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N _ o 0 0 � cc o' � m 0 o 3 v p I m � v c CD CD 0 v 8 0 � 6 ti c� O N �€O N RET MECHANICAL MANUFACTURED HOME > _. ... C) Footings l Setbacks Date By ribbons � Gas Piping � o InteriorDate By Interior-[late By Gate By m � Exter Date By Exterior-Date By Set-UP rn SSU Point Load r Isolated Footings, It ,�,�: 'I�IC1N Dow ey BCi!SLAB INSULATION Date By Efate By FIRE DEPARTMENT n Foundation Walls Floors Date By Date By Data By DECKS FRAMING Walls Date By Gate By Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundvvork Attic 9 ate By Date By Type: DRYWALL Date By Li.'VY:V _ Type- � Int Brace Wall Dale, By Date ey � Date By _ FINAL t �" TrCdN CD Water Line Firs Seperation O Late By Date By gate -1 I � �y �6 v O Pass or Request Inspect. CD Type of Insp. Fail Dfte Qate. Cone By Comments � 0 MASON COUNTY PERMIT NO. C-4 �� BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 cccq�7 $helttR (3ff3) 427=9670•Be!€ ww6.a75=4Z c •Elva(360)4$2=5268 On the we o.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION w Owner Ho kS C4c.f,1;c. Company Name Mailin Ad It"s /0 Mailin Address P City •n State WA Zip Code 9MY City SHELT bN State IAL4- Zip Code Phone 6' g-SS Other Ph, Phone Other Ph. Lien/Title Holder Contractor Reg.# 9 Exp. 10 h /0 7 E mail.address_ E Mail Address Drivers Lie.# DOB Drivers Lic.#EWTW ET 3&01 j& DOB SEPTIC%WATER SYET'EM INFORMATION -Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No / 1YO Fire District Legal Description Site Address(Please include stre t n e,stre t number and city) / o 11:r ; •» 'Directions to site L' .-;N Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wotlarid Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye TYPE OF JOB-New Add Alt Repair Other PRIMA Y AFSIDENCE Z SEASONAL M, Use of Building In4% s Describe Work • --� a v.n,onks ro No. of Bedrooms No, of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage AttachedDetached Carport Attached Detached MANUFACTURED HOME INFORMATION -Make Model Year Length Width Serial No. No.of Bedrooms No. of Bathrooms Type of beat Purchase Price$ Replacement Unit? Yee/No Installer Name Certification No. QWNER/DULDER AcknMWges submLssion of in rate infomWon may result in a stop mm*order or permit reV"oh,Admowled1goment of such is by signature below.I declare that 1 am the owner,owners legal representative,or the contractor.I further declare that 1 am entitled to receive this permit and to do the work as proposod_in the application,I declare that I have QOWned 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,l 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 infomiation provided is accurate and grants employees of Mason Coun�s to the above described property and structure for review and inspection. PROOF OF COy�lUAT10 F VV1tll CIS BY MEANS O A PROGRESS INSPECTION. X P Date; Owner/owners Representative, ontractor indicate which one FOR OFFICIAL USE BEYON POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Foe Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planninq Review Fee Mechanical&Base fee Other Wood/Gas/Pellet Stove Fee I State Fee 4 i Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES ar on coa MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. III, 426 West Cedar Street PO Box 186, Shelton, WA 98584 1854 www.co.mason.wa.us (360)427-9670 ext.352 Belfair(360)275-4467 Elma(360)482-5269 t � Roofing Sq ft area S3 Type of Roofing to be Applied f 4nn�co Ngrh� 3� A(Z Number of existing layers I Roof Pitch: C4112 Tear off: _XYes No Use of buildin Q Qs Construction Type: k-P60 Roofing Classification (Occupancy classification) (wood,steel frame,masonry etc.) (A,*. Q Include manufacture specifications verifing materials meet roofing classification. B&C roofing classifications require site plan drawn to scale. Will insulation be installed? Yes _XNo Existing Insulation, describe_R @ 34t^ 1++., t) l%4 i o,., Existing roofs shall be insulated to the requirements of R-30 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 nonexistent. , Roof ventilatio , describe :So"4 Vpuls L.We Ven h 1 A ..S6 RaA � S d c c alQ n . . r Name of Business: Qw Gro v Subject Property Address: G so Sl,P too Assessors parcel number(s): 22 001140 (Address and parcel number required for all applications) Applicant! M c.se.., �d o. R a a /-1 c Mailing address: T•�. .��-71 City:s Q ��c�•, State: H Zip: Phone ( 34 b ) 709? FAX (340 ) Y,&- ?Sr y-7 E-Mail: f � Applicant: Date: le y I hereby authorize Mason County representative(s)to inspect my property Monday-Friday between the hours of 8 a.m. and 5 p.m. during this permit application process for purposes of verifying site conditions. ARC 11/30/05 H drive comm.Re-roof doc x m 5 ' s� a � The American Heritage Series' of laminated fiberglass shingles by TAMKO ,tF,eR brings the rustic beauty of wood shakes to any home, with the added security R of a U.L. listing for Class A fire resistance. Heritage' shingles have a rich Shadowtone granule blend that creates the elegant, dimensional appearance of wood, without the high cost or safety concerns. The random-cut design eliminates zipper patterns common with other laminated shingles. And our Algae-Relief(AR) limited warranty provides for cleaning of discoloration caused by certain algae growth that may occur in areas with high humidity. All Heritage shingles feature double layers of durable fiberglass mat for strength. Each layer is coated on both sides with weathering-grade asphalt and topped with ceramic mineral granules for maximum roofing protection. A self-sealing strip of asphalt helps provide added wind resistance. Heritage'30 AR and Heritage' 50 AR shingles meet ASTM D 3462 at time of manufacture. Each Heritage shingle is backed by a 30- or 50-year limited warranty* for your peace of mind. Dallas 0 SelectTAMKO ROOFING PRODUCTS P.O. Box 1404 •Joplin,MO 64802 1-800-641-4691 www.tamko.com Certain colors and products may not be available in your area. *For specific information regarding TAMKO limited warranties,contact your local TAMKO representative or visit us online at wR'NCtamko.com. 997533 Cover roof color is Thunderstorm Grey. ©2005 TAMKO Roofing Products,Inc.