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HomeMy WebLinkAboutMIS95-0617 Propane - MIS Permit / Conditions - 9/5/1995 4 Permit N S '5--U&j MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar/P.O.Box 186,Shelton, WA 98584.427-9670 PLEASE PRINT #1 Owner Phone# t i - Z Z 7 Site Address City St a. Zip qS S S 4- Directions to Job Site ' rn:-. E UU Owner Mailing Address 'R O o 1.�� (Z�, City a-A'QSLin, St I a. Zip q g 5'4(`1 Lien/Title Holder Address City St Zip #2 Contractor Name La� �� o wtiu��� Contractor Reg.# Address Expiration date City St Zip Phone #3 Parcel No. 1W p u 1 a - 13 ©C30 ZLO Legal Description --2 02 S V2 06 #4 Use of building yy%-o Describe work #5 Type of Job: New. ✓ Add Aft Repair Plumbing Fixtures(t3 each) Egg Mechanical Fixtures(96%wW No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump,Other _Bath'Tubs NQ. SInb E= Showers Furn BTU _Hot Water Htr _ Heatpumps _Laundry Washer _ Vent Systems _Sinks Spot Vent Fans _Floor Drains Ng,, Boilers/Compressors _Laundry Basins _ HP _Dishwasher Ng, Air Handling Units _Disposal _ cfm# _Urinals Other _Other Gas Outlets _ Wood,Gas, Pellet Stove Permit Basic Fee 15.00 AL TOTAL PLUMBING $ Permit Basic Fee 15.00 TOTAL MECHANICAL $-QL� 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. 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, Spptic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking& Fronting Streets. Indicate directional by N, S ;Vl, etc. J d 0 � 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]AM AWARE OF THE AWARE OFTHE MASON COUNTYORDINANCE REQUIREMENTS ORDINANCE REQUIREMENTS REGULATING THE WORK FOR FOR WHICH THIS'PERMIT IS ISSUED AND THAT ALL WORK WHICH THE PERMIT IS ISSUED AND ALL-WORK DONE WILL BE IN DONE WILL BE IN CONFORMANCE THEREWITH.NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE SHALL BE MADE WITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTM`E�WT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 . 427-9670/1-800-562-5628 .:..,....e::r;:<»..:.;:..,>i,.»...�'.a..,.Y.�<�:v.v:::... .............. ... 1. !<:.. ::.>ltt`y•�•>•: .e.� ia�fl�t .��,�,.. 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DEPARTMENTAL REVIEW Proposal Proposal FOR OFFICIAL USE ONLY Approved Denied Planning: Building: Fire Marshal: i I - " 3 j pt� C I" ® � fi1f�Ap f •C• r1i IV D to11! t!t i!! > rn r p •- D iit {� mac? -i D z > OR o Mw O � C 30 m ! -- -f G J M i c > x0 po x . r D r ti @ .m0 Zi � z -fit A N � D xx a z "' a moo m � Z 9) -� a z m # � C to Q - i a ow m > � w C A a!� '~ •� tot- m A m 1 a � M to '. 0 w sr _ a # tst fot C f � � = -� r 00 1. _ � D 0 x C" 1 -� o O Y Mw x A t` z 0D -* O O .4 9) o i` m - A 0 0 P O.Q OD Cl 01 dw z I o oa 0 r -+ • z i m C) t 4 f- 1' .;4 to 1 V t V T CONCRETE MECHANICAL MOBILE HOME ngs-Setback date b Ribbons by Gas Piping date by ndation Walls date by Set Up 4, ;e by INSULATION date by BOYSLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Attic Groundwork date by date by WALLBOARD NAILING D.W.V. date by date by Water Line FINAL INSPECTION date by date by i a m 1 -► o — V s ZOMMZ > c a roZ = s as ow — roo < w o a o '« i1O — roMZ > Mto a -7 . �4 c 00 m oD oA as r- c - - - I rt -i - tm - -c — m? -44 '' Vr r+ _ 4a z — * t? rr3 o -4Zmm A473 i IQ * Z — — - ?- © -! 2CD = - Zra C -� ol" c � cc 4 f+ a0 < At47' 0 = f" Z O I m s c > mom — Ir roo -4cs v - ammro o I z "'#' cam C* — C)> 0 . 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