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HomeMy WebLinkAboutBLD2012-00314 Cancelled SFR - BLD Permit / Conditions - 11/26/2013 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 RESIDENTIAL BUILDING PERMIT BLD2012-00314 OWNER: PERDEW CHILDREN REV. TRUST RECEIVED: 5/9/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 6/26/2012 SITE ADDRESS: 420 E PHILURA LN SHELTON EXPIRES: 12/26/2012 PARCEL NUMBER: 221251200030 LEGAL DESCRIPTION: TR 3 OF NW NE PROJECT DESCRIPTION: DIRECTIONS TO SITE: RESIDENCE PICKERING RD TO NORTH ISLAND RD LEFT ON WINGERT LEFT ON E PHILURA LANE O ADDRESS General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 TyNc.DL f tr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 2 cup: 3U Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 ad: Building:1,968 Garage-Attached 672 Valuation: $ 228,499.68 Building Height: cusf Prim Basement: Manufactured Home Inf m ion Setback Info do Shoreline&Planning Information Make: Lengt, : t. Front: W 500. t. ho a e: 220.0 Ft. Water Body: wetland Rear: P�j 173 t. Slope: Ft. SEPA?: NO Model: Wid F ide . 73 0 Ft. Shoreline Desig.: Not Applicable Year: Serial N .: ide 05. Ft. Comp. Plan Desig.: Rural Plumbing Fixt res echanical Fixtures FEES Type Qty. ype Qty. Type By Date Amount Receipt Water Closets (Toilets) 2 Furnace<100K 1 Plan Check Fee GMM 5/9/2012 $ 1,115.50 S1201200000001 Lavatories 3 Ventilation Fan 4 Planning Review Fee GMM 5/9/2012 $205.00 S1201200000001 Bath Tubs Propane Tank 1 Fire Warden Review GMM 5/9/2012 $73.00 S1201200000001 Showers 2 Gas Outlets 2 EH Plan Review SJC 5/9/2012 $ 103.00 S6201200000001 Water Heaters 1 WOodstove 1 Water Adequacy Plan Revi SJC 5/9/2012 $ 103.00 S6201200000001 Clothes Washer 1 Exhaust Hood 1 Building State Fee DLC 5/31/2012 $4.50 S1201200000001 Kitchen Sink 1 Dryer Vent 1 Building Permit Fee DLC 5/31/2012 $ 1,716.15 S1201200000001 Dishwasher 1 Mechanical Permit Fee DLC 5/31/2012 $228.70 S1201200000001 Hosebibs 3 Mechanical Base Fee DLC 5/31/2012 $28.50 S1201200000001 Laundry Tray 1 Plumbing Permit Fee DLC 5/31/2012 $ 119.30 S1201200000001 Plumbing Base Fee DLC 5/31/2012 $24.70 S1201200000001 Total $3,721.35 BLD2012-00314 Please refer to the following pages for conditions of this permit. Page 1 Of 6 CASE NOTES FOR BLD2012-00314 CONDITIONS FOR BLD2012-00314 1) Contractor reoistration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are ent' I risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-6 - The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) Owner/ responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 3) Prior to final approval, all upland areas disturbed or newl to by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X / ! 4) Approved nsions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 5) There is a large wetland system (assumed c� gory ll) located approximately 220'from the proposed residence. The Mason County Resource Ordinance Wetland Chapter requires th a 10 200'buffer be maintained in native vegetation between the proposed development and the wetland. Please contact the Mason Co t nning Department for those activities allowed within the wetland buffer both with and without a Mason Env mental Permit. X 6) Appli ion acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Rural Residential 5. X 7) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT PROPE - TR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM OR RO X 8) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure these st re eet the setback conditions listed. X 9) Landings and,- i ust eet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved S 'I "t nsure these structures are shown and meet the setback conditions listed. X BLD2012-00314 Please refer to the following pages for conditions of this permit. Page 2 of 6 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. a dition a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building Departmen or t ny f her inspections being performed or approvals granted. X 11) Owner/ nt i r onsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 12) 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-appm'V_eed documents will result in failure of required building inspections. X 13) The "approved" site pla. 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 tie r ed. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and shall be collected by the Building Department pnor to any further inspections being performed or approvals granted. X / f 14) Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric forced air furnace, Compliance Method: Prescriptive option III, Window(Max U-Factor):0.28, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-38, Ceiling Insulation R-49 standard, Vault Insulation R-38, and Slab Insulation R-10. In addition the following credit from Table 9-1 shall be completed: Option 3A (.5 credit) Windows U-0,28, floor R-38, and fully insulated R10 slab. AND Option 54: (0.56 credit) Electric Water heater EF 0.93 or better. X 15) A permanent certificate, completed by the builder or registered design professional, shall be posted within three feet of the electrical distribution panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces-, U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 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 cbjAficates are a ilable online at the WSU Energy program website titled, " WSEC 2009 Certificate" and are available in 1/4or 1/2sheets. The Mason Count rm Gent r will also have some available. X BLD2012-00314 Please refer to the following pages for conditions of this permit. Page 3 of 6 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 efficac luminarie unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or installed ' orar and sw ming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps). Refere e:W X 17) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer' p stal_ tion i structions. X /f 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 cf with the septic design professional involved with the project. By calling for a final inspection of the building permit the owner/agent/contracto acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 19) The internati de requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access ro . ad are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such ro s cd t with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 20) All construction mpeetqr exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washi ancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocat n. X BLD2012-00314 Please refer to the following pages for conditions of this permit. Page 4 of 6 21) Installation of heating equipment in a single-family residence shall meet the requirements of the current Washington State Energy Code, applicable sections of the IRC and IMC. Heating equipment shall be sized in accordance to IRC, Section M1401. Heating and design load calculations for the purpose of sizing HVAC systems are required and shall be calculated in accordance with accepted practice, including infiltration and ventilation. Design calculations shall be available for inspection during inspection. Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous glass ducts shall comply with UL181A and shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape. Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened. Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal ducts shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or rivets equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation instructions. Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8 DUCT TIGHTNESS TESTING shall be conducted by person(s) trained to perform such testing. A signed affidavit documenting test results in accordance to WSEC Section 503.10.3 shall be provided to the Mason County Building Department prior to the final occupancy inspection. Affidavit forms are available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit" or"Duct Leakage Testing Results (Existing Construction)." Duct tightness testing is not required if the air handler and all ducts are located within the heated space. All heatiK�equilirnent shall meet the requirements of the National Appliance Energy Conservation Act (NAECA) and be so labeled. (WSEC503.4) or in accord nee EC Section 1411. X 22) 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 o ce a d the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Maso n Ro , Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be locate hin f a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 23) All change o p oved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinanc or r lation, must be reviewed and approved by Mason County prior to construction. X BLD2012-00314 Please refer to the following pages for conditions of this permit. Page 5 of 6 24) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of t e permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the inte tl nal odes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector all ade prior to requesting additional inspections. X 25) All property lines shall be clearly identified at the time of foundation inspection. X 26) All b*nrdinalnces hall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to reection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mas and building regulations. X 27) All permits expir -180 days aft, permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a pe i of a cee ' 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have en ction from being taken. No more than one extension may be granted. X m 28) ALL SURF CE AT AND P TENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT PROPERTii OR I REAS THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM OR ROA ' AY. X 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'T progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuatickn of rk is by means of a progress i pection. The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Ma ounty access th `.above des15 ed property and structure for review and inspection. OWNER OR AGENT: '' � DATE: BLD2012-00314 Please refer to the following pages for conditions of this permit. Page 6 of 6 RRW, CD CONCRETE MECHANICAL MANUFACTURED HOME M r( 1 rn y 1-4 X / .. �� N Footings ISetb s Piping /6 Da2/� By Ribbons � o Interior Date By4 interior-Date I /i3 By�U� Date By w Exterior Date 7/7 By / Exterior-Date-7 / I B wit-UP n INSULATION� Point Load I Isolated Footings elate By = BG I SLAB INSULATION - r Date_ 2 By Data By FIRE DEPARTMENT 0 Foundation Walla Floors /a Date By M Date �'Z By ' Data / �2a-�j� By DECKS � FRAMING Walla Date By Date - 12, BiA/ Data By PROPANE TANKS PLUMBING Vault Date By 70 Date gy OTHER �f-'l��,/` +;`g r 1 Groundwork Attic -- Date By Date By Type- /��/+�r9-� Date /�./yZ gyT D.W.V DRYWALL Type- Oats �O•L��/L, B ( / Int.Brac®Wall Date By W y Date By FINAL INSPECTION 0 v N Water Line Fire S®perationCD ) N Date ByP Date By �Y,// Date By O m IV o Pass or Request Inspect. CD c Type of Insp. Fail Date Date Done By Comments 81 aCD ct 0 icnCD p� fi P5? 11-13 cn 1 Is w)O -a T254 CD `3��� `,ss ►� t l L� i3 U0� l �1Y,r,�a t�v� c ewe 4 Iwo 7'J Seh� 0 0 00 o CONCRETE MECHANICAL MANUFACTURED HOME M N)o Gate ICU . Z _ Z By l� N footings I Setbacks Ribbons Gas Piping � m o Intenor Date By interwar-Date By Date BY 0 W Exteriar Date By Exterior-hake B � Set-up = Point Load t Isolated Footings INSULATION Date By BG I SLAB INSULATION r Date B,r data Y FIRE DEPARTMENT 0 Foundation Walls Floors Date By Z Date sy data By DECKS X FRAMING Walls Date By < Date ! - L By L� Data By PROPANE TANKS PLUMBING vaun Data ay Date By OTHER C cn Groundwork Attic —� Type_ Later By Este By — baw By ❑.W-'V DRYWALL ryp,_ Int.Brace Wall Date By a)�� /a -z y' z L Date By r— . CD FINAL INSPECTION 0 m Water Line t C Fire Separation CD Date By gate By Date By E N o Pass or Request Inspect. o Type of Insp. Fail Date [date Done By � Commentsw CD 46 o rr 1�-Z3- !� zY/ c e— CD -w O a Cn O s 3 v cu 0 PNM Case Activity Listing 2:05:322PM � 2:05:3 Case#: BLD2012-00314 Assigned Done Activity Description Date 1 Date 2 Date 3 hold Disp To By Updated Updated By BLDB500 Fire Warden Review 5/16/2012 5/6/2012 None DONE TFR TFR 5/17/2012 TW NO ISSUES.INCLUDE ALL NORMAL CONDITIONS AND HANDOUTS. BLDA010 Application Received 5/9/2012 5/9/2012 None DONE TW 5/9/2012 GMM BLDB130 Planning Review 5/9/2012 5/11/2012 None DONE GBM GBM 5/11/2012 GBM Large wetland to northwest of building site,approximately 220'. BLDB200 Environmental Health Review 5/9/2012 5/21/2012 None DONE ADR 5/21/2012 ADR Bedrooms and plot plans match. BLDB201 More Info Letter-EH 5/21/2012 None DONE ADR 5/21/2012 ADR BLDB110 Building Plan Review 5/9/2012 5/31/2012 None DONE DLC 5/31/2012 DLC BLDB120 WSEC Compliance Review 5/31/2012 None DONE DLC 5/31/2012 DLC Electric forced air furnace,precriptive option 3,Table 9-12,options 3a and 5a as noted in the WSEC condition. BLDB210 Water Adequacy 5/9/2012 6/18/2012 None DONE ADR 6/18/2012 ADR Need well log and satisfactory bacteriological sample. Well capacity test and satisfactory bacteriological sample provided.6/18/2012 BLDA100 Approved for Issuance 6/21/2012 None DONE GMM 6/21/2012 GMM CALLED PERDEU CHELDREN REV TRUST..LMOM PERMIT IS READY TO BE PICKED UP..ALSO GAVE THEM THE REMAINING AMOUNT DUE BLDA500 Issue Building Permit 6/26/2012 None DONE TW 6/26/2012 TW Page 1 of 2 CaseActivity..rpt Case Activity Listing 10/31/2012 2:05:32PM Case #: BLD2012-00314 Irflo Assigned Done Activity Description Date t Date 2 Date 3 Bold Disp To By Updated Updated By BLDA540 Print Inspection Card 6/26/2012 None DON TW 6/26/2012 "I w BLDC110 Footing Inspection 7/13/2012 7/17/2012 None PASS TFR TFR 7/18/2012 KS FTG/SETBACKS BLDC115 Foundation Wall Inspection 7/30/2012 8/2/2012 None PASS TFR TFR 8/3/2012 KS Page 2 of 2 CaseActivity..rpt ACCESS & GRADE INSPECTION BLD ADDRESS: y �� J L&//P q INSPECTOR: DATE OF INSPECTION: FIRE SPRINKLER REQUIRED? (circle) YES IF fire sprinkler required, was notification letter mailed? DATE MAILED: DRIVEWAY ACCESS ( ) need post at access of driveway with reflective address numbers Length: Width: Surface: Size of turn-around: Condition of shoulders: Vertical clearance: GRADE OF DRIVEWAY %, OF ROAD % ROAD ACCESS Length: Width: Surface: Condition of Shoulders: Vertical clearance: BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. 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 ( ) REMARKS: Mason County Map Output Page Page 1 of 1 Mason County Ma ., v LW too YOU tiA�W Ap y`' c " "- • AIL JAI . DISCLAIMER AND LIMITATION OF LIABILITY: The data used to make this map have been tested for accuracy,and every effort has been made to ensure that these data are timely,accurate and reliable.However,Mason County LEGEND makes no guarantee or warranty to its accuracy as to labeling,dimensions,or placement or location of any map features contained herein.The boundaries depicted by these data are Roads Federal Lands approximate,and are not necessarily accurate to surveying or engineering standards,and are intended for informational purposes only.Mason County does not assume any legal liability N Hignways City of Shelton or responsibility arising from the use of this map in a manner not intended by Mason County. In no event shall Mason County be liable for direct,indirect,incidental,consequential Rivers 8 Streams County Boundary(pNR 1 special,or tort damages of any kind,including,but not limited to,loss of anticipated profits pare*ls C6MMISSIOW D9MICtS or benefits arising from use of or reliance on the information contained herein sections Lakes ©2009-Mason County GIS La Ta 100 W.Public Works Dr [� arnShgds Puget S6un08 Mal6r icei Shelton,WA 98584 http://mapmason.co.mason.wa.us/servlet/com.esri.esrimap.Esrimap?ServiceName=amason... 5/11/2012 Planner: Grac Allan Rebecca MASON COUNTY PLANNING INTAKE CHECKLIST Owners Name: Date: —q_ 12, Project: Commercial ?: yes n Site Plan: A North Arrow 9 Property Dimensions: "l x Irregular Shape ? yes 0 �r Streets and Driveways shown Road Frontage Name: 'P 11 I r All Existing Structures Shown with setbacks and use. ❑ Well Location, Septic and Drain-field show with setbacks shown. • Identified Surface water(streams,ponds,shoreline,wetlands,natural/historic drainage, defined drainage) Topography (slopes) Minimum Structure Setbacks (direction/setback): F:\N /sZ00' R:_E,:7, _/ S 1N/ 17 7 T"S2 Utility and Drainage Easements: yes no (if yes enter condition #5022) Other Easements Accessory Appurtenances: ro ane Does site plan show landings at all exits ? Variance applied for: ye n Parking spaces allotted: � no County Access Permit Neede�condition #0010) '� ty ( ❑ State Access Permit needed (add condition 40020) 1>�,Standard Planning conditions: 45019 and #700 ^ Axe there any impediments (dogs/gates) that may restrict access to your site? yef��o ❑ If yes, do we need appointment? y s n ❑ Is site clearly marked Address Name Other ZONING UGA'S ALLYNBELFAIR/SHELTON Ru LAND DESIGNATIONS J GC J PF R-1 J R-1P RC 1 J RR 2.5 J AGRICULTURAL J POS J FR J R-2 J R-1R J RC 2 J RR 5 J LTCFL J BI GC-CI R-3 J RI J RC 3 J RR 10 J IN-HOLDING j HC J LTA J R-5 J RT J RW J RR 20 J TRIBAL j T J MU J R-10 RT/RTC J RNR J MHP ) BP J VC J RAC Critical Areas: (streams, ponds, shoreline,wetlands & steep slopes) Shoreline Designation: X N/A ❑ Urban ❑ Rural ❑ Conservancy ❑ Natural Water Body: SEPA: ye �y(t; ::�H�Aynknown n Flood Plain: y s n nknown Map # Aquifer Rec arg Map# Tags/Cases: RLC/SPI: 6 year Reforestation: ye --rra Eagle Nest Tag: yes no Other/North Bay Sewer: es Q Na e q t - 1 ^ Parcel# L�i —12-'OM,3(3-D# 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. T�-Ealct late IrnpervSudaces_�fease Complete`This Fable' 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) r X = Driveways X = X = 'Z 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 rmpervious area-of the pr ed opos site X = development is.greater than.20�0 sq>Jare feet a Small Parcel Stormwater.Site Plan is Required . T. tai lmperviout.Surface Are1.a(sum ofali are _ 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 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/mdex 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 INrTIAL 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 u i y signature below.I declare that I am the owner,owner's legal representative, or the contractor.I further 'e g a that the in ation provided is accurate and employees of Mason County are granted access to the above- described for review and pection as may be required. J X Owner/ gent/Contractor(circle one)Date: �'�✓/ Page 2 of 2 MASON COUNTY PERN(rf NO. � � �-�V rrL jr,j&BU[LQING PERMIT APPLICATION 426 W. Cedar• P.O. Box 156, Shelton, WA 98584 Shelton (360) 427-9670•Beffair(360)275-4467• Elma(360) 482-5269 On the web www_co.mason.waus APPLICANT INFORMATION CONTRACTOR INFORMATION Owner z �"' Company Name Maifin Address 2061 e _ -1 ,1 A­6or Do Mailing Address City ���l fa I, Stated Zip Code `i city State Zip Code Phon 3bO—` )- -) ►`i O�er P.h. (o/'S iD-:�oS Phone Other Ph. Lien/Tite Holder L-%?- Inc- Contractor Reg.it Exp. E mail address S -2- u L V e ; C_e kn E Mail Address DOB Drivers Lic. DOB Ij'l y-2_7 Drivers Lic. SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic— Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION- 12 Digit�a-cel No — / — 00 cd U Fire District Legal Description ^ Sit=-Address(Please i, ude street name strp-et number and city)- �r Di rFstosite I'iC ev;w jzcl Imo Ve4- j.c; 1 L�L� � Q% Leicl_ h I u r LL._4-i -t_ 1 Will timber be cut and sold in parcel preparation?Yes/No Is property within 2D0' of Saltwater Lake River/Creek Pond — Watland Seasonal Runoff Stream Slopes or Stubs ] 150/. Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YeslNo TYPE OF JOB-Nevr Add Aft Repair Other PRINu4RY RESIDENCE M] SEASONAL ❑ Use of Building Describe Wo, No. of Bedrooms —No.of Bathrooms _Square Footage-1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garaoe Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION -Make Model Year Length %tirdth Serial No. No.of Bedrooms No.of Bathrooms Type of Heat Purchase Price Replacement Unit? Yes/No Installer Name Cerfincation No. CYANERIBULDER A knoMadges sub,7 fission of ha=uras bfornabon may result in a smp work order or pent revD atiorL FelmoMedgament ci su-r is by sia-at-i re belox I d..:;Iare that I am the owner owners b..ga1 represant3frve,or the contractor.I further declare that I am enfited to rac&ve this Perri a and to do the work as proposed in the appli::AD.-L I deaare tat I have a5tained the permission from all the nam,-sary parts.ff pe nssion is required iran arty easement hoidar,or any other party in regarding the app5cabon or the wark pmpased in the apprLczfion,I have o5tai.-rad pa-ni.siah fram them to apply for this parrrit and condurt the work proposed. The owe or age-it on owners behalf,repr esarts that the inforrnaborl provided is as-r�t�andaOFOYR as of mason County access to the abova deed pmparty and sirucda e for review and inspection. PROOF NT INUS BY t,IIEANS OF A PROGRESS INSPECTION. x Date' Owner/ .e.;Rep�sentauv /Conta.^tor (mdimte whioh one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by. Date DEPARTMENTAL REVIEW ,APPROVED DENIED NOTES Bulling Department -3 —d ��y0 Planning Department G><8 Environmental Health Dapaitrnek7) Public Works Departments = Fire Marshal FEES Building Permit Fee / / /S Site Inspection Plan Review Fee // J S. S ) EH Review Fee Phimbing&Base Fee 7n f l 3° Planning Review Fee Mechanical&Base fee �` Other Wood/Gas/Peilet Stove Fee, State Fee \riolation Fee �X-e Pre-Paid at Submittal / S• .�(� Val uabon$ �o� `/ �I• �v8 TOTAL FEES PERMIT NO. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360)427-9670•Belfair(360)275-4467• Elma(360)482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATIgN CONTRACTOR INFORM T ON 4 `L Company Name h to- Owner (T� Mailin d s 11 A r Mailing Address City I-L State Zip Code S City State Zip Code Phone Gl. )-�;V'l Other Ph. 6 S l0'I� S` Phone Other Ph. Lien/Title Holder L 7 1 k"" L e'" 4 °"L Contractor Reg. # Exp. E mail address jjJ 2 . (_'Dull E Mail Address Drivers Lic.# DOB ig-/`I-2`7 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 2 2-1 LS - 1 2- -Oc'J` 30 Fire District Legal Description Site Address(Please i cluude streeta4rQe,.St et number and ci ) ?�r �l r Z-1 Directio tq ite .0 Al ti "T ' �'� t Is property within 200'of Saltwater Lake River/Creek Pond X Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% 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:Electdc_LPG_Natural Gas_Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs N14 Heatpumps pn Showers Spot Vent Fan op Water Heater Propane Tank Clothes Washer Gas Outlets / Kithen Sinks I Wood/Gas/Pellet Stove Dishwasher — Kitchen Exhaust Hood _ Hosebibs 3— Dryer Vent Other (.&omf I 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 a urate and grants empl s Mason County access to the above described property and structure for review and inspection. PROOF O NUATII NN F K I Y EANS OF A PROGRESS INSPECTION. Date:— Owner/ wners Representahv '/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 MASON COUNTY PERMFT NO. -rrujc-j BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 156, Shelton, WA 93584 Shelton (360) 427-9670•Belfair (360} 275-4467•Elma (360) 482-5269 On the web w,�w co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Maifin _Address 2061 6 - v, A r" r �T MJlaiGng Address City, �G�c.�fd�, Stated Zip Code S S'� City_State Zip Code Phone 3(.�� K 7�5 i`i Other Ph. (v�'3`i0-�oSc" Phone Other Ph. Lian/Title Holder L-% 1 'J'7r- Lc,,n y-,-i Contractor Reg. Exp. E mail address ,�j S Z y t 'V e % ( (_�n E Mail Address DOB Drivers Lic.m Dos'a-/9"z 7 Drivers Lic. SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic— Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION-12 Digit�arcel No — i71 — cc)a U Fire District Legal Description Site Address(Pleas in�Jude street name str et number and city) 12 o f7L,t/vrez _5447,01 Directi ns tq site ile G r" Will timber be cut and sold in parcel preparation?Yes/No Is property wiNn 200' of Saltwater Lake River/Creek Pond_ Wetland Seasonal Runoff Stream 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 Add Aft Repair Other PRIMARY RESIDENCE W] SEASONAL ❑ Use of Building Describe Wo No. of Bedrooms'—No.of Bathrooms_Square Footage-1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garaoe 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/No Installer Name Certification No. OWNER1BULD3R AcimDWedges submission of inaocurate Ifiomiabon may result in a stop work order or permit revanation.A:ImDwledgemert 1 such is by sign3hne brow.I declare that I am the owner,owners b-pi repreasatafrve,or the contractor.I further declare that I am entitled to rareive this pemit and to do the work as proposed in the appfic da-L I dare that I have obtaind the permission from all the necessary parties_if permission is raq<rred from arTy ease,-lent holder.or any other party in interest regarding this appGczSon or the work proposed in the app5ce5on,I have obtained pe-M iSaari from them to apply for this parr and conduct the work proposed. The owner or agent on owners behalf,represar s that the Vbmia5on provided is ace gate and g aT^ foyeas of tdlasah Cou ty amass b the above descrbad property and struchce for reA and irspe�o L PROOF NTWU QN OF O BY MEANS OF A PROGRESS INSPEC-nOl1. x 1 / � Cate- 2, Rexasentafry /Contracbr (mcfimte which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by. Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES