HomeMy WebLinkAboutMIS98-0555 Final Woodstove - MIS Permit / Conditions - 10/13/1998 Tr . >
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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 by
PLUMBING Atadtc by OTHER
Groundwork
date b date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date, - CC C`'/ by., date by
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
dato by Gas Piping date b
Foandation 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 date by
PLUMBING Attic by OTHER
Groundwork date by
date by WALLBOARD HAILING
D.W.V.
date by date by
Water Line FINAL INSPECTION
date by date by date by
I
FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD PERMIT NO.:
MASON COUNTY
r 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 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Contractor Name
Mailing AAdress 0 0 , r. Mailing Address
City State(L�..Zip t ode�4,1;Y^ City State Zip Code
Phone .ii, �j4c/._Other Ph.( Ph.(_ Other Ph.(_�
Lien/Title Holder -fit-- Contractor Reg. #
Address Expiration
SEPTIC INFORMATION-Connect to New Septic Existing Septic 7� Connect to Sewer System Name of
Sewer System
PARCEL INFORMATION-12 digit Tax Parcel No. Fire District
Legal Description - - =
Site Address(Please include street name, street number and city)
Directions to site '� - -
�G. t C
Is your property within 200' of the following: Body of Water (Name
) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream 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 FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric
Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump
Toilets Type of Unit No. of Units Fees
Bath Basins Furnace
Bath Tubs Heatpumps
Showers Vent Fans
Water Heater Propane Tank
Laundry Wsher Outlets
Sinks oo Gas/Pellet Stove
Dishwasher ect Vent?
Other Other
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT.
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 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. fijrst obtaining approval.
)( J. Date X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
;:. 'Dk"PAiRTMEfd l`A #i1^5i IEVtF APPRC]tlE[) pEIVI
GOtsJRiTIfJTV C'~?G3ES
Building Department
Occ Group Type Constr.
Planning Department
Other
Other
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Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee Other
LMechanical&Base Fee Other
s/Pellet Stove FeeE Pre-Paid at Submittalee TOTAL FEES