HomeMy WebLinkAboutMIS93-0231 - MIS Permit / Conditions - 6/3/1993 r, co
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date (i- t by Ribbons
date by Gas Piping date
Foundation Walls b
date date by Set Up
by INSULATION date b
BG/SLAB Insulation Y
date by Floors Final
FRAMING date by date by
date by Walls FIRE DEPT.
PLUMBING 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 ��j by date
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date b Ribbons
date b y
Y Gas Piping date by
Foundation Walls date by Set Up
date by INSULATION date b
BG/SLAB Insulation Y
date b Floors Final
FRAMING y date by date by
date by
Walls FIRE DEPT.
PLUMBING 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 No.
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
PLEASE PRINT
#1 Owner—/7eyr1.1.5 y lbe' s Phone# .
Site Address a.1 0'>> zT6w �� J�; �✓.
City SGi br/ .p St I'Z� Zip
Directions to Job Site ,7 �Y (I-Le
Owner Mailing Address L0 yy,2/ L L�` "°�� ���f `
City 51� u l is r St u' I+ Zip -5 3'
Lien/Title Holder A
Address
City St Zip
#2 Contractor Name a�z- G Contractor Reg#
Address Expiration date
City^ c v /s Stwa[ Zip Phone
#3 Parcel No. LIZ QQA -33 - al.'62
Legal Description
J
#4 Use of building Afel Describe work
#5 Type of Job: New--,,, Add Alt Repair
Plumbing Fixtures Fee No. Fee
No. Toilets Vent Systems (Central)
Bath Basins Vent Fans (Spot/WHole)
Bath Tubs Boilers/Compressors
Showers HP .00
Hot Water Htr Air Handling Unit
Laundry Washer cfm
Sinks Fire Protection System
Floor Drains
Laundry Basins
Dishwasher
Disposal
Urinals Other
Other
—Gas Outlets/hookups W 1�
Permit Basic Fee .00 Wood/gas/pellet Stove
TOTAL PLUMBING $ Other aZh-
Permit Basic Fee 5.00
Mechanical Fixtures TOTAL MECHANICAL $
No. Fuel Types
Furn .00
Heat Pumps .00
19If this permit application includes the placement of a fuel tank, a site plan
indicating lot dimensions, existing structures, structure setbacks, septic
systems, and easements MUST be attached.
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 ANYTIME AFTER WORK IS COMMENCED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH
THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
DEPARTMENT. DEPARTMENT.
X OWNER %'' � � X BY
DATE — 3 DATE
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
F`OR: OFFICI gSE ONLY. ACepied by Date
Approved Cond Hotd
DEPARTMENTAL REVIEW - for office use only Approval
Planning:
Building Plan Review:
Occupancy Group:
Fire Marshal:
FEES
Special Conditions: Plumbing Fee
Mechanical Fee
Other
TOTAL
Valuation: