HomeMy WebLinkAboutBLD28343 Plumbing and Mechanical - BLD Application - 6/12/1991 PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME�,-e / /`l MAIL ADDRESS CITY S STATE ZIP PHONE
OWNER T5- «110 ti u/z _e--IoVi
DIRECTIONS
TO JOB SITE -
r /�/ 11 n kaZ l A, T'
LEGA
DESCR. . t r !� I l ! ✓ z� T /O
CONTRACTOR NAME — MAILADDRESS CITY SSTATE LICENSE NO. ZIP PHONE
O r Z. Sit ,c w V- el- Al z o ccig 171 irtv 9vyl Z 3 7 7-0, 6
USE OF (oQ
BUILDING s /- f2-
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FE NO. TYPE OF FIXTURE FEE
WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00
BASINS FLOOR/SUSPENDED FURNACE 6.00
BATH TUBS BOILER/COMPRESSOR 6.00
SHOWERS REPAIR4ALTERATION 6.00
WATER HEATERS REFRIGERATION COMPRESSOR SYSTEM 6.00
AUTO.WASHER AIR HANDLIN6t�IITS 7.50
SINKS HEAT-PUMPS 6.00
FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET
DRINKING FOUNTAINS 3 VENT.FAN SYS.3.00 PER UNIT
LAUNDRY TRAYS / WOOD STOVES
CONNECT TO CITY SEWER WOOD FURNACE 5.00
DISHWASHER G C -L`( TC ✓
DISPOSAL
URINALS
PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00
TOTAL 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE X Y DATE-/�-
FOR OFFICE USE ON LY
APPLICATION ACCEPTED BY PLANS CHECK BY BUILD GROUP AP P E OR IS NCE PERMIT VALIDATION
�--� B CASH CK MO