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Fail Date Date Done By Comments m 0 00 o t1 5 IS?.d lZ g"?ri IZ 1,A:1/— d a 8 a 0 0 s N (D i } N O Rug 14 2012 10: O0RM 3G042G7154 p. 2 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. Ill,426 West Cedar Street PO Box 186, Shelton,WA 98584 www.00.mason.ws.us (360)427.9670 Belfair(360)275.4467 Elms (WO)"2-5269 NON-STRUCTURAL RE-ROOF APPLICATION i Roof Slope: Old Roof Material- C c5 m Ro S 1�11 rs� New Roofing Material: C �' t:oS�R t� Sheathing P I u 1,.ACM Underlayment: __4(5 f e Existing Insulation: New Insulation: Use of Structure(s) - (Le. garage, dwelling, etc): 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 coveting must be installed in accordance with manufacturer's specifications and IRC requirements. Insulation:WSEC 101.12.5 exception 2a&2b Existing roofs shall be insulated to the requirements of this Code i£ a) The roof is not insulated 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 arc&of the space to be ventilated. If 50a/s and not more than SO%of the ventilating area is provided from the upper portion of the space to be ventilated, then 1/300 is allowed. Applicant/Owner 1" GX'k W'i er.�� Contractor. Parcel No: 'R1112_'L3\—_ � ppp \ Permit No.: Signature: ` ,tea l f 1 dl3u„_ Date: rX,UBuading rt-toot yplieauoa(mired 7.7011/ Aug 14 2012 10: OOAM 3604267154 P. 1 MASON COUNTY PERMIT N �/?' 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 Mark&Valerie Wittenberg Company Name A-1 Roofing Inc. Mailing Address 220 F Ston .briar Plant- Mailing Address PO Box 2607 City Shelton State Zip Code 98584 City OLympja State W_ Zip Code 98507 Phone 360-426-5394 Other Ph. Phone 360-432-0296 Other Ph. Lien/Title Ho'der Contractor Reg. # A1R001*111PR Exp. 5/2013 E mal address E Mail Address Drivers Lic. # DOB Drivers Lie. # 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. 13 - 3-a0001 Fire District Legal Description Site Address (Please include street name, street number and city) 221) 2 Stoneariar Place, Shelton Directions to site Take N. US Hwv 101, right on Wallace-Kneeland. Leff on Rrnrkdale Rd right on Jensen Rd slight left on StoneBriar Place. 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?Ye o TYPE OF JOB - New__ ___Add Alt__ Repair=Other PRIMARY RESIDENCE ® SEASONAL ❑ Use of Building Describe Work Composition Tear Off Re-Roof Comoostion 22 Sa 4/12 No. of Bedrooms No. of Bathrooms Square Footage - 1st 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 aria 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 nave 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 providec is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X_ �? C4,'V Date-, 8/3/2012 Owncr/Owners T9cpresentative Q ortactor Vndicate which on© FOR OFFICIAL USE BEYOND THIS POINT Accepted by: __Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES ,Building Department 1Planning Department 'Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbin & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/ Gas/Pellet Stove Fee I State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES