HomeMy WebLinkAboutBLD2012-00937 Furnance Replacement - BLD Permit / Conditions - 12/21/2012 o CONCRETE G Plping MANUFACTURED HOME O
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Oi 1Tv1PIC HE 12/21e 2012 11: 44 3604277466 ATING PAGE 01/01
PLEA MUST BE SE PRESS HARD COMPLETED IN INK, �' � � � ,��
MASON �-�—
COUNTY PERMIT NO.
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar• RO_Box 186, Shelton,WA 98584
Shelton (360) 427-9670•Beifair(360)275-4467 • Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLIC T INFORMATION 7, CONTRACTOR INFORMATION
Owner ' '� � f�I Company Name Ot
Mailing Addres i MaEIEn Address
City c�t-t<-1 State Zip Code City -^t Mate IaJA Zip Coded
Phone a�-?4,S Other Ph Phone:�in9 ice`! 5 Other Ph.
Lien/Title Holder Contractor Reg. I`�-`�� 2-LBA Exp.
E mail address E Mail Address i3��l� ru•� �_
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. f 77 T Fire District
Legal Description
Site Address (Please include street name, street number and city) q
Directions to site_.
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New Add Alt_Repair Other Use of Building
Location of Fixtures/Units- 1st Floor 2nd Floor Basement Garage—Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS
Type of Fixture No_ of Fixtures Fees Fuel Type:Electriez LPG_ Natural Gas_ Heat Pump_
Toilets Type of Unit Natof Units Fees
Bathroom Sink Furnace ,I
Bath Tubs Heatpumps
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets _
Kithen Sinks 'Rood/GasiFuiietStove�
Dishwasher Kitchen Exhaust Hood _
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL_
OWNE R/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 the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application,f declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and Conduct the work proposed. The owner or agent on owners behalf,represents that the Information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X � (',�� t-.I � Date:j2-al-QOi
Owner/Owners epresentative/Contractor (Indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd I Ck# Date Bld Pd Receipt No.�
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group-Type constr.-
Planning constir.—
Planning Department
Environmental Health Department
FEES
-Plumbing & Base Fee Site Inspection
Nechanical & Base fee UFC Plan Review Fee
"Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
CASE NOTES FOR
BLD2012-00937
CONDITIONS FOR
BLD2012-00937
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance
Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0 . The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) ALL FURNACE INSTALLATIONS SHALL MEET THE MINIMUM EFFICIENCIES SET FORTH IN THE CURENT EDITION OF THE WASHINGTON
STATE ENERGY CODE (WSEC). ANY PORTION OF THE MECHANICAL SYSTEM THAT IS ALTERED OR REPLACED SHALL MEET THE MINIMUM
STAND,�RD /SET FORTH IN THE WSEC AND INTERNATIONAL MECHANICAL CODE.
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3) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revn.
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4) All building permits Shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason ordinances and building regulations.
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5) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder ve revented action from being taken. No more than one extension may be granted.
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This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any
time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be
occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate
and grants employees of Mason Co access to the above described property and structure for review and inspection.
OWNER OR AGENT: DATE:
BLD2012-00937 Please refer to the following pages for conditions of this permit. Page 2 of 2
Inspection Line (360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. 3 426 W. Cedar P.O. Box 279
Ir Shelton, WA 98584
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MECHANICAL PERMIT BLD2012-00937
OWNER: PAUL JOHANSSON RECEIVED: 12/21/2012
CONTRACTOR: OLYMPIC HEATING AND COOLING 360-426-9945 LICENSE: OLYMPHC986BA EXP: 1/1/20 ISSUED: 12/21/2012
SITE ADDRESS: 71 E SPRINGWOOD LN SHELTON EXPIRES: 6/21/2013
PARCEL NUMBER: 420125500011
LEGAL DESCRIPTION: SPRINGWOOD LOT: 11
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
FURNACE REPLACEMENT SHELTON SPRINGS RD TO SPRINGWOOD LN TO SITE
General Information Setback Information
Type of Use: SF Insp.Area: Front: Ft. Shoreline: Ft.
Type of Work: MEC Fire Dist.: 11 Rear: Ft. Slope: Ft.Side 1: Ft.
Valuation:
Side 2: Ft.
1
Mechanical Fixtures FEES
Type Qty. Type By Date Amount Receipt
Furnace<100K 1 Mechanical Permit Fee GMM 12/21/201 $18.30 S120120000(
Mechanical Base Fee GMM 12/21/201 $28.50 S120120000(
Total $46.80
BLD2012-00937 Please refer to the following pages for conditions of this permit. Page 1 of 2