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HomeMy WebLinkAboutBLD2008-00879 Final MFG Home - BLD Permit / Conditions - 4/7/2009 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 i� RESIDENTIAL BUILDING PERMIT BLD2008-00879 OWNER: DONALD CLARK RECEIVED: 7/15/2008 CONTRACTOR: D B & R LICENSE: DBRIN**044JQ EXP: 4/10/2010 ISSUED: 8/25/2008 SITE ADDRESS: 450 NE LARSON BLVD. BELFAIR EXPIRES: 2/25/2009 PARCEL NUMBER: 123305100043 LEGAL DESCRIPTION: BEARDS COVE DIV 4 LOT: 43 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Manufatured Home Beards Cove. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building: Valuation: Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Make:CMH Length: 52 Ft. Front: S 53.0 Ft. Shoreline: Ft. Water Body: None Model:YORKSHIRI Width: 27 Ft. Rear: N 2 .0 Ft. Slope: Ft. SEPA?: No 7 Side 1: E .0 Ft. Shoreline Desig.: Not Applicable Year:2007 Serial No.: Side 2: W 7.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee KKK 7/15/2008 $247.00 S22008000 EH Plan Review KKK 7/15/2008 $40.00 S22008000 Address Fee KKK 7/15/2008 $162.00 S22008000 Planning Review Fee KKK 7/15/2008 $190.00 S22008000 Mobile Home Issuance Fee ARC 7/21/2008 $247.00 S22008000 EH Plan Review CEW 8/22/2008 $60.00 S22008000 Water Adequacy Plan Review CEW 8/22/2008 $40.00 S22008000 Total $986.00 BLD2008-00879 Please referto the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2008-00879 • CONDITIONS FOR BLD2008-00879 1) 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 acEZ22=i�� ad. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where suh �tn{y-malntained public road or to another fire apparatus access road which connects to a county maintained public road. X 2) 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 onetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1- - 47-,9 erso signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. 3) A rye P.er,,=e �� rii--Ulacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. 4) 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 Depa�en�ri spections being performed or approvals granted. X (t 5) Owner nt i re pe a osfithe assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 6) 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 r val of.appr docu tg will result in failure of required building inspections. 7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 8) 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 approv -will t be ran d. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Bu' n ' e r to a urther inspections being performed or approvals granted. X 6 BLD2008-00879 Please referto the following pages for conditions of this permit. 2 of 6 9) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer perform or installe on number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X 10) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. 11) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BAST NO P - ND GUST) the wind speed for Mason County is 85 MPH. X '` 12) Per IRC -SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS- R905.1 Roof covering application. Roof coverings shall be applied in acco,rdance_Wi th ap le previsions of this section and the manufacturer's installation instructions. X 13) 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 own er/agent/contracto ack wl a o.mponents of the stormwater management system have been installed as approved on the stormwater site plan. X r`.. 14) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical con tq work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). r - _ X G� 15) 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 W�hington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit ev of �. � X BLD2008-00879 Please refer to the following pages for conditions of this permit. 3 of 6 16) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy(Final Inspection)will be granted for the residence. OWNER/CONTRACTOR(indicate which) Signature X ' 17) This permit is for the p18 t aftafi n of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X 18) Permanent Address must be posted and visible from the road Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails must be in good condition and meet code for year built or current code if replaced. Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit Gutters and downspouts must be installed with splash blocks provided All exterior penetrations must be sealed HWT Pressure relief line and dryer vent must exit skirting a minimum of 6" with a maximum of 24" above grade. The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4 panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection. All conditions on the original or issued permit must be met If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available It shall be the responsibility of the person requesting the inspection to provide the manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection. Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an inspection is requested and required items are not completed prior to the inspection being performed ENFORCEMENT PROVISION: Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action and uent v ola d-penalties pursuant to the Mason County Code. X - BLD2008-00879 Please referto the following pages for conditions of this permit. 4 of 6 19) 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 loc tied 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 proje X 20) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordin�inCee or.r, q e reviewed and approved by Mason County prior to construction. X 21) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND 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 Inspect a uesting additional inspections. X �¢ 22) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. 23) All property lines shall be clearly identified at the time of foundation inspection. X 24) 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 un ;0�i n an t ling regulations. X '- 25) 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 preen a eing taken. No more than one extension may be granted. X 26) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, co or ,,a fla IF.metal connectors approved for contact with the new types of pressure treated material. 27) Retaining walls needed to support a su 'h, r I t;t, s, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X BLD2008-00879 Please referto the following pages for conditions of this permit. 5 of 6 28) Land!�Wand stairs Must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Ap Fe these structures are shown and meet the setback conditions listed. X 29) W9ter n b e Wa -4o the detriment of the aquatic environment as a result of this project. X 30) Prior to final approval, all upland areas disturbed or ewly i tivities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 31) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X 32) All other necessary permits from Mason County, Washington State and/or Federal Agencies th %�ir osed development and Kf �� construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X 33) All Best Management Practices must be strictly adhered to throughout the proposed development. This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progr s inspection.The owneror the agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described pr rty and structure for review and ins ctio - , , OWNER OR AGEN DATE: BLD2008-00879 Please referto the following pages for conditions of this permit. 6 Of 6 r co o CONCRETE MECHANICAL MANUFACTURED HME r C) Date By eo CD Footings !Setbacks Gas Piping Ribbons �•_� o Intenor Date By Interior-Date By bate � jExterior Date By Exterior-Date _ B Set-up - 0 INSULATION Z Point Load r Isolated Footings Date G7 BG!SLAB INSULATION 3y D Date By Data By FIRE DEPARTMENT Foundation Wails Floors Date B Date By Data By DECKS FRAMING Waits Date By Date By Data By PROPANE TANKS PLUMBING Vault Date DateBy ---_.___--....._.._....__..__....____... Groundwork OTHER Attic Dale By Date By Type. Data gy D.w.v DRYWALL Type. Date B Int Brace Wall Date By y Date By r CD FINAL INSPECTION p m Water Line Fire Seperation iV Date By Date By Date By C m 00 Pass or Request Inspect. c EP Ty of Insp. Fail Date Date Done By Comments coo CD C ^411-1 �;IC Er v s. -v f-a -"9•oy i2 N 1, g V\U a LAW a 40 3 Sct 69 p-r. ��;rS �>i,.xr,•t o i i - a bee, r b TK4 N O /r 3 (D 0 D 2oo - oa 87 9 oe�U� zh� 123 000�f3 Do/v /< — �p°Pi r�oLi chef FILE �PP��°g chP�� f�111010 COPY x�� ber Of` era pages -lees THESE P1_ANS MUST BE ON THE JOB SITE FOR INSPECTION- CHANGES E SUP IOR TO CHANGES APPROVAL PERFORMING WORK MIDST MEET ALL CURRENT WASHINGTON STATE CODES \ C VFti1T v �Tc AT 1 Sq Ft Per 150 SO APPROVED MASON BUILDING INSPECTOR CHANGES SUBJECT TO ff[`R�VAL r e--P�se, vnA-Scq�s 0-ov,� , �S - � o e --3-) N, VENT AT 1 Sq Pt Per 150 Sq l't HESE PLANS MUST OE. ON THE JOB SIT7 FOR INSPECTION P CHANGES SUBMIT CHANGES FOR APPR lvAt. PRIOR TO PERFORMING VVORK e, co MUST MEET ALL CURRENT WASHINGTON STATE CODES CMH YORKSH, IRE altar MANUFACTURING a .. '' 11404 Sq. Fte Opt.6'S9der 9'-6" 10'-4' 5'4' Relocate Well for 60'Shower _ W-IS W-76 NM W-73 W-64 W-35 36' ^ 4n Sbl6�s, I Corner 54'Garden IN Opt.D.W. Tub h Tub/$hwr ti o UnL pt.$h &' _ Wardrobe Opt.Cafe Doors ; �J TR. � --- TCHN DINING BEDROOM #3 ;_B TH ''�"` 0 60'Tub/Shwr cc - II Snack g --------- c - ------- ----- FAU t; Bar 0A O o-- == =- Gd i� Pantry , d r . � WH OPT. GLAMOUR BATH Wardrobe Std,� able Opt.Double Gable MASTER BEDROOM % ,r �JREAT`,ROOM Den BEDROOM #2 r De a �3 -------------- \ W"35 W-35 W-35 W-35 W-35 . r (A 13'6' 10'-0' � W 2107 DP 85921.8 347C/KK Because our company has a continuous product update process,specifications,floor plan lay-out and dimensions shown on this literature are subject to change without notice or obligations.Construction end deslon specifications as well as features presented are conceptual,therefore should not be used as actual conaitrix-don data,anld'maynot be offered In all series or models.Our Retailer Partner will provide accurate;up=tb=date infnnnatian on ovailahla antinna and:anwnlfinia"mm fnr vrw,r hnrrA. 1 APPROVED MASON COU VTY DCU PLANNING SITE PLAN RE ! CHA �E � IiED TO BE ON SITE m � _c"W SUBJECT TO APP D yd� /-� BY 1 — — Date $ ... 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TOPOGRAPHY PROFILE: Direction: Scale: Approval: for office use Building Permit number: Building: Owner/Applicant: Date of Planning: Parcel Number. application: Env. Health: Request To Revise AnApproved Plan Permit Number: BLD200_- CC Nam Parcel Number 3l -MW2) Phone Number daytime ( Project Address Mailing Address Please provide a coin lete, detailed description of the pr posed r visions to th pro Tans: V) rr ,r Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No Are the approved site plans included? ❑ Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ No If Yes,Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note:No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes ❑ No If Yes,Is a revised site plan,with all new setback dimensions included with this request? ❑ Yes ❑ No Additional Information: Applicant's signature Date4Relved Office Use Only by: Date Sent Assigned To Approved By Date B. Original Valuation: $ Additional Valuation: $ P. Sq.Ft. x$ $ Sq.Ft. x$ $ tEH.* ' Total New Valuation $ ❑ Additional Fees: Additional Planning Dept. $ Additional Plan Review . $ . Additional Conditions/.Comments: Additional Building Permit $ Additional Plumbing $ Additional Mechanical $ Additional E.H. Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ CMH YORKSHIRE MANUFACTURING 01 -.521F 1 404 Sq. Ft. Opt. 6' Slider 52'0' 10'-4' 8'•B' Relocate Well for 60' Shower W-75 W75 W-73 W-64 W-35 36' L�0 Spurs -- +NJCorns' IDI Opt.D.W. Tub h Tub/Shwr __� o{•----� -- Walk-In pt. Shi i �- - .g Wardrobe IWI; Opt.Cafe Doors TR. TR I: �� �TC DHNG LL [BEDROOM e 3 9-B TH BATH I ,' - o; 60'Tub/Shwr cc g Snack d ® o ---------- FAU - Bar qAT =- i Welk-In i Walk-In Wardrobe i Pantry ,O - ' WH 1`•Iil OPT. GLAMOUR BATH Wardrobe � � Std,�Cable i Opt.Double i ,/ ; `.\ < Gable ; i +,,ROOM MAST 1 '4 ER BEDROOM BEDROOM #2 ' + 1 \ o C W-35 W-35 W-35 W-35 W-35 rn 'gam. 13'-6' 18'-6" 10'-0' 10'0' �t\ w 2/07 DP 85921-8 347C/K Because our company has a continuous product update process,specifications,floor plan lay-out and dimensions shown on this literature are subject to change without notice or obligations.Construction and design specifications as well as features presented are conceptual,therefore should not be used as actual construction data,f,nd may not be offered In all series or models.Our Retailer Partner will provide accurate,up-to-date infnrmatinn nn availahla nntinnn and armwArationa fnr mir hnma. 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: hgpLLwww.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" =EASE INITIAL BELOW TO INDICATE THE TVIAN-A-GEMEENT PLAIWFd-R 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. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 Name Parcel# 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. 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. $: ::;: .: ... .. .. ... ..:. ..:.T . lrx#ate. rvtAr�s:; ctrac #'ie ... prrr . e# :> ' rrs. hE. s ........I...:...... ... ..:. .......... . ......................., : :::::.:::::::::::::::::::::: A:::::::::::::::: .................................... ..... .... p.................................. Surface Type Length X Width = Area *All dimensions in feet BuildingR X wanX = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: 57-2 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 to. above table Patios/Walks X = _ Any paved, gravel or packed area per definition above table X = Others X = — "``` zfj>tZa'` ''set:€ > f,tFity#al; "etvivr . X P.;:.;:.::.::.::::.:::.;:.;:.; R:.;:1 :.::.:............::.::.::.;: 00< , iiariafeti d welt r ;is:`ri>asti?r;rf3art...^Q. _::::. ::::.:... X = P 0: ',I �rriEE Pr ;�t4rrnwater:S�C�Phan %[�� d Total lmperu�ous 6urface Aria{aum of e1E areas "1 (� 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- describ perty for review and inspection as may be required. X V/Ie-z 4zx Owner/Agent/Contractor(circle one)Date: 7 �O 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 MASON COUNTY PERMIT NO. t�606 BUILDING PERMIT APPLICATION All a 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 ► Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 i4v On the web www.co.mason.wa.,us APPLICANT NFORMATIO CONTRACTOR I ORMA�TION Owner �t/ Company Name ^ `1 •�' h�G Mailing Add r ss , 2 /0 Mailing Address G 'c City e I +d. j ip COO City tate Zip Code Phone'- .2 7 f ? er PIS i-s be-4"a-sct� Phone �'63 after Ph. Lien/Title Holder,��)J G- Contractor Reg. Exp. I E mail address E Mail Address Drivers Lic. # 14 / DOB r` y Drivers Lic.# 4 DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic y Existing Septic Connect to Water System Name of Water System c r en JC r.,j 4 -4-f- y� Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 4 4 Q 42 42 Fire District Legal Description12 ix Site Address (Plea _e include street name, streiat number and city) o d Directions to site IE '` /d w h Will timber be cut and sold d parcel preparation?Ye / o �. Is property within 200' of Saltwater Lake River/Creek lPond Wetland Seasonal Runoff Stream /1, /V Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New_V. Add Alt Repair Other PRIMARY RESIDENC SEASONAL ❑ Use of Building A`i T L A E Describe Work o✓f2 S L 4 8 J d , s No. of Bedroom-,, No. of Bathrooms -I— Square Footage- 1st Floor 2nd Floor 3rd Floor A/A Basement Deck��Covered Deck Other Sq. ft. Garage Attached Detached AL-0— Carport-A/ Attached Detached MANUFACTURED HOME INFORMATION - Make ` Model Year Length Width 2-I Serial No. A L J;?0 31/ C4 a edrooms No. of Bathrooms Type of Heat 45r— Purchase Price$ 40 , 0 c) — Replacement Unit? Yes QQ Installer Name a�— Ir-61 fI I%^ hie -)" e- r Certification No. 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 Iggal 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 informaticn provided is accurate and grants employees of Mason County access to the above described property and structure 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 OFA PROGRESS INSPECTION,INACTIVITY OF�THIS�PERMIT APPLICATION ERMITAPPLICATION OF 180/DAYS WILL INVALIDATE THEAPPLICATION. X r 3 � ,�IY-� _ Date/ p Owner/Owners Repr�tat�Contractor (indicate which one)FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW A P P RJQ V DENIED i NNOTES I'c- Building Department V Planning Department Environmental Health Department Fire Marshal FEES i Building Permit Fee T Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee NOE Pre-Paid at Submittal Valuation $ TOTAL FEES