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HomeMy WebLinkAboutBLD2025-00037 SFR - BLD Application - 1/13/2025 4 MASON COUNTY Permit No: 8L.(J?n25-00031 COMMUNITY DEVELOPMENT RECEIVED k Permit Assistance Center,Building,Planning BUILDING PERMIT APPLICATION JAN 1 ZsEs PROPERTY OWNER INFORMATION• CONTRACTOR WF0RMAn64§) W.Alder $ reet NAME:S'A M00[�r '�Q�p 0.�. NAME: OBI (Yl MAILING ADDRESS: Z ( MAILING ADDRESS: 4!t E CITY: STATE: ZIP:�y(�( CITY: STATE: ZIP: PHONE#1: PHONE:ZS3 rAa• A LL: PHONE#2: EMAIL: M. (�v+ fY1. �rar EMAIL:6 L&I REG#e f1V A�.I�L 894 Q n EXP.(Q/_�/­2S PRIMARY CONTACT: OWNER❑ CONTRACTOR OTHER NAME EMAIL MAILING ADDRESS CITY 'STATE WAz ZIP PHONE 24(� VA�� CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Ntunber) '�•2��^��^ (')(jO2( ZONING_R,RS LEGAL DESCRIPTION(Abbreviated) Lo'[5. 2 2 MJ 1 L—C DISTRICT_V e SITE ADDRESS 100 F— wi ttAA I DIRECTIONS' CTI"s TO SITE ADDRESS _ IE \C Rl Vb} Q u d v IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO*& SNOW LOAD:IS nsf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW* ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Rcridmce;Garage,Commercial Bldg.Etc) P- tdle.(1 t' IS USE: PRIMARY" SEASONAL❑ NUMBER OF BEDROOMS_NUMBER OF BATHROOMS Z HEATED STRUCTURE? YES(lf%d BW❑ YES(partfs)ofBldgJ 11;0i allo c�tC�► DESCRIBE WORK (r0 2• W aim SQUARE FOOTAGE:(proposed) IST FLOOR"sq.ft 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.& COVERED DECK LG sq.ft. STORAGE sq.fL OTHER sq ft. GARAGE,4 sq.R Auached% Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGEISEWER SOURCE: SEPTIC SEWER❑ / NEWU EXISTING❑ PLUMBING IN STRUCTURE? YES NO❑ If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO.- EXISTING SQ,FT. EXISTING BEDROOMS PROPOSED BEDROOMS 3 TOTAL BEDROOMS _ OWNER acknowledges that submission of inaccurate information may result in a stop work order a permit revocation.Admowledgement of such is by signature below.I declare that I am the owner and I further declare Mat i am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of Interest regarding this project The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and sbrur3we(s)for review and Inspection. This pernitlappka ion becomes null 8 void if work or authorized construction is not commenced within 180 days or If construction work is suspended for a period of 1 BO days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) x�l�iytn. .�l1OOAL ,F ��alah 184 00,l s 01 /08/2025 Signature of OWNER(Must be sianed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Doc ID:dcblb9af379949dOced937ffaf1cd2154b82c567 Permit No: C),102 -06037 MASON COUNTY COMMUNITY DEVELOPMENT Permit Assistance Center, Building,Planning PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: S-kPMQA A 1>1CO`pW lj�(L NAME: Cowxt t kOM&S MAILING ADDRESS:22Sk Wltk floWe1' & MAILING ADDRESS: 202S 125`& E CITY:kiMfy*1X 1 STATE: Ot',4: ZIP: SC,U()11 CITY-'rox o Y nL STATE: W A ZIP: RibLALAS Is'PHONE! Gla-Rkp9- kk(nq PHONE:-15a. Got3.444(eCELL: 2"d PHONE: EMAIL : M�CdclolaQ_CAVC�.�4lofy%-U •Com EMAIL: S ,c]1ebOlb��ArJSA 4MRr►.►1•e0M L&I REG# COVM.W-18g4 40 EXP. 10 /�/ 2S PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): '22005- 55-0001 k Zoning: RR 5 LEGAL DESCRIPTION (Abbreviated): WILL- VtAk A LL L E t_OT 2l ZZ SITE ADDRESS: ►(JC) E W',k%c_6a_ ' &ad CITY: DIRECTIONS TO SITE ADDRESS: FMfv\ S-k Qzk3 , taVt F pioskA,CN9 (td�. RtiBV*- o(\ E pIn„1vg6 LM%Le RI\1 LZ,� O n E pq�k11 t pS L JLL L p Rd, Lem 00 E W l\dW- B\vCk. TYPE OF JOB: NEW[1 ADD=ALT=REPAIR=OTHER=USE OF BUILDING SIF%Z LOCATION OF FIXTURES/UNITS—I ST FLOOR®2ND FLOOR=BASEMENT=GARAGED OTHER= PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric[X]LPGQNatural Gas[=]Ductless0 Toilets Z ✓ Type of Unit No.of Units Fees Bathroom Sink 3 ✓ Furnace Bath Tubs 1 ✓ Heat Pump Showers 1 ✓ Spot Vent Fan — y -3 V--' Water Heater l '� Propane Tank Clothes Washer I ✓ Gas Outlets Kitchen Sinks 1 ✓ Wood/Gas/Pellet Stove Dishwasher 1 '� Kitchen Exhaust Hood 1 ✓ Hose bibs Dryer Vent I ✓ Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative,or contractor. I further declare that 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 OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WIL LIDATE PLCATION. X 1 • I- •ZS nature o r Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN Name Parcel# BLD# Mason County Department of Community Develop ent Small Parcel Stormwater Management Application orksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwat/iled,macadam lan is re uired whenever a building application is made for residential devel pment,or redevelopment', with m 2,00 square feet of impervious surface'. 'Redevelopment means,on a already developed site,the creation on impervious surfaces,structural development including construction,install\include, ut sion of a building or ot e,and/or replacement of impervious surface that is not part of a routine maintenance and disturbing activitiesd with structural or impervious redevelopment. ZCommon impervious surfacesare not limited to,rooftkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gracked earthen materials, ,macadam or other surfaces which similarly impede the natural infiltration of stormwac vered retention/detentlities shall not be considered as impervious surfaces. To Calculate lmpe ous Surf, ces Please Complete This Table Surface Type Length X Width = Area ' All dimensions in feet Buildings X — X Measurements for buildings are taken at the X perimeter of the farthest projections (example: eaves/gutters) X = Driveways X X = Length of drive begins at the right of way X = Parking Areas X = X = Any pav , gravel or packed area per definition above table X = PatiosMalks -X = _ Any paved, gravel packed area per definition above table Others X X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surf ce Area (sum of all areas) If the Total Impervi s Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the in ation you have provided a Stormwater Site Plan IS NOT required for this development activity. owner/Builder/Age t 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 1 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. Pagel of 2 3�_o'Lozs - o0o3-J PLN Approved 01/29/2025 Mason County Community Development Gavin Scouten All Changes Subject to Approval Disclaimer Mason County does not require surveys for building.As a result,site plans may not reflect accurate data.It is the applicant's responsibility to comply with setback requirements. Bowman Permit RR5 STANDARD SETBACKS* Consulting Front:25' Shanea Bowman Sides:10'(LOT WIDTH=100') EH Setbacks 360.860.1234 Rear: 20' A-)-Drainfield/Reserve requires 10'setback from footing/foundations bowmanpermits0outkfok com `unless otherwise stated on the site Ian B.)Septic tank(s)requires 5'setback from all footing/foundations p C.)No foundation/Perimeter Drains within 30ft,downgradient of DATE: .all setbacks measured from the farthest Drainfield/Reserve area' D.)No Cut Bank(s)(greater than 51t and over 45 degrees)within 1/7/25 projection of the building. 50ft,down gradient of DrainfiebReserve area 'subject to EH setbacks DRAWING: • Existing 4 Culvert -Stormwater Ditch Site Plan FRONT 1T. OWNERS: Steven Moore& 29' 2, rord EH APPROVED Deborah Brooks Setback Rhonda Thompson 01/31/2025 PARCEL: CV to'S,do 22005-55-00021 iSetback 100 E Willchar Blvd W I NOT AN APPROVED SEPTIC DESIGN Shelton98584 t 't........_-------. 205 Must use SWG2024 00327 for septic installation V� SCALE: 1^=30' p m Proposed I LD i Septic 3 BR Home N N Tanks i� r SYMBOL LEGEND `. �.._ Roof ----- Buflding Setbacks Oyerhang I 30'Stormwater 5'Contours 4d Buffer Direction of Natural Drainage t I � Existing 2-Party Well I Reserve 1 0'&100'Well Radius 5'k ------ -J ❑ AC — _ 10'No Build proposed Zone ��-2Q Re -. 3 BR Drainfield Reserve isetbarxar' IMPERVIOUS SURFACE TOTALS ------ l House w/Eaves 2,557 SF - - -----.r ''100 - Driveway/Walkway 785 SF � an3a BLD DATE STAMP MASON COUNTY COMMUNITY DEVELOPMENT Permit Assistance Center,Building,Planning RCVD BY: APPLICANT INFORM"ATION (please print clearly) Name of Applicant: �r�.n� 12)O1/J Parcel Number _U-005 "SS -0002-1 Site Address: This checklist must be completed and signed by the owner or owner's authorized agents at time of submittal. Incomplete applications will NOT be accepted For a complete application, all items on this checklist shall be submitted,unless waived by Staff. PERMIT APPLICATION RECEIVED Provide a completed and signed(by owner or authorized representative)application and applicable (� fees are due at submittal. �J Provide a completed plumbing and Mechanical Application SITE PLAN VERIFIED Provide one(1)copy of proposed site plan. Drawn to scale of either. 1"= 10' or 1"=20' depending on lot size. North Arrow, location and dimensions of all property lines and easements. Vicinity map showing location and names of all roads and easements.(public andprivate) Show distances to all structures,septic tanks,drain fields, property lines,top of slopes or cuts and ❑ easements. Zoning(indicate): Rural Residential:O2.5 6 5 O 10 O 20 Other: Urban Growth Area: Zone: 9-PIS Front yard: 15 ' Direction: Side yard: 101 Direction: E Rear yard: 20- Direction: Side yard: 1p► Direction: W All access points,width of access. easements and driveways). Contour lines in twenty 20 foot increments. See Parcel Map Viewer on website Building height shown on elevations at all four corners of structure. Flood lain boundaries and setback distances. See Plans for additional requirements. Wetland or surface water(if any)and any applicable buffers. If yes,a wetland report may need to be ❑ submitted. Is the site near a Shoreline stream, creek,lake, saltwater if yes,please indicate? Name of shoreline: Shoreline designation: Stream type F, S,Ns,N : Is the proposed site within 300 feet of a slope 15%or greater?If yes, a geological report or assessment ❑ in be required. Existing/proposed on-site septic s stem and reserve areas,providing setback to structures. Existing/proposed wells show 100 ft well radius,with distances to structures). Existing and proposed stormwater controls(downspouts,dry wells,etc. Exterior storage tanks(propane)and HVAC equipment. CONSTRUCTION PLANS LOCATED Provide three(1)copy of plans(I full size min. 18"x 24"and 1 small size)and one(1)copy of all specifications and engineering.Plans must be drawn to scale of/4"= 1'.All notations and drawings must be clear and legible.All Engineering callouts must be on plans. Engineered plans most provide calculations/analysis.Analysis must include the following information: • Adopted International Code • w load(by location) • Seis 'c zone(D-2) • Expos (by location and topography) • Winds 85 MPH basic and 110 ultimate w/3 second gust) Z If project is in a flood hazar a,the submittal must include an Elevation Certificate, fl venting compliance and an elevation d 1 indicating the location of finished floor relative to ase Flood Elevation or DesignFlood Elevati as designated by surveyor or engineer. FOUNDATION PLAN Plan view of foundation/footings/pads Type,size and location of footing ste undation provide detail Elevation view of foundation steps,with fma ade Cross-sections of footing and foundation(incluNg height of wall). Floor joist and spacing(each floor). Location of flood venting,size and method of compNpce for venti when in a flood zone Type and locations of hold-downs and anchors. Crawl access location and size. Insulation value for foundation(if slab or basement). See En Credits for additional requirements, credits must be indicated on the plans. If the project is in floodplain provide flood venting comp ' ceing vent locations,vent type, elevation detail for ventinglocation interior and exterio of the craspace. FLOOR PLAN Square footage of each floor Use of each room Attic access size and location Dimensions of building and rooms. Location and type of furnaces,water heate , smoke detectors,and carbon mono xi a detectors.Include location of bollard for appliances located ' ara e. Heat Detector in garage(required in all es attached,must be hardwired to smoke carbon Plumbing fixture locations Location of doors,windows(incl!W size,egress,tempered andskylights) Insulation value in floor. See En Credits for additional requirements,must be indicated o e plans. Location of ventilation fans an FM for each. Location of whole house fan g6d CFM continuous or intermittent Location,side and type of b ce wall or shear-wall panels.If structure is engineered,must supply two copies of required anal si calculations Dimensions and framin details of decks(including joists,beams,posts, ledgers.Plan MUST include size,grade,spacing,lejfgth and species or type of material ELEVATIONS WALL DETAILS Typical and rated Valls a separation) Listing of fire-resistive wall designs(duplex or townhouse Building eleva " ns-all 4 sides Show distance from grade at each corner. If project is in oodplain must provide Elevation detail indicating the location of finished floor relative to the Base Floqfi Elevation or Design Flood Elevation as designated by surveyor or engineer. Exterior wal details when distance between overhangs is less than 5 feet to property line or other structures. Insulation value for walls. See Energy Credits for additional requirements,must be indicated on the plans. ROOF PLAN Layout of roofs stem LOCATED Provide three(1)copy of plans(1 full size min. 18"x 24"and I small size)and one(1)copy of all specifications and engineering.Plans must be drawn to scale of 1/4"= 1'.All notations and drawings must be clear and legible.All Engineering callouts must be on plans. Engineered plans must provide calculations/analysis.Analysis must include the following information: • Adopted International Code • Snow load(by location) • Seismic zone(D-2) PJ • Exposure(by location and topography) • Winds 85 MPH basic and 110 ultimate w/3 second If project is in a flood hazard area,the submittal must include an Elevation Certificate,flood venting compliance and an elevation detail indicating the location of finished floor relative to the Base Flood to r� Elevation or Design Flood Elevation as designated by surveyor or engineer. FOUNDATION PLAN Plan view of foundation/footings/pads SZ 2. •0 3 C Type,size and location of footing(stepped foundation provide detail Elevation view of foundation steps,with final grade Cross-sections of footing and foundation(including height of wall). Floor joist andspacing each floor). Location of flood venting,size and method of compliance for venting. when in a flood zone Type and locations of hold-downs and anchors. Crawl access location and size. Insulation value for foundation(if slab or basement). See Energy Credits for additional requirements, credits must be indicated on the plans. If the project is in floodplain provide flood venting compliance including vent locations,vent type, elevation detail for venting location interior and exterior of the crawls ace. FLOOR PLAN Square footage of each floor 00 Use of each room Attic access size and location Dimensions of building and rooms. Location and type of furnaces,water heaters, smoke detectors,and carbon monoxide detectors. Include location of bollard for appliances located in garage. Heat Detector in garage(required in all garages attached,must be hardwired to smoke&carbon Plumbing fixture locations Location of doors,windows include size,egress,tempered andskylights) Insulation value in floor. See Energy Credits for additional requirements,must be indicated on the plans. Location of ventilation fans and CFM for each. LC1 l Location of whole house fan and CFM continuous or intermittent Location,side and type of brace wall or shear-wall panels.If structure is engineered,must supply two copies of required analysis(calculations) Dimensions 1 Dimensions and framing details of decks(including joists,beams,posts,ledgers.Plan MUST include size,grade,spacing,length and species or type of material) pv ELEVATIONS AND WALL DETAILS Typical and rated walls a separation) 2 Ox Listing of fire-resistive wall designs(duplex or townhouse Building elevations-all 4 sides Show distance from grade at each corner. If project is in floodplain must provide Elevation detail indicating the location of finished floor relative to the Base Flood Elevation or Design Flood Elevation as designated by surveyor or engineer. Exterior wall details when distance between overhangs is less than 5 feet to property line or other structures. Insulation value for walls. See Energy Credits for additional requirements,must be indicated on the plans. G1 ROOF PLAN Layout of roof system Label of roofs stem,rafters,engineered trusses&spacing 1 Headers noted at each location or typical header noted. Roof pitch and covering materials Sheathing s,dimensions and fastening Attic venting ,location and amount Insulation value for roof(R38 vault and R49 ceiling)See Energy Credits for addition requirements,must be indicated on the plans. ENERGY CODE REQUIREMENTS RECIEVD Completed Washington State Energy Code form Plans must indicate fuel source for furnaces,water heaters and other appliances. Manufactures Specifications for each unit or compqnent for HVAC&plumbing Compliance to the Washington State Energy Cody and required Credits.Construction drawings/plans PAGE # MUST include all credit information on the plan details such as insulation,ventilation,furnaces, N©O i windows etc.Plans must also include the number of credits and which credits are chosen. I verify all required documents,plans,and specifications associated with this application have been submitted and are accurate. $k Si o owner or authorized agent Print Name Date Permit No: MASON COUNTY COMMUNITY DEVELOPMENT N Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: MAILING ADDRESS: MAILING A DRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: PHONE#1: PHONE: CELL: PHONE#2: EMAIL EMAIL: L&I # EXP. PRIMARY CO CT: OWNER❑ CONTRA OR❑ OTHER❑ NAME EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATIO . PARCEL NUMBER(12 Digit Number) ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT SITE ADDRESS CITY DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S) ATER THAN 14%: YES[] NO❑ SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOL IN . (check an that apply): SALTWATER❑ LAKE❑ RIVER/CREEK POND WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDIT N ❑ ALTERA ON ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,C 1 Bldg,Etc.) IS USE: PRIMARY ❑ SEASONAL❑ NUMBER OF BEDROO NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg) YES(Part[s]of Bldg)❑ NO DESCRIBE WORK SQUARE FOOTAGE: (proposed) 1ST FLOOR sq.ft. 2ND LOOR sq. ft. 3RD FLOOR sq.ft. ASEMENT sq.ft. DECK sq.ft. COVE DECK sq.ft. STORAGE sq.ft. O R sq.ft. GARAGE sq.ft. Attac ed❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED H INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH DROOMS BATHS SERIAL NUMBER ENVIRONMEN AL HEALTH: SEWAGE/SEWE SOURCE: SEPTIC ❑ SEWER❑ / NEW❑ EXISTING❑ PLUMBING TRUCTURE? YES ❑ NO❑ Ifyes, attach completed Water Adequacy Form PERPAETE OUNDATION DRAINS PROPOSED? YES ❑ NO[] EXISTING SQ. FT. EXISTIN BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER a nowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature b w. I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or legal representative reoresents that the information provided is accurate and orants emnlovees of Mason Countv access to the above described orooerty Name%kWm mm(e % Parcel# 22 C)5 ' S5 'CC)()Q.I BLD# �zkxX�ah �bp� 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 2. '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 re&ntion/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X = 2. X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways X = �� X = Length of drive begins at the right of way X = Parkinq Areas X = X = Any paved, gravel or packed area per definition above table X• _ Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further ac ow edge that the information provided is accurate and employees of Mason County are granted access to the above- de roperty for r'cie�+�►�s d inspection as may be required. 1 1 X Owner/Agent/Contractor(circle one)Date: `' [ 1S 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. Pagel of 2 Name ',yV\ tAOG . Parcel# --LOGS—55 -00 0 2 J 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: hgpL/www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details*are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout' PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A)% The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AN D 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- de property fo ew and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: 1 - 3 2� Page 2 of 2 Date Received: MASON COUNTY RECEIVED COMMUNITY SERVICES DEPARTMENT BUILDING•PLANNING•FIRE MARSHAL JAN 13 202 -_— Mason County Bldg.8,615 W.Alder St Shelton,WA 98584 www.co.mason.wa.us 360-427-9670 ext 352 615 W. Alder Street Permit#.• OCo —1 Property Owner's Authorization Letter I (we): Steven Moore & [*borah Brooks (Print Propero,Owners Name/Firm/Organization) Hereby Authorize: Shanea Bowman (Applicant-Name of Person to Sign Permit) Representative of: Bowman Permit Consulting (Applicant Company Name/Organization) To apply for,sign, and pick-up building permits for the following proposed work: Single Family Residence (Brief Description of Work to be Done) Job Location: 100 E Willchar Blvd, Shelton 98584 (Property Site Address) As property owner(s),I(we)hereby grant permission to the applicant referenced above to apply for,sign,and pick- up the building permit for the work as indicated above.All work performed must meet all provisions of the Building Codes and the Laws of Mason County and the State of Washington,as applicable,whether specified or not.Residential Contractors are required to have a current State of Washington Contractors License(RCW 18.27). AveA Afo&& ,t, &JOA&A '6A00, y 01 /02 /2025 (Property Owner Signature) (Date) Rev.03/10,12016 jlbn Doc ID: 7c84123fcd5a748fa2bb6878fe3e69f094017flb