomfort associated with these activities including, but not limited to: dust, odor, noise, and chemical
applications
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35) The heated storage space above the bedrooms shall be finished to meet the 2012 International Energy Conservation Code as amended by
Washington State(IECCIWSEC). Not less than R38 shall be installed in the rafters while maintaining at least 1-inch of air space with a
continuous vapor and air barrier.
The area is approved as uninhabitable attic with storage with a live load limit of 20 psf in accordance with the 2012 International Building Code
(IBC), Table 1607.1.
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BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 6 of 7
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 1 AYS WILL INVALIDATE THE APPLICATION.
Sign une Date
OWNER - REPRESENTATIVE - CONTRACTOR
Print ame (Circle one to indicate)
BLD2012-00639 Please refer to the following pages for conditions of this permit. Page 7 of 7
o CONCRETE MECHANICAL MANUFACTURED HOME
2
Date 7,1Z1)1-1 By �JQi ( C
N Footings J Setbacks Ribbons
Gas Piping
oInterior Date By Interior-Date Z1Z�1�+� BY �IL Date By X
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W Exterior Dater Q /Z BY Exterior-Date B S _ p rn
Point Load!Isolated Footings INSULATION Date By
BG/SLAB INSULATION C n
Date By Data ey FIRE DEPARTMENT Z
Foundation Walls Floors Date By --I
Date By Data O
L 1 By �A/ DECKS Z
F RAM I NG walls Date By
Date 3 /j f��-( By (. Data ._ By PROPANE TANKS
PLUMBING— Vault Date eY
Date ./Z M By OTHER
Groundwork ��S Attic
Dale By Date By Type.
Date By
D.w.v DRYWALL Type-
Date By L00
InL Brace Wall Date By W
m Date By v FINAL INSPECTION p
y Water Line Fire Separation N
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Date ByCz
Date By Date B
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MASON COUNTY Pmmrr No..—
BUILDING PERMIT APPLICATION
426 W. Cedar• P.O. Box 136, Shelton,WA 98594
Shelton (360) 427-9670•Belfair(360)275-4467•Etrna(360)482-5269
On the web www.co.mason.waus
APPLICANT INFOR�ATION CONTRACTOR INFORMATION
Owner tl i n t- J Vt t,�-+►'ttt�t-f Company Name
Marlin Ad, ressa Mating Address
C'dy —State Sel�Zlp Code City State Zip Code
PhoneA4''l?&- 161 3 Other Ph.ar ,SC,'i 5303 Phone Other Ph.
Lien/Trice Holder' Contractor Reg.# Exp.
E mail address_(Ti.r+`Z +'1 e i ►'�h rV C Om E Mail Address
Drivers Lic.# l�l(�r1+t:C 1 J DOB __2�'Z _ Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Sepbc Existing Septic_ r:1 r ti` �F W t q'
Connect to Water System Name of Water System
Well__$—Water System Name of Water System
PARCEL INFORMATION-12 Digit Parcel No
Z el OCR Fire District -
Legal Description _S A 2- - & e - 'a,4 :3 3() Q,;24 e I �v ►J
Site Address(Pleasq inc ude street rt e,street number pnd city) ('VA
Directions site c e i `
L G-- LAt1
Will timber be cut and sold in parcel prepa 'on?Yes/ o
Is property within 200'of Saltwater�_1 ;3 River/Creek Pond r'1
Wetland t Seasonal Runoff Stream .^ Slopes or Bluffs ] 15% +�
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Y g/
TYPE OF JOB-New Add Alt Repair Other PRIMARY RESIDENCE JKJ SEASONAL ❑
Use of Building Describe Wo
No. of Bedrooms _No.of Bathrooms 3 Square Footage-1 st Floor f2L 2nd Roor
3rd Floor Basement Deck 3 4041r Covered Deck Other Sq.ft.
Garage ? Attached—Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION -Make Model Year
Length Width Serial No. No.of Bedrooms No.of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes J No
Installer Name Certification No.
OVANIER/EULDER Admowledges submission of riac= infomsafion may result in a stop work order or permit revocafjon.Acimuwliedgeane-rt of
such is by sig mtz re brlow.I declare ttrat I am the owner;owners legal representative,or the contractor I further declare that I am entitled to revive this
pe and to do the work as proposed in tfie apprrcafion.I declare that I have obtained the permission from all the neoessary parties If pea mission is
regr>irEd from any easement hotder.or any oftier party in irAerest regardh►g this applica m or the work proposed in the app6cafion,I have obtained
pe mussim from them to apply for this pemt and conduct the work proposed. The owr,ff or agent on owners behalf,represents that the inforrriation
provided is a=zate and grai its employees of Masai County access to the above desorbed property and structure for review and Corr.
PROOF OF N OF WORK IS BY MEANS OF A PROGRESS INSPEGM
x Dat Z—
Owne Owners Representa5ve/Contractor (indrc z to which one)
FOR OFFICIAL USE BEYOND TFPS POINT Accepted by. Date
DEPARTMENTAL REVIEW PROVED DENIED NOTES
Buld►ng Department It?-
Planning Department
Environmental Health Dep ent
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee $-�O`-- EH Review Fee
Plumbing&Base Fee �° * oZ 4-10 Planning Review Fee
Mechanical &Base fee /00 . rJ a f PS Other
Wood/Gas/Pelet Stove Fee Stye Fee
Violation Fee Pre-Paid at Submittal 1 0.,;k
Valuation$ TOTAL FEES
PERMIT NO.
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton(360)427-9670•Belb (360)275-4467• Elma(360)482-5269
On the we www.co.mason.wa.us
APPLICANT INFORMATION_ CONTRACTOR INFORMATION
Owner (A I��--SV\_c,Ui1�.c b',r. - Company Name
Mailin Ad�resG 17A _ Mailing Address
City�i Cam✓' State W Zip Code q 9 5J- City State Zip Code
Phone '-7 f 5 Ot er Ph. VQ--,5or5-S5.303 Phone Other Ph.
Lien/Title Holder Contractor Reg.# Exp.
E mail address & c,:arA bd ,Cc9y-1— E Mail Address
Drivers Lic.#5AU-01 E(`-( DOB e -25--?5 Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION- 12 Digit Parcel No z O Fire Dis rict
Legal Description - ` ,() C_f_:km'_ Sey'r1H ell a C, UJ
Site Address(Please include tr�,et ame,street umber and ci )
Directions to site rX
�.` \/ rn-,
Is property within 200'of Saltwat r a V Lake V_\ River/Creek i/ A, Pond
Wetland YN Seasonal Runoff Stream�''� Slopes or Bluffs 15% V-1
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units- 1 st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric_LPG_Natural Gas Heat Pump
Toilets 3 Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs I Heatpumps
Showers L Spot Vent Fan
Water Heater ! Propane Tank
Clothes Washer I Gas Outlets 14
Kithen Sinks ! Wood/Gas/PelletStove
Dishwasher I Kitchen Exhaust Hood
Hosebibs '4 Dryer Vent I
Other 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 the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and nts employees of Mason County access to the above described property and structure for review and inspection.
PROOF O IN OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X — Date:
Owne Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
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i APPROVED
- MASON COUNTY DCD PLANNING 1 ' . Qm' EA57, wfy 4 NO'1?k•
!� r SITE PLAN REQUIRED TO BE ON SITE F .{ ��(o(Jo6Et7 +'1Cs(a4Nq�- Cr SL�Q�' Uw�� I
CHANGE§SUBJET TO APPROVAL i h4ce 5 Nph{ y y NU S ou+h-
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Name(�1 n�Sh��r��� Parcel# ) ���1 G�- 'q 5 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'.
'Redevel_pment 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.
Tom:-calculate ImpeTuoos Surfaces �fease GompleteThis Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings X 3-7 y
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways Z.W X `-I L = 00
X = Length of drive begins at the right of way
X =
Parking 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 Stte Plan is Required
Total1mpetvioijs Surface Area(sum ofiall areas) Z _ _
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
Name Parcel# BLD#
Mason County
Department of Community Development j
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/commissioner-s/index.htrn
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 pr o Teview and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date: D
Page 2 of 2
ACCESS & GRADE INSPECTION BLD �
ADDRESS: LW3 �h�''"'INSPECTOR: LLO Y, DATE OF INSPECTION: .3 J Z
FIRE SPRINKLER REQUIRED? (circle) � YES
IF fire sprinkler required, was notification letter mailed? DATE MAILED:
DRIVEWAY ACCESS
K) need post at access of driveway with reflective address numbers
Length: 200 F' Width: Surface: 64�146-C4,ss
Size of turn-around: (,,,I( �C' 6-O CST- frf'r�r�L✓�,
Condition of shoulders: 1� -
Vertical clearance: niki
GRADE OF DRIVEWAY %, OF ROAD %
ROAD ACCESS
Length: Width: Surface: ��ci1
Condition of Shoulders: p V—
Vertical clearance: p lL
( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE.
U LOT INSIDE UGA-NO OUTDOOR BURNING PERMITTED.
LOT TOO SMALL FOR: BURN PERMITS 4 X 4 FIRES
2 X 3 FIRES
PASSED ( ) FAILED ( ) ON HOLD ( )
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