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O• O O- � �. 3 0 o (n(p y -O W O W 0 n (D N (D C. 3 D 0 0 Q m c �, CD 3 v o(U N 3 (D E (0 CD =r (D o CONCRETE MECHANICAL MANUFACTURED HOME U Footings r tr���l� _ Date By c Lis Fttaln Ribbons Z o Interior Date y interior-Date By bate By (� 0 00 Exterbr Date lay Exterior-Rate B Set-ate + Point LoadIsolat�d Foortin INSULATION _ Dates By y Data sus INSULATION By FIDE DEPARTMENT D Date — Foundation Walls Floors Date €3y � Date By Data By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING Vault Dates By Bata By EITHER Groundwork Attic By Type-, By Data By €a.w.v DRYWALL Type into Brake Wall Date By � Rote By fete By FINAL INSPECTION 0 v Water FireSaDratior, ^Z©_ / N Gate By Daw By bate YU By / O cD , Pass or Request Inspect. o Type of Insp. Fail Date _ date done By Ccl�»nr►ehts co s v 0 0 in 0 N (D 3 N (D 0 MASON COUNTY PERMIT NO BUILDING PERMIT APPLI ATION 426 W. Cedar• P.O. Box 186, Shelton, A 98584 Shelto (360) 427-9670 • Belfair (360) 275-4467 • Ima (360) 482-5269 On the web www.co.mason.wa s APPLICANT INFORMATION. CONTRACTO INFOR TIO Owner S Company Name G Mailin Address r Mail'n Address City State ip Code City State A, Zip ode %5$ IJ Phones-IC—A- "I-�163 Other Ph�75- '��- $$ Phone - 73 -% ` k Other Ph Lien/Title Holder Contractor Re # �A% Ex a0il a----. E mail address E Mail Addres Drivers Lic. # DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12. Digit Parcel No a - - Fire Dist ict Legal Description -TR- \ Site Address (Please include sir et name, street number and city) Dire tions to site \4 - t �,. Will timber be cut and sold in pa cel preparation? Yes Is property within 200'of Saltwa er Lake River/Creek Pond Wetland Seasonal R noff Stream Slopes or Bluf s ] 15% Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement acti n? Ye No TYPE OF JOB - New Add Alt Repair Other PRIM Y ESIDZCE SEA L ❑ Use of Building Describe Work $$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 IP 1 IFORMATION - Make Model _ Year Length Width Serial No. No. of Bedrooms No. of Bath looms Type of Heat Purchase Price $ Replacement Unit? Yes/No Installer Name I Cei tiff ation No. OWNER/BUILDER Acknowledges Submission of inaccurate information may result in a stop vork order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the co 1 tractor.I further declare that I am ntitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the pe ssion from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or th work proposed in the application I have obtained permission from them to apply for this;:ermit and conduct the work proposed. The owner or ac ant on owners behalf,represents Mat the information provided is accurate and grants emplo ees of Mason County access to the above described Pr perty and structure for review anc inspection. PROOF F CONTINUATIONUzi K IS BY MEANS OF A PROGRESS INSPECTION. XDate' L-1a)-- Owner/Owners Re resentati 7 Contracto (indicate which one) FOR OFFICIAL USE BEYO 4D T POINT Accepted by _Dat I oZ DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Ins ecti n Plan Review Fee EH Review Fee Plumbin & Base Fee Plannin Rev ew Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation S TOTAL FEE I DEPA�TMENT OF COMMUNITY_DEVELOPM NT * Permit P ocessintvinspeclions/Addressing Magon C)unty Bldg. III 426 W.Cedar P.O. BoxI1,186 Shelton,WA 9e584 (360) 4 7-9670 Belfair (360) 275.4467 fzlma (360) 482.5269 NON-S RUCTU-ZA.L RL_RO F AP P L I CA -I \ U_ - 5 Roof Slope: Old Roof Material: New Roofing teri C --- �• �'�tc� ' --- _ Sheathing: ' --- Underlaynient: - 4 Existing Insulation: -- -. New Insulation: - Roof Slope : IRC section R9 4.1 Roof slope must be iidicated to ensure selected roof coveringu wed on des' tgned pitch. Roof Covering : MC section R905 Selected roof covenag' must be uutahed its accordance with manufa is specif;cauoas and I Issulatioa : WSEC 10L3.2.5 exception 2a &2b Exisdag roofs shall bc insulated to the requirements of this Code d: .a- 'Ile roof.is uainsulated or insulation is removed to the vel of the sheathing or, 'D, All insulation In the roof/cetliag was previously install exterior to die sheathing Attic Ventilation : IRC sectidn 806 Enclosed attic and n4er area shall be supplied with cross-Yentih60 1 Lrhe net area shill not be 1 1/150 of the area of t�e space to be ventilated. If 50% and not mon than 80% of the ven6hL I 1:; from the upper ponio�a of the space to be ventilated, then 1/300 owed. WL E- 1 O U ETS Contract r : Parcel No Permit N Signa[ttrY ; ' Date �2- 1a — �Ol ARC 10/19/cH rcroo(ip((cu oadoc