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III, 426 West Cedar Stree PO Box 186, Shelton, WA 98584 1854 www.co.mason.wa.us (360)427-9670 B 'Ifair(360)275-4467 Elma(360)482-5269 NON-STRUCTURAL RE-RO APPLICATION Ll % Roof Slope: Old Roof Material: New Roofing Material: Sheathing: Underlayment: Existing Insulation: New Insulation: Roof Slope: IRC section R904.1 Roof slope must be indicated to ensure selected roof covering is all wed on designed pitch. Roof Covering: IRC section R905 Selected roof covering must be installed in accordance with manufi cturer'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 i a. The roof is uninsulated or insulation is removed to e 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-ventilatic n.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 i 0% of the ventilating area is provided from the uLi �_'UL portion of the space to be ventilated, then 1/300 is allowed. Applicant/Owne � Contract Parcel No: �/ o 57( =x- Permit 1 Signature: Date: /7 ARC 10/19/04 re-roof application.do MASON COUNTY PERMIT NO. BUILDING PERMIT APPL CATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 Elma (360) 482-5269 e On the web www.co.mason.wl.us APPLICANT INFORMATION /r, CONTRACTOR INFORMATION Owner =j LLC,..• Company Name Mailing Address Mailing Addre3s City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor R g. IL Exp. E mail address E Mail Addre s 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 Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. = ' "" Fire District Legal Description �°{ Site Address (Please include street name, street number and city) Directions to site 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 Noti4o or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st F loor 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 Certfication No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in e 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 applicatio . I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other Daily in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this pern ii and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants 3mployees of Mason County access to the above described property and structure for review and inspection. This permit/application bec es null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 18 ays. PROOF OF CONTINUATION OF WORK IS BY MEANS. FAP OQR SS NSPECTION.INACTIVITYOFTHISPERMITAPPLICATIONO 80 DAYS WILL INVALIDATE THE APPLICATION. X �— Date. wner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Acce d by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins e ion Plan Review Fee L EH Review ee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTALFE ES