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Home My WebLink AboutMIS93-0257 Gas - MIS Permit / Conditions - 6/10/1993 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 C C_ U. L A h# V 101 tJ If "43- 021ti 7 1,Is r . . . . . . . . . . . . . MIR ION I WE't 1) 1, f'A I It 111 of of 10 ts J182A 1 0 OFF 'SPRING:, ROAD RIGHT ON' BOARDWALK R16HI PAS- I IS1 AND I AI(1- 10# R 0.1 t C I NO I I- AMOUN I by I I W Iv. 1 0 0 144 of�'11 10 /1) 1 4 6 0 0 1 kj t (I fit If If I, ilj: w'i Ho All, H I A N C f AI A C 14 U 1) C 0 N 1)11 1 10 H Q11 I RI:D 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 by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date date by +I I i J MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 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 FRAMING by date by date by Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Permit kv (S -1 MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670 PLEASE PRINT#1 Owner Phone# 42L(.- ,.15r-C/,3 (_� Site Addre s F, 1 a r W15L City e o St ti/a. Zip g S4- cf DirectioT to Job Site e v< a K Ka WI e e Owner Mailing Address .Su v-t:e City St Zip Lien/Title Holder _I ►tit-e_ as a ba v'P Address City St Zip #2 Contractor Name Contractor Reg. # Address Expiration date City St Zip Phone #3 Parcel No. 2O 1 Z - .21 - (MO&tom Legal Description #4 Use of building Describe work #5 Type of Job: New Add_ Alt Repair Plumbing Fixtures ($3 each) EP& Mechanical Fixtures ($6 each) No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs No. Unk 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 No. Other Other / Gas Outlets Wood, Gas, Pellet Stove Permit Basic Fee 15.00 TOTAL PLUMBING $ Permit Basic Fee 15.00 TOTAL MECHANICAL $ l 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 i i it FOR OFFICIAL USE ONLY: Accepted b : �' 1r�- - Date: p y i Receipt No. Referred To DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Proposal Proposal Approved Denied Planning: Building: PRE Fire Marshal: