HomeMy WebLinkAboutCOM2004-00162 Cancelled ReRoof - COM Permit / Conditions - 8/10/2004 n
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FORM MUST BE COMPLETED IN INK MASON COUNTY AITXN - �J� l�n
PLEASE PRESS HARD BUILDING 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 INFORMATION CONTRACTOR INFORMATION
Owner Company Name 10r Set- a-
Mailin Address W Mailing Address PO ISox Rog2
CityState Zip Code 10S719 CityJ!dzQrcLa.-ol State Wd Zip Code q'366
Phone a7S= '3rX S Other Ph. Phone 769 - olVI Other Ph. TVA-3-7YS-
Lien/Title Holder Contractor Reg.# Exp.
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
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 QD 1
PARCEL INFORMATI N- 12 Digit Parcel No. Fire District
Legal Description `r•
Site Address (Please include street name, street num er and city) e
[Directin 1:6 site4; K 4 ;
Will ti be cut and sold in parcel preparation?Yes/
Is property within 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 Noticp,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Describe Work-fit-r Aux -
No.of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq.ft.
Garage 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.
OWNER/BULDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.AcknwAedgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further decla ceive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the fission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the n I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, r t�torrrtation
provided is accurate and grants employees of Mason County access to the above described property and structure for review andd`� n.
PRO0?1F CO NUAT�N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. 426 W: CEDAR STt
X JT/lvK �11�IPA^- Date- m
Owner/Owners Representative/Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED JQENIED TES
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 U
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Topic Index Contact Info ___ ___.........
Labor
Find a Law or Rule Get a Form or Publication
Look Up a Contractor, Electrician or Plumber
General/Specialty Contractor
A business registered as a construction contractor with L81 to perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
License Information
License CLOISMC991 L7
Licensee Name CLOISE It MIKE CONSTRUCTION INC
Licensee Type CONSTRUCTION CONTRACTOR
UBI 602128841 Verify Contractor Premium Status
Ind. Ins.Account Id 0
Business Type CORPORATION
Address 1 2149 LONG LK RD SE
Address 2 CLOISE ORAND 11
City PORT ORCHARD
County KITSAP
State WA
Zip 98366
Phone 3607690141
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 6/27/2001
Expiration Date 7/22/2006
Suspend Date
Separation Date
Parent Company
Previous License
Next Licensel JDUBBC1994NP
Associated License
Business Owner Information
Name Role Effective Date
https://fortress.wa.gov/InAbip/detail.aspx?License=CLOISMC991 L7 8/10/2004
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ORAND, CLOISE II PRESIDENT 06/27/2001
HOLBROOK, MICHAEL J VICE PRESIDENT 06/27/2001
ORAND, MICHELLE M SECRETARY 06/27/2001
ORAND, CLOISE TREASURER 06/27/2001
COWAN, THOMAS J VICE PRESIDENT 07/09/2003
Bond Information
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
ACCREDITED
SURETY it
#3 1 CAS CO 10018450 06/12/2004 1 $12,000.00 07/22/2004
#2 GULF INS CO B32644721 06/12/2002 06/26/2004 $12,000.00 06/24/2002
#1 GULF INS CO B32644721 06/12/2001 06/12/2002 $6,000.00 06/27/2001
Savings Information
No Matching Information
Insurance Information
Company Effective Expiration Cancel Impaired Received
Insurance Name Policy Number Date Date Date Date Amount Date
NATIONAL
FIRE Ft
MARINE INS
#5 CO 72LPN307877 07/16/2004 07/16/2005 $1,000,000.00 07/22/200
MAXUM
INDEMNITY
#4 CO BDG0000351091 06/25/2003 06/25/2004 $2,000,000.00 07/01/200
ATLANTIC
#3 CAS INS CO L088000014 06/25/2002 06/25/2003 $1,000,000.00 06/24/200
MUTUAL
OF
#2 ENUMCLAW PK94225 06/25/2001 06/25/2002 06/25/2002 03/14/200
MUTUAL
OF
ENUMCLAW
#1 INS CO TBA 06/25/2001 06/25/2002 06/27/200
Unsatisfied Summons/Complaints Information
No Matching Information
Start a New Search
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https:Hfortress.wa.gov/h i/bbip/detail.aspx?License=CLOISMC99IL7 8/10/2004
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1-800-547-8367 �
m Washington State Dept.of Labor and Industries.Use of this site is subject to the laws of the
state of Washington.
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Staff only link
https:Hfortress.wa.gov/lni/bbip/detail.aspx?License=CLOISMC99I L7 8/10/2004
FI LE
COPY
NON-STRUCTURAL RE-ROOF APPLICATION
Roof Slope: S" Z — z
Old Roofing Material: Cow,p 3 Tub
New Roofing Material: 1"1 t�rlG�, So V R_ l+eG�.W
Sheathing: .
Underlayment: /5" # e! - u.,od.e.�� �-
Existing Insulation:
New Insulation:
THESE PLANSB SITE
UST BE
ON THE JO
FOR INSPECTION
Roof Slope:UBC Table 15-B-1&15-B 2
Roof slope must be indicated to ensure selected roof covering is allowed on designed pitch.
Roof Covering: UBC Section 1507
Selected roof covering must be installed in accordance with manufacturer's specifications and UBC requirements.
Insulation:WSEC 10132.5 exception 2a&2b
Existing roofs shall be insulated to the requirements of this Code if:
a.The roof is uninsulated or insulation is removed to the level of the sheathing or,
b.All insulation in the roof/ceiling was previously installed exterior to the sheathing or non-existent.
Attic Ventilation:UBC Section 15053
Enclosed attics and rafter areas shall be supplied with cross-ventilation. The net free ventilation area shall not be less than
1/150 of the area of the space to be ventilated. If 50%of the ventilating area is provided from the upper portion of the space to
be ventilated,then 1/300 is allowed.
Applicant/Owner: I C?wl rjQWC^`�_ Contractor:
Parcel No.: Permit No.:
I
Signature: Date:
BUILDING INSPECTOR
Re-roof application.doc SUBJECT T A 0 AL
DATE 0