HomeMy WebLinkAboutCOM2002-00025 Propane - COM Permit / Conditions - 4/16/2002 n
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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 b
PLUMBING date by OTHER y
Groundwork Attic
date b date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
v�v� ,
�M e h� CC�nN C 'o15
f � �- ! PERMIT NO.:
MASON C UNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
r+ 426 W.Cedar/P.O.Box 186,Shelton,WA 98584
i
' Sh&Hon 36 427-9670 Belfair 360 275-4467 Elma 360 2.5269 Seattle 206 64-6968
APPLIC T.INFORMATION CONTRACTOR INFORMATION
Owner Contractor Name
Mailing Add I V371 Ig nr.oftiffle..v Mailing Address PA aria ' G,7
City , State Zip Code City Act s,da.+ State WA Zi Code 9 SYQ
Phone(360 )VX.-�39'A5 Other Ph.( Ph.( Ss"77-C311 Other Ph. 9 35
Lien/Title Holder Contractor Reg.# CCA DWK
AddressI Expiration G18 / /
SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of
Sewer System
ARCEL INFORMA_XON 12 digit Parcel No. Fire District
Legal Description ( -44 i C e
Site Address(Please include streetnathp,street num4pr a `e; .J
Directions to site 3 bnd c )ye
I 4
Is your property within 200'of the following:Body of Water(Name) Saltwatet, ,
Lake��River/Creek Pond Wetland Seasonal Runoff' Stream
Slopes or Bluffs
TYPE OF JOB New Add. Aft Repair Other Use of Building
Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS fuel Type: Electric___._.,
Type of Fbdure No.of Fixtures EM LPG Natural Gas Heatpump
Toilets Ty No.of Units Em
Bathroom Sink Furnace
Bath Tubs Heatpumps
Showers ISpot Vent Fan
Water Heater Propane Tank $
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
} Hosebibs Dryer Vent
�. .,Z! Other her
Base Fee Base Fee
T' TOTAL PLUMBING: TOTAL MECHANICAL
} s
A FLOOR PLANAND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTUREIUNIT.
! NOTICE: THIS PERMIT.BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF.180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINuATioN OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on'ownees behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
{
OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. first obtaining approval.
X Date X Date ��
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
h'{>f:< },� �s is s •� • � ��y.„,: t f ? .... . i;:::a:;:;}:oil;
}.fi, :.,..«. .. t,:}:::}.:{•::. ......Fin .,
Building Department
Oce GroupT Constr. J
i Planning Department
1
Other
Other y
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Permit Fee` Site Inspection
I
Plan Review Fee UFC Plan Review Fee
Plumbing&,Boo Fee Other
Mechank:al&Base Fee Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( )
Violation fee TOTAL FEES
PERMIT NO..
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.CetlaiNP.O.Box 186,Skelton,WA 98584
S 27-9670 Elm&"i380 2-6269 Seattle 206 64.6968
APPLIC T INFORMATI N CONTRACTOR INFORMATION
Owner w K > " Contractor Name a��:1( a s AI
Maitin Add Mailin Address 7
City. State Zip Code City s State WA Zi Code >F� S'Y9
Phone( Q )Y. —, VCf Other Ph.( ) Ph.(3 )_ -S3/l Other Ph. 11
Lien/Title Holder Contractor Reg.#
Add Expiration_g2k_/_g./�_/Q X
SEPTIC INFTMATION-C nnect to New Septic Existing Septic Connect to Sewer System Name of
Seger Syste
ARCEL INFORMAADT QN-12 digit Parcel No. Fire Qistrict
Legal Description
Site Address(Please include street na street numtrr and c" )
Directions to site it
y
Is your property within 200'of the following:Body of Water(Name) Saltwa _
Lake River/Creek Pond Wetland Seasonal Runoff Stream 'w
Slopes or Bluffs
TYPE OF JOB New Add Alt Repair Other Use of Building
Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FDCTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric
Tvoe of Fixture No.of Fixtures Fees LPG Natural Gas Heatpump
Toilets No.of Units Fbes
Bathroom Sink Furnace
Bath Tubs Heatpumps
Showers Spot Vent Fan
Water Heater Propane Tank O a
Clothes Washer Gas Outlets 10
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kdchen Exhaust Hood
Hosebibs Dryer Vent
^� Other Other,
s
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
h
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. `
NOTICE: THIS PERMIT BECOMES NULL&VOID IF W9@l1K OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABAN ED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
Inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval first obtaining approval. ll
X Date X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
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Building Department
Occ GrOUD Type Constr.
Planning Department
Other a m &-- 3
x
Other
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Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&gase Fee Other
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( )
Violation Fee TOTAL FEES