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Home My WebLink AboutMIS95-0173 Propane - MIS Permit / Conditions - 3/20/1995 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 J M I S C E L L A N E O U S PERM I T FOR INSPECTIONS CALL 427-9670 MIS95-0173 PARCEL :420181200050 PLAT : DIV : BLK : LOT : JOB ADDRESS : W 7620 SHELTON-MATLOCK RD SHELTON APPLICANT : JACKIE GROVES 427-2622 OWNER : JACKIE GROVES 427-2622 LEGAL : TR 5 NO NE EX R.R RII FS 18427 PROJECT DESCRIPTION : 100 GALLONS PROPANE TANK PROJECT LOCATION : 7 TO 6 MILES WEST OF SHELTON RIGHT SIDE OF ROAD ( NEXT TO ESPRESSO BAR ) PROJECT NOTES : TYPE AMOUNT BY DATE RECEIPT MCFE $ 12 .00 KS 03/20/95 38608 bt- 5 TOTAL : 12 .00 NER OR AGENT DATE 9IS-PRNT, rev. 04/01 /92 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 - - I PF_: RiM 1 Y CWC) N0 1 'IF 1 C3N �S Case No . t MIS95-0173 For : TACKIE GROVES Page : 1 1 ) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305(C ) AND SUCTION 513 , ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS" ON SITE PRIOR TO REQUESTING INSPECTIONS . 2 ) The owner shall have available on site for inspection by Mason County, a report Indicating the name and license number of the installer , the amount of pressure at the time of testing 4nd -the length of test time . This report shra I l be signed by the person conducting the test . x i 3 ) if -ithe tank size Is between 125 and 500 gallons you must follow these gulde1ines : 1 . Tank is to be 10 feet from any buidiing, public way or property line . — — CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I I I -�_ MASON COUNTY Mason County Bldg. III 426 W. Cedar RO. Box 186 Shelton, Washington 98584 2. . If the tank Is exposed to probable vehicular damage, provide protective bollards . 3 . All weeds, grass , brush, trash and other combustible material shall be kept a minimum of 10 feet away from LP containers . X I CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by i i Permit No. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670 PLEASE PRINT #1 Owner .J ffil`l�S {- J a C i �iP,fJ(ft S Phone# k_�4&9 - Site Address �b-w f/'e H" 111 ema-k fy'( City f A4� St zip ow-TY Directions to Job Site Owner Mailing Address City St Zip Lien/Title Holder Address City St Zip #2 Contractor Name ,n YYl aA Contractor Reg. # Address Expiration date City St Zip Phone #3 Parcel No. - _- (7(DOEM Legal Description 1 , #4 Use of building Describe work #5 Type of Job: New Add Alt Repair Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs No. jLk Fees _Showers Furn BTU _Hot Water Htr Heatpumps _Laundry Washer Vent Systems _Sinks _ Spot Vent Fans _Floor Drains No.. Boilers/Coml2ressors _Laundry Basins HP _Dishwasher No.. Air Handling Units _Disposal cfm# —Other No. Other Other Gas Outlets Wood, Gas, Pellet Stove Permit Basic Fee 15.00 00w. TOTAL PLUMBING $ Permit Basic Fee 15: TOTAL MECHANICAL $ NOTICE: This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. Proof of continuation of work is by means of a progress inspection. I NOTE: If this permit application includes the placement of a fuel tank, heat pump or other unit to be located outside of the existing structures, a plot plan MUST be submitted as required below: Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc. iL sn � OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRAC- THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE AWARE OFTHE MASON COUNTY ORDINANCE REQUIREMENTS ORDINANCE REQUIREMENTS REGULATING THE WORK FOR FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK WHICH THE PERMIT IS ISSUED AND ALLWORK DONE WILL BE IN DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE SHALLBE MADEWITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUIL G DE PAR MENT. DEPARTMENT. X OWNER ILA X BY DATE y ' DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY: Accepted by: Date:` Receipt No. Referred To DEPARTMENTAL REVIEW Proposal Proposal FOR OFFICIAL USE ONLY Approved Denied Planning: Building: Fire Marshal: