HomeMy WebLinkAboutBLD30072 Plumbing and Mechanical - BLD Application - 3/13/1992 PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 t
427-9670 DATE ISSUED
PERMIT NO.
CITY 6 STATE �5�� ZIP PHONE
NAME M DORESS �� �7 7
OWNER ! !i. a//2 1� 41l� L
DIRECTIONS OF / k. 73 0.1j t�T
TO JOB SITE L L� iU0
LEGAL �Q
DESCR. �" LICENSE NO. ZIP PHONE
NAME MAIL ADDRESS CITY&STATE
CONTRACTOR
USE OF � ���
BUILDING
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP
FEE NO. TYPE OF FIXTURE FEE
WATER CLOSETS FORCED-AIR I GRAVITY TYPE FURNACE qOO
j FLOOR ISUSPENDED-FURNACE
2 BASINS —
BATH TUBS BOILER/COMPRESSOR
REPAIR/ALTERATION 6.00
SHOWERS — —
WATER HEATERS — REFRIGERATION COMPRESSOR SYSTEM 6.00
AIR HANDLING UNITS 7.50
AUTO.WASHER
HEAT-PUMPS 6.00
SINKS
�7 . EACH GAS PIPING SYS.2.00 PER OUTLET
FLOOR DRAINS ��10
DRINKING FOUNTAINS � VENT.FAN SYS.3.00 PER UNIT
FIRE SUPPRESSION 5.00
LAUNDRY TRAYS S.00
CONNECT TO CITY SEWER WOOD FURNACE
DISHWASHER 4lir_IXIctltL.
DISPOSAL
URINALS
PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00
TOTAL i i TOTAL —
SPECIAL CONDITIONS: 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.
OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED
THE CONTRACT OR REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE ORDINANCE
COUNTY ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL
WORK DONE WILL BE IN FORMANCE THEREWITH. NO CHANGES SHALL BE MADE W�HOURK DTO FIRST OBTANE WILL EN NGAPPROVALFROMTHE IN CONFORMANCE EBUIILDINGDEPARTMENT..TH. NO CHANGES ALL BE MADE
WITHOUT FIRS40AIN�ZINA OV FROM THE BUILDING DEPART ENT.XOWNERDATE X BY DATE
FOR OFFICE USE ONLY
APPLICATION ACCEPTED BY PLANS CHECK BY
BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION BY CASH CK MO