HomeMy WebLinkAboutBLD2024-01078 Replace Deck - BLD Application - 9/5/2024 MASON COUNTY Permit No:
COMMUNITY DEVELOPMENT 0 5 2024
Permit Assistance Center, Building,Planning
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: LETTUCE LOAF LLC CIO GAIL OTTO NAME: JESFIELD CONSTRUCTION
MAILING ADDRESS: 3205 62RD AVE NW MAILING ADDRESS: PO BOX 1590
CITY: GIG HARBOR STATE: WA ZIP:98335 CITY: ALLYN STATE: `NA ZIP: 98524
PHONE#1: 253-265.3785 PHONE: 360-535-6684 CELL: 360-535-2106
PHONE#2: EMAIL: SMERRILL@JESFIELDCONSTRUCTION.COM
EMAIL: GROTTO47@OUTLOOK.COM L&I REG# JESFII-228DO EXP. / /
PRIMARY CONTACT: OWNER❑ CONTRACTOR 9 OTHER❑
NAME EMAIL
MAILING ADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32224-51-01010 _ZONING RR5 _
LEGAL DESCRIPTION(Abbreviated) COTHARY BEACH TRACTS BLK:1 LOT:)O&T.L. FIRE DISTRICT
SITE ADDRESS 9541 NE NORTH SHORE RD CITY BELFAIR
DIRECTIONS TO SITE ADDRESS FROM BELFAIR,APPROXIMATELY 9.5 MILES WEST ON HWY 300&NE NORTH SHORE RD
TO ADDRESS ON LEFT.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESQ NO❑ SNOW L0.4D:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check.!!that applv):
SALTWATER E] LAKE❑ ILIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR 0 OTHER ❑
USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Eic.) SFR
IS USE: PRIMARY❑ SEASONAL Q NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(rnoleBldg)❑ YES(pan/s1 ojBldg)❑ NO❑
DESCRIBE WORK REPLACE EXISTING DECK IN THE SAME FOOTPRINT
SOUARE FOOTAGE:(proposed)
1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK 391 sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ 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 d SEWER❑ / NEW❑ EXISTING El
PLUMBING IN STRUCTURE? YES 0 NO❑ /fyec,attach completed Water Adequacy Form
PERIMETEPUFOUNDATION DRAINS PROPOSED? YES❑ NOE] EXISTING SQ.FT,
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
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 struclure(s)for review and inspection.This perniVappticabon 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)
X q�d/to- oeta� 4-20-2024
SignatXe of OWNER(Must be signed by the OWNER I Date t
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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