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o CONCRETE MECHANICAL MANUFACTURED HOME
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CD Footings!Setbacks Date By Ribbons
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Exterior Date By Exterior-Date By Set-up
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BG!SLAB INSULATION y
Date By Data By FIRE DEPARTMENT
Foundation Walls Floors Date By
Date By Date By DECKS
FRAMING wails Date By
Date By Date By PROPANE TANKS
PLUMBING vault Data By
Date By
Groundwork Attic OTHER
Date By Date By Type
Date By
D.w.v DRYWALL Type-
Date Byy Int.Brace Wall Date By a)Date FINAL INSPECTION p
m Water Line Fire Separation N
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{ MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Processing/Inspections/Addressing
Mason County Bldg.III 426 W.Cedar
P.O.Box 186 Shelton,WA98564
(366.) 427-9670 Selfair(360) 275-4467 Elma`(360� 482-5269 Seattle (206) 464-6:
NON-STRUCTURAL RE-ROOF APPLICATION
Roof Slope: 9112
Old Roofing Material: pda,r .S'�-Ck.l
New Roofing Material: C o�os;�,
Sheathing: 7Z 6 6.S 13
Und,erlayment: i Y Ab_ 3T H
Existing Insulation: 30
New Insulation:
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
11150 of the 4rea 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: J t J w1 in Contractor: /-r c i e co
Parcel No.: 29 3 2 3-Y 6 o o11_ Permit No.:
Signature: Date: ^� 6
Re-roof applicatiori.doc
MASON COUNTY PERMIT
BUILDING PERMIT APPUCATfON
426 W. Cedar°P.O.Box 186,Shelton, WA 88584
$ l {gf •:f3$ �..427-6t .g� $ � 11` �. _5147..' li � :.�> = �t3•:
6n fhe web www.co.mason.wa.us
.APPI:!•�AN� Company M�!.4�?• cQK��A�'>E'gR.,k�1�QEkMA'EkQN.
Owner f3; S Name
luJ#Nit nrtrartc� P D 8' hligffl, A
City T e^ State Zip Code 9 � City State ITIA-—Zip Code
now 4itflfli`P0. Phpn@ . Qth@r Rh.
LieNTrtle Holder Contractor Beg.# Exm
E Mail Addrsss
t �!' ► s ` Drivers Lic.# [_Kj 3 L01 ALL DOB
Drivers Lic.# DOB
jf=f�T-ILA/�I Hf`�t-�s`V617ENFW96FFIM-1l ION"-Connectto New Septic Existing Septic
Connect to Water System Name of Water System
Weit Water System_ _. Name of�Water System
PARCEL INFORMATION-12 Digit Parcel No Fire District
.Legal Description Y L
Site Address(Please include street name,street number and city (`� -
Di ections tto�site ® °
Will timber be eut and-sold-in pareel-preparation�Yes ACUO
Is property within 200'of Saltwater Lake River Creek Pond
W"%'11t� 01 S#141fr90t�MI-Off: - StMal : SIt9 eS f3l`B11Jft a > 1:5%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YesW
TYPE OF JO$-New .Add Ali Repalr Other PRIMARY ASSIDENCE 5• SEASONAL
Use of Building.R—%k gol• e Describe Work r� —
No.of Bedrooms No.of Bathrooms Square Footage-1 st Floor 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq.ft.
[pie
rage Attached—Detached Carport Attached Detached
Ni)FAQT1)RF_t?I1QMR JNFQNN(AT1QN'-M*e M:a0.ei Yeas
gth Width Serial No. No.of Bedrooms No.of Bathrooms
e of beat Ru.,Cgh�ep FCice$ R•ep(e m..eRt,t Rt? Y@g/No
aller Name Certification No.
s by signature below I declare that I am the owner,owners legal representative,orthe contractor.I further declare that i am entitled to receive this
t and tQ dQ the.W.k a RC�2pg.<Qd in the apRlie&tiQn:I dW@n ftt I I> rom�11 !@rle4@S�ery J2 @$:If RQrmis�ignised-fmnanyeasement hoiden or any otherparty in interestmaMIM thisappllcatlon orthe workproposed-in the applieatlon,FhaVeobtalned
ssion from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
F OF CONi1 TION BY MEANS OF A PROGRESS INSPECiIOr.
Owner/Owners Representative ntract ndicatewhichone
FOR OFFICIAL USt-ErE'1fi NEY THIS PfOI SIT Accepted.by: -Date_
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
P10031 4 D.al d ttt;
Environmental Health Department
Public Works Department
Fire Marshal
FEES
QUIldlilb.POfftit Fed. 81te.IG10 00tido
Plan Review Fee EH Review Fee
Plumbing&Base Fee 'Planning Review Fee
Mg2hen1eal 4.Bug fee Qjh9r
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee_ Ire-P id at tubmittal
Valuation$ TOTAL FEES