HomeMy WebLinkAboutBLD2023-00657 Cancelled Plumbing - BLD Application - 4/16/2024 MASON COUNTY COMMUNITY SERVICES PI
PERMIT ASSISTANCE ENTER 0 0
*BUILDING *PLANNING *FIRE A"RSHAL
615 W. Alder St- Shelton, WA 985U
www.tx mason wa..is
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PLUMBING & MECHANICAL PERMIT APPLICATION
(3WNF,RINFORdMATION CQNj (JtIli--I'\1__[Ilt\tp�lIt)\
N i4l I ; c NAME:
MAILtI X60-7 ;tro ta.� or"I MAILING�P�
CffY *",,A0- STATEgw4 P: + C"t Y. 1 t 4 Jul _ tF.
PHONE: a Sm
I,. :I RE O n EXP,
P,'�ItC"h4I< 1�'�JF'+ttK'►1;�,T1C?:ti,
PAR( ( I '\I 'III 1 X t f: zonrng,
LEGAI. i)i��t hii"t lt't�1��w�a�. IL34,lI 'P �' z.k i%¢ALA
MITI'. :,I I 1e I t eta[,".ta Maaon t. 0".F
C TY:
DIltt,(!I i+ �N,� I SITE AT)T)RCSS:
INSTALL YARD HYDRANT ON CUSTOMER UNDEVELOPED LAND
TYPE OF JOB:
.NL-W=A1)[ AL.I�.�..]XEPAJPf.=OTHFJt=USE OF BVILDING
L(C'ATI()N C FIXTURE&V ZITS I"r FL(X) 2'*OFLO()=BMEM NT�tiA tAtiL s t I iI
P'LUMBINC, FIXTURES(SHOW NUMBER OF A01) MECHANICAL UNITS
Trt1tc%A I L, tufc Nu..OII»t W Fuel T c:I IrLtrx=l.ft N-,*turn
tlathn-omi Scat Furnace
Shoves Spot'4`Crtt FAA
Water Hewer Propane 'Task
("411hcs N'aslter Gu Outlets
1Cttchtm striks Wood t;as;Pellct Stove
140fre bibs ' Dr),"\Oil
I Solo I' rc
ter
But Fee [
TOTAL.PLUMBING TOTAL MIEC°IIANWAL
OWNER ackowMedge submISSIM of hoccurnto wfonn tOn MSY NIStA in a strap Wur*otdW Or pWftt of su(h is
by w7'iaklure I dectare IIW I Wn the mar owws Iwo rwesontavve of Contractor I Iurtf r die-:are tat I am entitled to rec oe this
9! PWTM and to do tho a(k. a v. - ub a t per rrvs . ftima€ erssrary pa mdua any a ams arr rat mar or pay*%ut
n;or+tra�i th sc�# T er or"tom boost represents that the inf xsawn prvvicted is acceorate sod grants amooyees of
vn Cvunty b tl1r� ov s smarty arx!sMxtu*6j)fo(rovrev ans cb-. s This ita6Ps'(-altian becomes t 6,roll
1 if wark or l z � rw s not car r1C1lt1 wiVvn I days or 0 ciunsmx1ton work is susperAod for a porpod of 160 day PROOF
OF CORNTINUATi t?f INSPECTION.INACTIVITY OF THIS Pf"IT APPLICATION OF 140 DAYS
WILL INVALIDATE TH PLICAT
x
__. C;
Signattwe of Owner
1Wr1%K,t sIF,N,I;%I, REVIEW APPROVED 1)+4TE 01"' kIED I)1%1 F T;(:!11,%O l Vs, ONDI I IONS
FIT IT I?IN4i W 11,�R°TMUNT
PLANNING I)I"PAItTMT-N"T
P tltP tAItSHAI
MASON COUNTY COMMUNITY SERVICES Permit No:
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL
615 W. Alder St-Shelton, WA 98584
www.co.mason.wa.us
Phone Shelton:(360)427-9670 exit 352• Fax:(360)427-7798
Phone Belfair.-(360)275-4467• Phone E/ma:(360)482-5269
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Scott and Janette Embrey NAME: Liquid Environmental Solutions of Washington,dba Flohawks
MAILING ADDRESS: 1e0 East Mason Lake Drive E MAILING ADDRESS: 7651 Esters Bid Ste 200
CITY:Grapeview STATE:WA ZIP:96584 CITY:Irving STATE:TX ZIP:75063
1 st PHONE:360-970-3686 PHONE:253466-5307 CELL: 253-324-4927
2nd PHONE:360-5a0-3269 EMAIL :
EMAIL:jnlembrey@zoho.com L&I REG#22108-55-00038 EXP. 9 /30 / 23
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): 22108-55-00038 Zoning:
LEGAL DESCRIPTION(Abbreviated):UNDEVELOPED LAND
SITE ADDRESS:180 EAst Mason Lake Drive E CITY:Grapeview
DIRECTIONS TO SITE ADDRESS:
INSTALL YARD HYDRANT ON CUSTOMER UNDEVELOPED LAND
TYPE OF JOB:
NEW=ADD=ALT[=REPAIR=OTHER=USE OF BUILDING
LOCATION OF FIXTURES/UNITS—IST FLOOR=2ND FLOOR=BASEMENT=GARAGED OTHER ✓0
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric[ ILPG=Natural Gas=Ductless=
Toilets Type of Unit No.of Units Fees
Bathroom Sink Furnace
Bath Tubs Heat Pump
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hose bibs 1 Dryer Vent
Other Solar Panel
Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge 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 contractor. I further declare that I am entitled to receive this
permit and to do the work as proposed. I have obtained permission from all the necessary parties,including any easement holder or parties of
interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of
Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION.
X
Signature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE I TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN