Fillable PRE-APPLICATION CONFERENCE REQUEST FORM

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PRE-APPLICATION CONFERENCE REQUEST FORM

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PAR_________ - ___________
DATE_________________
Rev. January 2021
615 W. Alder St. – Bldg. 8, Shelton, Wa 98584
Phone: (360) 427-9670 ext. 352 ♦ Fax: (360) 427-7798
PRE-APPLICATION CONFERENCE REQUEST FORM
Tax Parcel Number (12 digits):_____________________ Site Address:________________________
The purpose of the pre-submission conference is to identify and/or eliminate as many potential problems regarding a
proposal. Representatives from the Fire Marshal’s Office, Building Department, Environmental Health, Planning, and
Public Works Departments may
attend the meeting to discuss rules and regulations applicable to the proposed project.
Topics covered during the meeting may include the comprehensive plan, land divisions, shoreline program, zoning,
availability of sewer and potable water, development concepts, building construction, fire protection and life safety
concerns of the proposed project. The pre-submission conference is intended as an informative meeting. The intent is to
provide detailed information to the applicant in regards to codes and process.
Incomplete applications will not be accepted. If application is deemed incomplete it will be returned.
All Conferences are on Mondays (except holidays)
To schedule a meeting you must complete the requirements for submittal including the required one
(1) copy of the detailed site plan (max. size 11”x17”).
To submit either by mail or in person at: Mason County Permit Assistance Center at 615 W Alder
Street, Shelton WA 98584 by 3:00 PM on the Monday two weeks prior the proposed meeting.
Please make check payable to: Mason County Treasurer Check amount: $640.00
Owner:
Name: ______________
_____________________________________________________________
Mailing Address: ___________________________________________________________________
_________________________________________________________________________________
Daytime Telephone: ________________________________________________________________
Email address: __________________________________ Fax number:_______________________
Representative:
Name:
___________________________________________________________________________
Mai
ling Address: ___________________________________________________________________
_________________________________________________________________________________
Daytime Telephone: ________________________________________________________________
Emai
l address: ____________________________________ Fax number:_____________________
2
♦Description of Project: ______________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
♦Square footage of structure: _________________________________________________________
♦Use of building and rooms (i.e., office, warehouse, restaurant, storage, etc): _______________
_________________________________________________________________________________
♦Occupancy classification per IBC, Section 302.1, and construction type: __________________
_________________________________________________________________________________
♦Will grading or excavation be included in the project?
If so what is an estimate the amount of grading: cut ____________cy , fill ____________cy
♦Will Forest Practices be included in the project?
If so what is the estimated amount of logging: ___________ board feet
♦Are there any historical stormwater and/or geotechnical reports (prepared for previous
development)? Please Indicate Yes
□ No □
♦ Has the project been discussed during a previous Pre-Application Conference?
If yes, please indicate date. ________________________________________________________
♦ Will the building have employees? Yes □ No □ If yes, how many?______________________
♦ What is the proposed source of water? (Please indicate):
□ Proposed Individual Well, □ Existing individual well, □ Proposed water system, □ Existing Water
System, Name of existing water system:___________________________
♦ What is the proposed source of sewage disposal? (Please indicate):
□ Existing onsite sewage system, □ Proposed onsite sewage system, □ Existing sewer connection,
□ Proposed sewer connection, Name of Sewer System connected to:___________________________
♦ Will the project include signage? Yes □ No □
If
Yes, describe; size, material and location:___________________________________________
♦ Is there a fire hydrant located within 400 feet? Yes □ No □ If, yes include on site plan.
The following items must be included (attached):
♦ Provide two sets of proposal/plans including a floor plan. Max. paper size 11” x 17”.
♦ Provide ONE (1) copy of the site plan including all items required (see page 3)
Provide specific comments or specific questions we can help you with: ______________________
___________________________________________________________________________________
3
APPLICABLE BUILDING CODES
2018 International Building Code/2015 International Residential Code
2018 International Fire Code - ANSI A117
201
8
Int
ernat
ion
al
Mec
h
anical
Co
de – WAC 51-42
2018 Uniform Plumbing Code – WAC 51-56/51-47
2018 International Energy Code / Washington State Energy Code – WAC 51-11C & 51-11R
Mason County Ordinance Title 14 & Code changes are on a 3 year cycle; effective in July of that particular year.
⎕ Indicate Scale and North Arrow
⎕ Pr
operty line dimensions, easements, and right-of-ways.
⎕ The
location of all existing and proposed structures. Include square footage of existing and proposed
structures.
⎕ Set
back distance, in feet from all property lines and structures.
⎕ Ex
isting and proposed road access to and from the site.
⎕ Par
king sites
⎕ Locat
ion of on-site sewage tanks and drainfields.
⎕ Locat
ion of drinking water supply. Include location on the proposed site and surrounding parcels.
⎕ St
eep slope, wetlands, streams, and bodies of water
⎕ Location of fire hydrants and emergency vehicle access roads, including grade.
⎕ Sur
face and storm water run-off routes.
⎕ The
site plan should be provided on letter (8.5" by 11"), legal (8.5" by 14"), or 11" by 17" (a larger one
could be provided in addition to this).
⎕ If there are several buildings on the site and/or proposed, to label each one A, B, C, D, ...
⎕ Show EXISTING drainage features (infiltration ditches, retention ponds, etc).
⎕ Show BOUNDARIES, area and volume of proposed site disturbance (this includes clearing and
grading limits, proposed timber harvest activity/ tree-cutting, landscaping.
⎕
Show all the existing and proposed impervious surface areas (including gravel driveway,
loading, parking etc) in square feet.
Site Plan Requirements
1 copy is required at submittal
Include the following information
Location of Conference: 415 N 6th Streets, Shelton WA Planner: ext.
Date of Conference: Time of Conference:
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PRE-APPLICATION CONFERENCE REQUEST FORM

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Completed 18 April 2022

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