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BLD2004-00990 - BLD Permit / Conditions - 6/23/2004
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EJ \ & / . � 35En $ / t \ / \ ƒ 8 a E | $ / 7 . . . 7 \ ; � \CD / \ CL ¥ \ ZD' \ & = o = w . \ CD \ � 9 ± 7 \ £} 8 /- \ % \ 8 \ ] $ \ 0 k ® Cc: § a & ' \ CD0- § f ° r \\ f eCD . mac » » Eo / \ \ / 7 \ cl . \ / 3 aaD 3 $ ) � m � 2 & An � § � R u 0 =3 o 00 u . C: / % CD 0 . mp » E E , W r o CONCRETE MECHANICAL MANUFACTURED HOME; Footings I Setbacks Date By Ribbons 0 0 Date By Gas Piping Date By 0 Foundation Walls Date `, .'f By Set-up Date By INSULATION Date By B G 1 Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date V By f Date By ,�V�h(iw,,;xy4(��Vd 1M 1 ) .u����L ',�': Date By m En 5 r—, �y . 7-6—cv /,�-�GCD a 0 r d N � N � 8 O a O � o' .p 0 0 Z � O 0 FORM MUST BE COMPLETED IN INKX-� . PLEASE PRESS HARD PERMIT NO.:' MASON COUNTY 0090j0 PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Shelton(360)27-9670/Beellf ir(3606 '275467'E fk a9 3601482-5269 APPLICANT INFORMATION _ CONTRACTOR IN RMATION_ Owner ' , y� Contractor ame Mailing Address ' ft`_ Mailing Address City; a- t�i State Zip Code L= c, City State t> Zip Code Phone ,,42& `i",Other Ph.0 Ph. r' Other Lien/Tit[6 Holder Contractor Keg. # oC Address Expiration Z,_/ SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 diait Tax Parcel No. / _ / ` Fire District Legal Description �` _ '" Site Address(Please include street name,street nu and city) Directions to site - 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 .-K 2nd Floor Basemen t Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No.of Fixtures Fees LPG Natural Gas tY\, Heatpump Toilets -Type of U it No.of Units Fees Bathroom Sink Furnace Bath Tubs Heatpum s Showers Spot Vent Fan Water Heater Propane Iank Clothes Washer Gas OUtIE is Kitchen Sinks Wood/Gas/Pellet Stove _ Dishwasher Kitchen E haust Hood Hosebibs Dryer Vert Other Other Base Fee y�_ v� 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 CONTRACTO VS AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in th 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 r ulating work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done i onformance erewith. No changes shall be made without approval. first obtaining proval. X Dat� X Date ` FOR OFFICIAL USE BEYO IS POINT Accepted by Date Submittal Amoun Due Receipt No. AEPARTMENT .EHIEW APPROVED p NIEf) GOhIfJt IS?N GQpES Building Department Occ Group Type Constr. (lLJ Planning Department Other Other ...................... ES . ....................................................................................................................................................... Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fe Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittai ( ) Violation Fee TOTAL FEES