HomeMy WebLinkAboutMIS95-0674 Propane - MIS Permit / Conditions - 9/19/1995 a6 ob-,
ESO� Permit No.
U `� � �� MASON COUNTY &-& � ;
AU� � G/MECHANICAL PERMIT APPLI ATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASEMERAL (SERVICES �bUrq.�PA_ d .Zn7� ►�6l� - �ee�)
#1 O ner ��T e U e. v"_ L 1A e �1 Phone# 3G,0 SS -7�
Site Address oZ 1 3 1 I.� 17
City o St a Zip
Directions to Job Site L V� ! e /\j"
Owner Mailing Address 10 8(p O 3OX-
City o o s In ar St -1rKD A Zip
Lien/Title Holder J e n w — I,-,- 4 e +
Address c�: c
City St 1'J'. 1 Zip 9
#2 Contractor Name _ e ('r a'1 Contractor Reg. #
Address Expiration date
City St Zip Phone
#3 Parcel No. �/,2 D-
Legal Description Tr �' v L_" 1 r-1
#4 Use of building Describe work a,
#5 Type of Job: New Add Y Alt Repair re CVO D rn�✓S
Plumbing Fixtures($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
Bath Tubs No. Units Fees
Showers Furn BTU
_Hot Water Htr _ Heatpumps
_Laundry Washer _ Vent Systems
_Sinks Spot Vent Fans
_Floor Drains No. Boilers/Compressors
_Laundry Basins HP
Dishwasher No. Air Handling Units
_Disposal _ cfm#
Urinals No. Other
_Other Gas Outlets
Wood, Gas, Pellet Stove
Permit Basic Fee 15.00 to
TOTAL PLUMBING $ Q3\1__ 15''
Permit Basic Fee 15.00
TOTAL MECHANICAL
No Basic Fee for Wood, Gas, P� etttovq
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 fuel tank, eat pump or other unit to be located
outside of the existing structures, a plot plan MUST be subml required below:
Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems,
Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc.
q '
�tl
o
2 fit- c�ze-Q
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 RCVV 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I 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
SHALLBE MADE WITHOUT FIRSTOBTAINING APPR LFROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DE ARTMENT. / DEPARTMENT.
X OWNE T 2 X BY
DATE DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, VVA 98584 - 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY Accepted by: _. Date:
Receipt No. Referred To
DEPARTMENTAL REVIEW Proposal Proposal
FOR OFFICIAL USE ONLY
Approved Denied
/
Planning: D t3� yc ��tm �'' ,►may., / f! -�.,.
Building:
Fire Marshal:
Sk
O N O US 0 'O � 00
C.. .i C-
m Am rO - n :7t
C I
6) z b O S R
ml A D M z =
z r ..f O m -r rm
l! 9 z O — rn ..
m V N .9i Ce —1 cs T -.4 z S !
S — O
vrn
Mz
Ij 2 C 2 0 rn j N
IP rr -d z vs V V 2 00
j a O A rt1
tSt 's rS1 rm 0 ^� co
N iv n ra +
T,1 �7 -► �7 � O
Wo
00 O
'' .• °' z
rm
Q z
cn N
., �. cn
00
0 O �
<
I z
! Q)
I
� Zv rR
o O
I � �
I
I Ffi
I �
i I
CONCRETE MEC I ! MOBILE HOME
Foot r ings-Setback date `c1_ (— , Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by dwe by
D.W.V. WALLBOARD NAILING
date by da+:e by
Water Line FINAL INSPECTION
date by date date by
5 ;3-C fi��
i
azrn x w'v NO - W N) a rn T
Z a c I = . -1 - - . . C} M rn Z
v < = ID O _ Z7 1Q O O
—
C � 2 Q "' rr < < < fa'
- 'II -1 :D -• of :!" .+ 'r2 -•4 - 1
` $ < w G rr
— J -1 I — 3 rn ^n m < rQ
In < ap C4 xmQVI
Q m -+ M Z
cD - s G Z •n fp = 0) 0OzcD — x h mO IM -4 Z
-, � c € - maw •-- s � � `� a v
i tly it ff 3 - x 7 z —
Q 0 z m �
—i O 7a Q C i6 -+ < C3
'I in i O C
fT1 >
rn z rnZ��y
imp i9 T ^- a tQQb
JI
33 fA Z z flC gD =
'I a rn " ?+ v o _ 0
DGO ; rY ?I CD K 0z c rn o ? w ao 7 Q rn D
-n � o - � -n � x O
I J rn a <D -• tS - � X n O
�J <- K fl 6^ figL9
Z - O < -- � -0 z O
CO -6F+ (V _ r" � z
- m m 's =' =r -1 z a Ol
_ ^
2 z O ,1 c is
j a 0 fiJ � < S 0
j rnn` c�a O a -± _
c Z
!ti •. — Cr D m c cn zC.0 N
II� 7 O -1
'+ O L5 -- ni n
DOm ct < -� — p f1+
;r, z :l) - Q O :) CD
o -a - a s 3E 10 Q
z a -- m m -i 0 co
cn
co
z � � c z
-� WCIO
RtbD = M.
z Cl)
Z— co
< w —
r. Z I
m5
i
I
� 1
i
� I
i