HomeMy WebLinkAboutBLD29262 Plumbing and Mechanical - BLD Application - 10/11/1991 PLUMBING & MECHANICAL PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED I
PERMIT NO.;&-�D(se "a
OWNER NAME J'6vr7/ �G%LMAILADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
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LEGAL
DESCR. T 41
NAME MAIL ADDRESS CITY&STATE L AE �NKp ZIP PHONE
CONTRACTOR �s0M c1
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USE OF
BUILDING '
PLUMBING FIXTURES MECHANICAL FIXTURES
NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE
WATER CLOSETS q FORCED-AIR/GRAVITY TYPE FURNACE 6.00
BASINS qDD FLOOR I SUSPENDED FURNACE 6.00
BATH TUBS BOILER/COMPRESSOR 6.00
SHOWERS REPAIR/ALTERATION 6.00
WATER HEATERS �'� REFRIGERATION COMPRESSOR SYSTEM 6.00
AUTO.WASHER AIR HANDLING UNITS 7.50
SINKS HEAT-PUMPS 6.00
FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET
DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT
LAUNDRY TRAYS FIRE SUPPRESSION 5.00
CONNECT TO CITY SEWER WOOD FURNACE 5.00
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DISHWASHER e= -jlc i �'►�� Z Tr.�
DISPOSAL
URINALS
PERMIT BASIC FEE [j�fl
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.
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X OWNER DATE X BY DATE !2r f
FOR OFFICE USE ONLY
APPLICATION ACCEPTED BY j $CHECK BY y DING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION
BY CASH CK MO