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CD Interior Data By Interior-Date By Date By C) 0') Exterior Date By Exterior-Date Bv Set-up Point Load I Isolated Footings INSULATION Dalte ay M BG I SLAB INSULATION z Date By z Data By FIRE DEPARTMENT Foundation Walls Floors Date By Dole By bata By DECKS FRAMING Walls Date By Date BY Date By PROPANE TANK S Vault Date 13Y PLUMBING Date By OTHER Groundworh Attic Date By Date By Typwate By DRYWALL 0.W.1V Type- Int.Brace Well [)ate By 00 Date By Date Sy r FINAL INSPECTION (D WAter Line Fire separation a) C Date By Date By Date By IQ CD 90 Pass,or Request I n spect C) 0 Type of Insp. Fail Date Date Done By Comments (D CD cn 0 M co 0 CD 0 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. �j PLEASE PRESS HARD BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 L+ 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 GL F_iL 0 VV*-) r Company Name Mailing Address P C 130*k 25q / Mailing Address City E3 I e`i r State LL 0�t Zip Code 9' = City State Zip Code Phon&AL07 7'q---S/11_S-' Other Ph. Phone Other Ph. Lien/Title Holder G�.OA U All t Contractor Reg. # Exp. E mail address -- E Mail Address Drivers Lic.#01 DOB -A Drivers Lic.# DOB SEPTIC /WATER-SV§TEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. i~ - i" Cl/I`I 1 Fire District :2- Legal Description )P s-A r Cf__ W LA2 Q h P,II -<-P Z d(c I Site Address (Please include street name, street number and city) /1 C 10 T_i i_i=i4i H �.`m t-- t Directio ins to site r= ®''t Z r=t4 i f. . C_ �` 1^ ,�i a ['t_,-c r 1 . Will timber be cut and sold in parcel-preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seascrhal 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 PRI AR RESIDENCE ❑ SEASONAL ❑ . Use of Building Describe Work 1a� 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`IVo. 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 informaticn provided is accurate and grants employees of Mason County access to the above described property and structure 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 IS BY MEANS OFA PROGRE=INSPFINACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYSWILL INVALIDATE THEAPPLICATION. Date: / C Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES Co MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. III,426 West Cedar Street PO Box 186, Shelton,WA 98584 Z�54 www.co.mason.wa.us (3Q0)427-9670 Belfair(360)275-4467 Elma(360)482-5269 NON-STRUCTURAL RE-ROOF APPLICATION Roof Slope: 4t -� Old Roof Material: O New Roofing Material: 30;Tc i+ Sheathing: a C Underlayment: Existing Insulation:_ - New Insulation: -- Roof Slope:IRC section R904.1 Roof slope must be indicated to ensure selected roof covering is allowed on designed pitch. Roof Covering:IRC section R905 Selected roof covering must be installed in accordance with manufacturer's specifications and IRC 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: IRC section 806 Enclosed attic and rafter area shall be supplied with cross-ventilation.The net area shall not be less than 1/150 of the area of the space to be ventilated.If 50%and not more than 80%of the ventilating area is provided from the upper portion of the space to be ventilated,then 1/300 is allowed. Applicant/Owner: 'JLs i L_C— _ Contractor: ( ; e�= -k-i"1 ,! GC=j^;5-���K Parcel No: r r`1 Q j / ( Permit No.: Q_/ to t 5 i4l c / Signature: � '�- Date: — 7z/3/ ,L2 ARC 10/19/04 re-roofapplication.do