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HomeMy WebLinkAboutBLD2014-01049 w.stove - BLD Permit / Conditions - 12/1/2014 � $ � / / . 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CD '* D -n � cn (D (D 0 v am Z � (n o aC) � (D m (D m � (Dc� 0 ° - mti ocn � o ° Q n� o o (nm D (ncQ o O 0 O o CD O Z = (D �• = � O � o 3 m (C (D ° o sv -0 1 D � Cr0_ � � CL a o o a 77 O < * (D 3(D o � � x 3 (n «' x 0 (0 O O 0 O 0 CD v (D O .� O : C) O W CO ((D 0- Cn O Q. 0 O W 2 G O —I Q _= (D lD v (D j (n (n -0 (D ° Cn .0 O (D CS (D v l (D 3 [D O. CD A cope MASON COUNTY PERMIT NO. td zi���� / DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING.FIRE MARSHAL _ WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext.352 �hsr PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext.352 PLUMBING & MECHANICAL PERMIT APPLICATION Ke �nrr OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:LCura_ (LJ sb►N. NAME: ,6k.c.�Cl� MAILING ADDRESS: meaiws p)ucc. MAILINGADDRESS:7it r ;�nidmf CITY: $Ae,86 STATE:t&hk ZIP:IK 8 CITY:5AeA6n, STATE: Ina— ZIP: $ 8 PHONE:360 87639/9 CELL:,?/b 1?V ?yl9 PHONE: CELL:?ta 2By_gsy( EMAIL: EMAIL : awa, L&I REG EXP. 12 1Sr /S PARCEL INFORMATION: , PARCEL NUMBER(12 DIGIT NUMBER): LEGAL DESCRIPTION(ABBREvIATED): SITE ADDRESS: &/ Q . CITY: S"�' DIRECTIONS TO SITE ADDRESS: ¢L a� 'd aa// 4kc W-4. ✓ Am /Yl 7`g TYPE OF JOB NEW ADD _ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS—1ST FLOok:y<2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_ Toilets Tyne of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer tc �.F ets Kitchen Sinks /Pellet Stove Dishwasher xhaust Hood Hose bibs Dryer Vent Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. 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 necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permitlapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PER PLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. x Q bec � Signature of Applicant Date Owner/Owners Repre ativ /Co 'ntracfor"�`) Print Name (indicate w i`F` one DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Gas Piping o CONCRETE MANUFACTURED HOME N) Interk)r-Data By > CD Footings I Setbacks Exlerior-Date By Ribbons 0 Date Date BY z 0 INSULATION -;N. CO Foundation Walls Set-up 13G I SLAB INSULATION > Date By Cate By Date By C: Floors X FRAMING FIRE DEPARTMENT > Date By Date By Date BY Walls DECKS PLUMBING Dale By Groundwork Vault TANKS Data BY Date BY Date BY Attic D.W,V Date By OTHER late By DRYWALL Type. Data By Wa ter Line Data By Type: co Date By Int..Bra w Wait' Date By r— Date By W MECHANICAL FINAL INSPECTION 0 (D Fire Separation Q �B & Date By Date HY Drite BY ................ C> 0 Pass or Request Inspect. E; CD (D Type of I nsp. Fail Date Date Done By Comments "V (n 0:3 27 0 :3 Cn 0 Cn 3 CD 0 Permit number BLD Mechanical Permit Checklist • Name of owner: � Name of Installer: ' .. • Fuel Type? LPG Nat Gas Electric Other • If propane, what is the proposed size of tank(s)? • What type of medical unit will be installed?(i.e.freestanding stove,forced air furnace, etc.) • If the unit is a wood stove, provide: Make �h Model Year Label Number • What is the use of the structure? (Circle one) Residential Commercial (A permit application for a commercial mechanical perms satisfactory review by staff. Include a floorplan showing the location of unit(s)and layout of duct work with the permit application.) • Type of structure: (Circle one ,i.e, u t Home anufactured Home Other r • What room will the mechanical unit be located? • Will the unit be located in a basement? (circle one) Yes • How will combustion air be supplied to the mechanical unit? (Describe, i.e. direct vent, air inlets, etc.) • How will the mechanical unit be exhausted to the outside? Applies to appliances using gas, (Indicate B-vent, direct vent, L-vent,etc.) • What year was the structure constructed? 'e.q•�-1*•► Was this structure part of a PUD upgrade. • What type of controls will be installed? (i.e. thermostat, etc.) • Will the proposed mechanical unit be a heat source?(circle one) • Additional information: Signature of Applicant F° Date ------------------------- Typical mechanical fees: Forced air furnace $ 18.30 Heat pump 18.20 Propane tank 73..00 Gas Outlets 6.20 additional outlets over 1-5 ($1.20 each after 5) Mechanical base fee 28.50 or $ 9.00 if base fee was paid on an active building or mechanical permit Freestanding unit, fireplace,pellet stove or wood stove $73.00 Final Inspection fee 73.00