Loading...
HomeMy WebLinkAboutMIS94-1017 - MIS Permit / Conditions - 12/12/1994 77, 7r -71 eRt 14 z > rr z z oo x ___j 0 OD C ol U) '17 z 00 10 Q- 0 cri Z) 00 -71 IT 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 b PLUMBING date by Y Groundwork Attic OTHER date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date Z_ � by date by L 6-f- 'ill s ?� 7-t°--7- l-�•-U .� � '�i�..��- �r�--- ,gam-= �v 77 m r-, z I 73 n z > --i Z > z 17 7 77 :z V Z 0 -4 00 w z> ol > cf) 141 cn :)7 71 z C� 7Z 10 00 -4 cri 00 z -n > Z 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 by i FRAMING Walls FIRE DEPT.date PLUMBING by date by date by Groundwork Attic OTHER date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Permit Non1 1q ot ` MASON COUNTY PLUMBING/MECHANICAL PERU IT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98 534. 427-9670 PLEASE PRINT 7 #1 Owner /� « ='� Phone# �� �� IS Site Address City _ St Zip Direc ions to Job Site �o o l /� h/_ le-1127 771 6- ©GCS D/'t ✓z Owner Mailing Address Q� City l�/1 St Ll� Zip Lien/Title Holder hQlZe, d�' G� @ Z Address City St_ Zip #2 Contractor Name Contractor Reg. Address Ltl1 Expiration date_ City �� St z//� Z Phone _ 3 #3 Parcel No. - - Legal Description #4 Use of building S ` Describe work 2�r l� #5 T e of Job: New-71 Add Alt Repair Plumbing Fixtures ($3 each) Fee Mechanical Fixtures 6 each No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatp imp, Other Bath Tubs No. Units Fees _Showers — Furn BTU _Hot Water Htr — Heatpumps _Laundry Washer — Vent Systems _Sinks — Spot Vent Fans _Floor Drains No. Boilers/Compressors _Laundry Basins — HP _Dishwasher No. Air Handling Units _Disposal _ cfm# _Urinals NN Other _ _Other / Gas Outlets Wood, ellet Stove 25.00 Permit Basic Fee 15.00 Gas, TOTAL PLUMBING $ Perm t Basic Fee TOTAL MECHANICAL $ �' No Basic Fee for Wood, Gas, Pellet Stove NOTICE: This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. Proof of continuation of work is by means of a progress inspection. NOTE: If this permit application includes the placement of a fuel tank, heat pump or other unit to be!located outside of the existing structures, a plot plan MUST be submitted as required below: Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRAC- THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE AWARE OFTHE MASON COUNTYORDINANCE REQUIREMENTS ORDINANCE REQUIREMENTS REGULATING THE WORK FOR FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE SHALLBE MADE WITHOUT FIRST OBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY: Accepted by: Date: Receipt No. Referred To DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Proposal Proposal Approved Denied Planning: Building: Fire Marshal: