HomeMy WebLinkAboutBLD2020-00639 Final Fire Damage Repair - BLD Application - 1/18/2022 MASON COUNTY COMMUNITY SERVICES Permit No:
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PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL j 815 W.Alder Street,Shelton,WA 98584 RECEIVED
Phone Shelton:(360)0)427-9670 ext.352•Fax:(360)427-7798 Phone
Be/fair.(360)2754467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION JUN 18 2020
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Cathy Jennings-Sargent NAME: Jeremy Chappell,Charter COnstrUCRUr •AJder Street
MAILING ADDRESS:PO BOX 1381 MAILING ADDRESS: 980 South Harney Steet
CITY:Belfair STATE:WA ZIP:98528 CITY: Seattle STATE:WA ZIP: 98108
PHONE#1:360-731-0082 PHONE: CELL: 206-892-8288
PHONE#2: EMAIL: Jeremyc artercon.com
EMAIL: cathy.sargent60@gmaii.com L&I REG# CHARTCI171 PM EXP. 4L
/
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER
NAME Lisette Terry EMAIL Lterry@deaen olb.com
MAILING ADDRESS bQ0 University Street, Suite 720 CITY Seattle STATE WA_ZIP 98101
PHONE CELL 206 790-7594
PARCEL INFORMATION: Rural Residential-
PARCEL NUMBER(12 Digit Number) 123305300036 ZONING 5 Acres
LEGAL DESCRIPTION(Abbreviated) BEARDS COVE DIV 6 LOT:36 FIRE DISTRICT
SITE ADDRESS 981 NE Larson Lake Road CITY Belfair
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WrrHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO WSNOW LOAD:25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkall that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR OTHER ❑
USE OF STRUCTURE(Residence,Garage.Commercial Bldg,Etc.) Residence
IS USE: PRIMARY[SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS_^/
HEATED STRUCTURE? YES(Whole Bldg)Lam" YES(parr[,)ofBldg)❑ NO❑
DESCRIBE WORK A fire damaged two roof rafters and sheathing.Remove and replace damaged structure in like-kind.
SQUARE FOOTAGE:(proposed)
I ST FLOOR 1.116 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT 528 sq.ft.
DECK 725 sq.ft. COVERED DF,CK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE 480 sq.ft. Attached Er 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:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS 2 PROPOSED BEDROOMS 0 TOTAL BEDROOMS 2
OWNER 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 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,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK 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)
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C� ""(�►'""dP June 18,2020
. Signature of OWNER(Must be sianed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT 7
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH