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Fail Date Date Done By Comments 1`0 hi hi ........... ca CD Cn 0 =3 0 U) 0 W -a 3 IT (D 0 MAR731-2015 07:29 From:Jim, s Heating & Air 3604273120 To:4277798 Fage:2,3 26 CL tr CD M: -. 0 CD '? R-31-2015 07:28 From:Jim, s Heating & Air 3604273120 To:427779S Pa9e:1/3 MASON COUNTY PERMIT I O, DEPARTMENT OF COMMUNITY DEVELOPMENT 4; BUILDING.PLANNING a FIRE MARSHAL °31 Z. - WWW.CO-MASON.WAMS (360)427-9670 Shelton ext.352 Mason County Bldg, III,426 West Cedar Street k° PO Box 279, Shelton,WA 98584 (360)275-4467 B®If it ext. 352 (360)462-5269 Elm ext. 352 PLUMBING 8r MECHANICAL PER IT APPLICATI N OWNER INFORMATION- CO I ORMATI N: 11 NAME:_ 04L,0 &,,-ZAS'Eo NAME- _SS:ADDRESS: I`tp► 14, �,�� MAILING DDRESS: S ' - CITY: S e K FL.v STATE: ZIP. CITY: s PHONE:_ CITY: titSTATE: PHONE, �r' '?-S" Z CE EMAIL: EMAIL : �t y�nr .,� �]¢o ,�st<G+cc�. L&I REG r > Ila q 3S"� Exp. PARCEL xNFO MATION• PARCEL NUMBER(I2 DIGIT NUMBER); I i LEGAL DESCRIPTION(ABEREYI.QTED): SITE ADDRESS: DIRECTIONS TO SITE ADDRESS. CITY: ` TYPE OF JOR NEW ADD ALT REPAIR OTHER USE OIL BUILDING 1 OCATION OF FIXTURES/UNITS—1ST FLOOR 2N1DFLOOR BA�ENfENT G GE OTHER. PLUMBING FIXTURES(SHOW NUNMER OF EACH Type o Fixture ) MECHANICAL UNITS _ No.o Lures Toilets FM .Fuel Type.Ele ric LPG Nat ral Gas Ductless I i Bathroom Sink Type 2f Unit No.of LTnt� Fees Bath`Pubs Eutzaace i h we Heat Pump Vent Fan V Spo t Water Heater �� StPropane Tank � } Clothes Waslaer �— Gas Outlets Kitchen Sinks �— --I DishwasherWoodlGas/Pell Stove �— Hose bibs �— Kitchell Exklaus blood Other Dryer Vent Solar Parcel Base Fee Other TOTAL PLUMBING Base Fee - TOTAL MECHANIC L OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or pe it revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or ntractor.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 ecessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized gent represents that accurate and grants employees of Mason County access to the above described property i e information provided is ew and ins permd/application becomes null&void if work or authorized construction is not commenced within 180 days ore construct onpwork is This suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION INACTIVITY OF THIS PE RMITICAF 180 DAYS WILL INVALIDATE THE APPLICATION. XPP Date Print Naaaie Owner/O ners Re resent five/COr1tr2C#or �— {indicatewhic one) DEPARTMENTAL REVIEW APPROVED iDATE DENTED DATE TAG /NOTFS/CONDITIONS BUILDING DEPARTMENT` PLANNING DEPARTMENT FfRE MARSHAL