HomeMy WebLinkAboutBLD2009-00041 - BLD Permit / Conditions - 1/22/2009 �
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Permit number 3LD
Mechanical Permit Checklist
• Name of owner: /�� ���l.J Name of Installer:
• Fuel Type? LPG Nat Gas Electric Other
• If propane, what is the proposed size of tank(s)? 6-6 0
/
• Wh type of me hanical unit will be installed?(i.e.freestanding stove iced air furnace, etc.)
• If the unit is a wood stove, provide: Make Model
Year Label Number
• What is the use of the structure? (Circle on :� esi
dential Commercial
(A permit application for a commercial mechanical permit a Issue upon sa'isfactoty review by staff. Include a floor plan
showing the location of unit(s)and layout of duct work with the permit application.)
• Type of structure: (Circle one Site Built Home Manufactured H me Other
• What room will the mechanical unit be located? k/U/'v eyr1
• Will the unit be located in a basement? (circle one) Yes No
• How will combustion air be supplied to the mechanical unit? (Descr be, i.e. direct vent, air inlets, etc.)
DOAJ t k A-j a j,)
• How will the mechanical unit be exhausted to the outside? Applies to appliances using gas, oil or wood fuel.
(Indicate B-vent, direct vent, L-vent,etc.) L2% L (��,a
• What year was the structure constructed? l l,, Was this stru ture part,of PUD upgrade?
• What type of controls will be installed? (i.e. thermostat, etc.) j�10 --�
• Will the proposed mechanical unit be a heat source?(circle one) ryes No
• Additional information:
Signature of Applicant Date rX of 0
Typical mechanical fees:
Forced air furnace $ 18.30
Heat pump 18.20
Propane tank 73.00
Gas Outlets 6.20 additional outlets over 5, $1.15 e ch
Mechanical base fee 28.50 or $ 9.00 if base fee was paid onan active building or mechanical permit
Freestanding unit, fireplace, pellet stove or wood stove $73. 0
$4.50 state fee will not be collected on mechanical permits
Gas Piping 0
o CONCRETE MANUFACTURED HOME ' 0
Iriterior-Date By
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CD Footings I Setbacks Ribbons m
1P Exterxx-Dale t)I V1 BY ic
CD
CD Date BY
Date BY >
CD - INSULATION z
Foundation Walls G I SLAB I NSU LATION Set-up
Date By Date By Date By
0
FRAMING Floors FIRE DEPARTMENT
Date By BY
mil
Date By s Date
:DEC KS
PLUMBING Date By t
Date BY
Groundwork T
Vau TANKlt S
S
Date BY Date BY
Date By Attic
D.W.V Date By OTHER
Date Ely DRYWALL Typql-<We'
--- Date I I Sold-1 By "iL,
Water Line Date BY Type: 100
Date By Int.Brace Wall Date BY
MECHANICAL Date By — FINAL INSPE TION C)
Fire Soperabon
ik�Tlc C)
Date By Date By Date 1 5610-t BY (D
C�
40
0 C)
(D Type of I nsp. Date Comments
Fail Date —11
Pass or Request Inspect. Done By
11 Z7ji3,t LA !L
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...........
PERMIT NO.
MASON COUNTY
PLUMBING/MECHANICAL PERMi
APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, 98584
Shelton (360) 427-9670• Belfair(360) 275-4467 a (360) 482-5269
On the web www.co.mason.w <<
APPLICA INFOR T N CONTRAC ill FOR ATI N
Owner o - /-14`J Company N I Yi t C`
Mailin Address 6�. �' Mailing Add ss r
City ?� , (S`at _Zip Code City�Phone— ,t State Othee p Code
Phone, __Other Ph.
Lien/Title Holder Contractor F eg )r-- I / 1gpl .,
E mail address R�C�' ' n,�= /�� �L. CC' E Mail AddrE ss J
Drivers Lic.# DOB Drivers Lic.4 COB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sew r System
Name of Sewer System
PARCEL INFOR ATIQN - ig�t Parcel No. 'Cs- 77 Fire istrict
Legal Description - / /� C
x Ad r sus (Please iridude, treet na a street number and c'ty)
Di eEtion to�site bra ••%�, h K ,,. U
6 4
Is property within 200'of Saltwater Lake River/ reek Pond
Wetland Seasonal Runoff Stream Slopes or B jffs > 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:El ctric— LPC-L-- Natural as_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heatpumps
Showers Spot Vent F n
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/P IletStove—
Dishwasher Kitchen Exh ust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OVVNER/BUILDER Acknowledges submission of inaccurate information may result in a st p 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 orl,the work proposed in the application, I have obtained
permission from them to pply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is r nts employees of Mason County access to the above described l property and structure for review and inspection.
PROOF, N OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X /Cl Date:
—
Owner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND TH IS POINT
Accepted by: Planning Pd Ck# Date Bld Pd R9ceipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Ins a :tion
Mechanical & Base fee UFC Plan F eview Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FE S