HomeMy WebLinkAboutMIS93-0207 Hot Water Heater and Gas Furnance - MIS Permit / Conditions - 5/27/1993r
MASON COUNTY
PERMIT
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Mason County Bldg, III 426 W, Cedar NULL OID BY EXPIRATION
RO, Box 186 Shelton, Washington 98584 DATE BY
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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 b date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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 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 by date by
Permit No.
MASON COUNTY Mt'SCA S--bib
• PLUMBING/MECHANICAL PERMIT APPLI TION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670
PLEASE PRINT
#1 Owner Scat- 4 C r(Ehne. SLol'sher Phone d
Site Address ILI 6wilau.Zod r')1'!l/V__
City St (J04
Directions to Job Site Ff PA�J/V(v/WIV g-jAj�v UJ0
1�t4st,csa_ �vL 4k4 Lae. F�
Owner Mailing Address ZISA,YVt<(>�
City t St l L Zip i
Lien/Title Holder
Address
City St Zip
#2 Contractor Name G Contractor Reg. #
Address 1 M6 G Expiration date
City A St wL)A- Zip a 5Ty Phone 4Z& -q-145
#3 Parcel No. L4Q1'-)1Q -55 - C=@
Legal Description nawjk= cc*-4
#4 Use of building l' Describe work ::f�,34-X NeLi
#5 Type of Job: New Add Alt__X Repair
Plumbing Fixtures ($3 each) Fgg Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric;
_Bath Basins Heatpump, Other
_Bath Tubs No, Un2ia Fees
_Showers �C Furn BTU
X 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 N Other
_Other Gas Outlets
Wood, Gas, Pellet Stove
Permit Basic Fee 15.00
TOTAL PLUMBING $
Permit Basic Fee 15.00
TOTAL MECHANICAL h?�
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 C'k� 1, . O W'�"`�� X BY
DATE 15-`7i-1 l q' 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:
i Receipt No. �U Referred To
DEPARTMENTAL REVIEW Proposal Proposal
FOR OFFICIAL USE ONLY , Approved Denied
Planning:
Building:
Fire Marshal: