HomeMy WebLinkAboutBLD93-1144 Hot Water Heater and Furnance - BLD Permit / Conditions - 7/26/1993 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
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Permit No.
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670
PLEASE PRINT
#1 Owner Tc4&k ni j+k Phone#
Site Address o d
City 0YA St 1rV Zip
Directions to Job Site 1
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�c�cf2 M. 5 yr r
Owner Mailing Address _D 005 PciEensor\ Poa d
City - .� St uoA Zip
Lien/Title Holder ccC
Address 2U :P �.
City she l st k.,OA zip 94
#2 Contractor Name SP r Contractor Reg. #
Address Expiration date
City St Zip Phone
#3 Parcel No. 1} Zpl--=s Lit- - 2p0 - i 0 y
Legal Description SE%aE NW Y-4 CS SF_ Yg- SF-LTXC14 13 _F 2LU N e q-Ld
#4 Use of building h 0 rri,--, Describe work ins v«
Y VIc'CeL CILLCJS I �'1 ►zi
#5 Type of Job: New ✓Add Alt epair
Plumbina Fixtures ($3 each Eg Mechanical Fixtures ($6 each)
No._Toilets CIRCLE FUEL TYPE(Gas lectric,
_Bath Basins Heatpump, Other
_Bath Tubs No. Unk Fgga
_Showers Furn -75-, L BTU _Lf�
-_riot Water Htr o� 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 � Gas Outlets
Wood, Gas, Pellet Stove
Permit Basic Fee 15.00
TOTAL PLUMBING $ 00
�go�
vS o� Permit Basic Fee 15.00
S �� TOTAL MECHANICAL $'c
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 COUNTY ORDINANCE 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
SHALL BE MADE WITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE 2.(, 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 Proposal Proposal
FOR OFFICIAL USE ONLY
Approved Denied
Planning: Y 1
Building: Cc)A-14 ion 4(e"n,4 SyOS Afewi/e- � F
Fire Marshal: