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Name of T staller: :5 - !R4 ► Fuel Type? LPG- Nat Gast' Electric Other ► If propane, what is the proposed size of tank(s)? ► What type of mechanical unit will be installed? (i.e.freestanding stove,forced air furnace, etc) ► What is the use of the structure? (Circle one) Residentiai� Commercial (A permit application for a commercial mechanical permit will be issued upon satisfactory 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 onef`Iite Built HonManufactured Home Other ► What room will the mechanical unit be located?(--=1 F-}y-,k -� ► Will the unit be located in a basement? (circle one) Yes No ► How will combustion air be supplied to the mechanical unit? (Describe, i.e. direct vent, air inlets, etc.) �-)"k ► How will the mechanical unit be exhausted to the outside? Ik plie to appliances using gas, oil or wood fuel. (Indicate B-vent, direct vent, L vent,etc)-�—� vL.� ► What year was the structure constructed? _Was this structure part of a PUD upgrade? ► What type of controls ill be installed? (i.e. thermostat, etc) ► Will the proposed mechanical unit be a heat source? circle on ) Yes No ► Additional information: Typical mechanical fees: Forced air furnace $ 14.80 Heat pump 10.65 Propane tank 10.65 Gas Outlets 10.65 additional outlets over 5, $1.00 each Mechanical base fee 23.50 or$ 7.25 if base fee was paid on an active building or mechanical permit Freestanding unit, fireplace, pellet stove or wood stove $52.30 $4.50 state fee will not be collected on mechanical permits W r o , -CC NCRETE MECHANICAL MANUFACTURED HOME .f- Footings 1 Setbacks Date By Ribbons 0 co Date By Gas Piping Date By � Foundation Walls Date 1,40 Set-up Date By INSULATION Date By B G I Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL I SPECTION Water Line Date 3 1 os Date By M Date By CD 0 a v tz �d 0 8 Q O a. O C 0cn O zr �.+ CD o r '� 4-ol 4 FORM MU$T BE COMPLETED IN INK PERMIT NO.: PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482.5269 Seattle 206 464-6968 APP ' C TION CONTRACTOR INFORMATION Owner r Contractor Name Sunset Air, Inc. Mailing Address y Mailing Address 9210 T.a y Blvd. SE City ` State Zip Code City1.acelz State WA Zip Code 98503 Phone Other Ph.( Ph. 456-4956Other Ph.(� Lien/Title Holder Contractor Reg. # SUNSEA*220CM Address Expiration 02 03 / 04 SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORM ION-12 digit Tax Parcel No. / / / 00) 1 Fire District Legal Description Site Address(Please include street name, street number and city) Directions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Rt'inoff Stream Slopes or Bluffs 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 Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas )CHeatpump Toilets Type of Wnit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers Vent Fans Water Heater Propane',Tank Laundry Wsher Gas Outlets Sinks Wood/Glas/Pellet Stove Dishwasher Direct Vent? Other Other Other Other Base Fee Base Fee 2.3 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 'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance ,Contr for in t 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 requir ent 'r n e ork f which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall doe conf rmanc the ith. No changes shall be made without approval. first in' ppro 1. )( Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amour! Due Receipt No. I . ... ....... £11##iTMFNTAIr#ZE3lf�yv APFRC7�tED.; ,DENIM};:: 60NDITIQN:GflDES Building Department Occ Group Type Constr. Planning Department Other Other ......:;:;;.;:.;:.;:.::.:;.;:.;;;;;;:.;: :::::::::::::::::::::::::::.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :: :::: ............................................... :.: :::::::::::..: ::::::::::. :>:: :>:>:::>:::<:»::>:::<:>:: ::: ::::>::>::>::»>::»:<::::<:>::»:>:>:: :>:»:::< :::>::>::i::>:::;:>::: Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES