HomeMy WebLinkAboutBLD04-01112 Final ReRoof - BLD Permit / Conditions - 7/22/2004 -G o m
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o CONCRETE MECHANICAL MANUFACTURED HOME
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Footings / Setbacks Date By Ribbons
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Date By Gas Piping Date By
N Foundation malls Date B y Set-up
Date By INSULATION Date By
S G / Slab Insulation Floors Final
Date By Date By Date By
FRAMING Walls FIRE DEPT
Date By Date B y Date B y
PLUMBING Attic OTHER
Groundwork Date By
Date By WALLBOARD NAILING
D.W.V. Date By
Date By FINAL INSPECTI
Water Line Date
Date By .3 "f Date By
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FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO.L)�_
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 INFOFWATION /- CONTRACTOR INFORMATION ,
Owner iQQ ate.E .c L 42Ce�_'.�1 CI C.) Company Name-k-lin &-$4 4 ZIc C'
Mailing Address �PC I 0 MailinAddress. <, X ' ck4e t 'a
City k16J/Q,y- state L--,1,4 Zip Code_91 r_! f7z City i-z ra State Zip Code C& a�z 4
Phone CX) 8- _ -'V2!�Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg.# Yjalb''FAIn? gIr= Exp. c>' `e7)
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# F,4)f ff6ytL2_ _ 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
PARCEL INFORMATION - 12 Digit Parcel No. 2 n Fire District
Legal Description
Site Address (Please include street name, street number and city) 1,P160 E f��f P—# CO, oru UY\,
Directions to site
Will timber be cut and sold in parcel preparation?Yes/No
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 Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other P I ARY RESIDENCE ❑ SEASONAL
Use of Building Describe Work
No.of Bedrooms No.of Bathrooms Square Footage- 1 t 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/BUILDER Acknowledges 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 the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is acc rants employees of Mason County access to the above described property and structure for review and inspection.
PROOF O ONTINUAT N O WORK IS FANS OF A PROGRESS INSPECTION.
X C._...... o ate:
Own Owners Re rese tative/Contractor indicate which one
FOR 00FICIAL USE BEYOND THIS POINT Accepted by: Yj Date ZI
DEPARTMENTAL REVIEW APPROVED DENIED WOES
Building Department15� AC
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal 1
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 S�
Violation Fee Pre-Paid at Submittal
Valuation $
TOTAL FEES D D a
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General/Specialty Contractor
A business registered as a construction contractor with Lltl 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 JOHNER1033BF
Licensee Name JOHN EASTER ROOFING INC
Licensee Type CONSTRUCTION CONTRACTOR
UBI 601758181 Verify_Contractor Premium Status
Ind. Ins. Account Id 80647601
Business Type CORPORATION
Address 1 3350 W SATSOP CLOQUALLUM RD
Address 2
City ELMA
County GRAYS HARBOR
State WA
Zip 98541
Phone 3604824062
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 1/6/1997
Expiration Date 1/6/2006
Suspend Date
Separation Date
Parent Company
Previous License JOHNGECO44DF
Next License
Associated License
Business Owner Information
Name Role Effective Date
https://fortress.wa.gov/lni/bbip/detail.aspx?License=JOHNERIO33BF 7/8/2004
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EASTER, JOHN 01/01/1980
EASTER, LAURIE 01/01/1980
Bond Information
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
,,,Bond Name Number Date Date Date Date Amount Date
43 CBIC SD2036 01/01/2002 $12,000.00 10/30/2001
#2 CBIC SD2036 01/01/2001 01/01/2002 $6,000.00 12/01/2000
OLD
REPUBLIC
#1 SURETY CO YL1232816 01/01/1997 01/01/2001 $6,000.00
Savings Information
No Matching Information
Insurance Information
Company Policy Effective Expiration Cancel Impaired Received
Insurance Name Number Date Date Date Date Amount Date
ATLANTIC
#8 CASINS L065000622 12/31/2002 12/31/2004 $300,000.00 01/06/2004
ATLANTIC
CASUALTY
#7 INS AIL065000293 12/31/2002 12/31/2003 $300,000.00 01/08/2003
INDIAN
HARBOR
#6 INS CO AIL065000293 12/31/2001 12/31/2002 12/31/2002 12/27/2001
FRONTIE
#5 INS CO G20003934000 12/31/2000 12/31/2001 12/18/2000'
PENN
AMERICA
#4 INS CO PAC6063670 03/10/1998 01/01/2001
WESTERN
NATIONA
ASSURANCE
#3 CO CG464081371 08/10/1997 08/10/1998
WESTERN
NATIONAL
#2 ASSURANCE TBD 08/10/1997 08/10/1998
AMERICAN
#1 STATES 01CC6429197 08/10/1996 08/10/1997
Unsatisfied Summons/Complaints Information
Tax
Cause Warrant Dismissal Complaint Complaint Jt
Summons/Complaint Number License Id Plaintiff County Date Date Amount
OLSON,
GERALD
https://fortress.wa.gov/lni/bbip/detail.aspx?License=JOHNER1033BF 7/8/2004
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at GRAYS
#1 002006272 1OHNER1033BFI I MARILYN I HARBOR 106/06/2 000I$0.00 I
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state of Washington.
Access Agreement I Privacy and security statement I Intended use/external content policy Visit access.wa.gov
Staff only link
https://fortress.wa.gov/lni/bbip/detail.aspx?License=JOHNERI033BF 7/8/2004
NON-STRUCTURAL RE-ROOF APPLICATION
Roof Slope:
Old Roofing Material: An o
New Roofing Material:
Sheathing.
Underlayment:
Existing Insulation:
New Insulation: 4*,11g7jX2 /'/';r�
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 101.3.2.5 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 1505.3
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.
7
Applicant/Owner: �� C,6' oc� Contractor: '/��t f9,%�f(` /ez)01,! mot'
Parcel No.: Permit No.: )
Signature: Date:
Re-roof application.doc