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D CD 'O O n O O O 3 CD to ° N goy 3 c m " �' 0CFO :3 :3 c N CCDD 0 y mac, CD COD 09, - � -^ s = o gay v ga. g � °1 ' O 3g a d vi W r 0 o CONCRETE MECHANICAL MANUFACTURED HOME 0 Y, Footings / Setbacks Date By Ribbons 0 co Date By Gas Piping Date By A rn Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date By Date By ....,. ". F Date By 0 C m 0 0 f v o N 8 r O � V1 0 S �M V W uOu l"Tl y 0 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT N6 V0(35 0 -�lo 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 1766 A6.elsoywCompany Name lyk rA^ re_ Mailing A dress l`/ E Mailin9pd�rss �17i City h tate�Zip Code , City JJll��c may+ State Zip Code 9858�/ Phone '/32-/9Z I Other Ph. Phone '-!?fe• 70S 7 Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address E Mail Address M A Drivers Lic.# DOB Drivers Lic.#6 T6n1 E:r?62M6 DOB 7 ?6 6y 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. 3.71 b Fire District Legal Description Site Address (Please include street name, street number and city) / N X Directions to site b+�L an 14.21 + , t E e T � I e( ,015 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?Yesw TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑ Use of Building R a� �e�c< Describe Work-All! 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.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 accurate and grants employees of Mason County access to-the above described property and structure for review and inspection. PROOF OF INUA IS BY MEANS OF A PROGRESS INSPECTION. X Date: S�?316s Owner/Owners Representative ontrac o indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES 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 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Perk Proc:essingAnspections/Addressing Mason county Bldg.III 4M W.Cedar P.O.Box 18e Shelton,WA 9e584 (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269 Seattle (206)464-6968. NON STRU RE-ROOF APPLICATION w.. Roof Slope: 8/1 2 Old Roof Material: c 4e S "c e, New Roofing Material: S Sheathing: Underlayment: 76 Lb /4S'j'M Existing Insulation: 7 0 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 requirerne ts. 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-vent:7ation.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: PO 6 db t l.s o r Contractor: ��S oil Parcel No: 3?13 6 ?y 5 3//0 Permit No.: Signature: Date: S1?�/o S ARC 10/19/04 re-roof vplimtion.doc.