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(D W O 0 m � CD Q- 0 n c :3 mow o ? 0Q n� , (p > cmn � 0 o 0 0 ° 0cy, O Z3ccD (a < o O ` o Z Z � D- Q m av � � -1 < * a5CD 3 0l< (C) x v o o m W TOQn a fn O o- ° O a '-' o o '" 3 -0 -I W 2v � � a �_ m m v m O (D �. O �« m ASo �oary�F. MASON COUNTY COMMUNITY SERVICES DEPARTMENT B L D 2 0 I ' n _ 606 y� Mason County Bldg. 8, 615 W. Alder Street, Shelton, WA 98584 www.co.mason.wa.us (360)427-9670 x352 fax#(360)427-7798 Belfair(360)275-4467 x352 Elma (360)482-5269 x352 1854 NON STRUCTURAL RE-ROOF APPLICATION APPLICANT l jFORMATI Qi: / Owner 7 �N�t Mailing Address City State �Iq—Zip C�Code Phone Cell e- S A� ti— Email Clc �'%�� � CO �a �_ 7 CONTRACTOR INFORMATION: Company Name 6 U & Mailing Address City State Zip Code Phone Alt. Phone Contractor Reg. # Exp. PARCEL INFORMATfj lei- Site Address t �' C hat City Tax Parcel Number(twelve digit number) 3-5'ZM0©© STRUCTURE INFORMATION: �/ Roof Slope: (pitch) Old Roof Material: Comp Metal❑ Shingles ❑ Tile❑ Hot Mop❑ 00: New Roof Material: Comp Metal❑ Shingles ❑ Tile❑ Hot Mop❑ Sheathing: New El (Size ) Existing❑ Skip Sheathing❑ attz Existing Insulation: Yes/No❑ (Manuf. Homer Require L&I Permits 1 New Insulation or Va ulted Ceiling. See Below IECC 101.4(.-3 9112 SUse of Structure(s) - (i.e.garage,dwelling,etc.): I12-1 tot, Roof Slope:IRC section R904.1 Roof slope must be indicated to ensure selected roof covering is Insulation:IECC 101.4.3 exception#5 allowed on designed pitch. Roofs without insulation in the cavity and where the sheathing or insulation is exposed during re-roofing shall be Roof Covering:IRC section R905&907 insulated either above or below the sheathing.Insulation is not Selected roof covering must be installed in accordance with required for roofs where neither the sheathing nor the insulation is manufacturer's specifications and IRC requirements.A drip edge exposed. (Reference IECC/IEISEC R101.4.3) shall be provided at eaves and gables of shingle roofs. Attic Ventilation:IRC section R806 Enclosed attic and rafter area shall be supplied with cross-ventilation.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. 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This perm it/appIication becomes null&void if work or authorized construction is not commenced in 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEAN F I PECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X _.._ �` Z- Sig re�Aggli ` / e X � 7�i.t C��o�F,--�,c�47` OWNER REPRESENTATIVE/CONTRACTOR Print Name LE ONE)