HomeMy WebLinkAboutBLD2013-00690 Final Heat Pump - BLD Permit / Conditions - 8/27/2013 co
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W ,
o CONCRETE Gas pips"s MANUFACTURED HOME
N interior-Date By �
w Footings!Setbacks Ex Ribbons lernr-Date By O
0) Date By INSULATION Date By Z
o Foundation walls Set-top
BG I SLAB INSULATION 0
Date By Date By Date By cn
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FRAMING Floors FIRE DEPARTMENT X
Date By Date By W
Date By walls DECKS m
PLUMBING Date By Date
By
Groundwork Vault TANKS
Date By Date By
Date By Attic
D.w.v
Date By OTHER
Date By DRYWALL Typo.
Date By
Water Line Date BY Type:
Date By Int.Brace wall Date By
MECHANICAL °iresaperanor, �' FINAL INSPECTION a
Dale By Date By BY
0
0 Pass or Request Inspect.
Type of Insp. Fail Date Date Done By Comments c
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MASON COUNTY PERMIT NO. D " S_ w b
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360)427-9670•Belfair(360)275-4467•Elma (360)482-5269
On the web www.co.mason.wa.us
APPLIC INFORMATIO � `/ CONTRACTOR IN 0RApATION
Owner �j �/�- 4163s Company Name �a G / +1�"`S
Mailing Ad ress /ArLi�oc% 4L� [N� Mailing Address �
City State�st�Zip Code City State d Zip Code > �'"�-7
Phone <L� �Other Ph Phone 3 -AG` Other Ph.
Lien/Title Holder Contractor Reg. # i6l R j' /6-¢Sc�?
E mail address E Mail Address h'iltnTP AoL, t'b
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION- 12 Digit Parcel No Fire District
Legal Description
Site Address(Please include street name, street number and city`-?I( L- GOyc l,s,9,2�L'
Directions to site
Is property within 200' of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs J 15%
TYPE OF JOB - New Add_Alt_Repair Other Use of Building
Location of Fixtures/Units- 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric_LPG_Natural Gas_Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heatpumps /
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/PelletStove
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is a urat and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF: O UATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X Date: T /
Owner/Owners Representative Contracto (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bid Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group_Tvoe Constr.—
Planning Department
Environmental Health Department
FEES
Plumbinq& Base Fee Site Inspection
Mechanical &Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES