HomeMy WebLinkAboutMIS93-0362 Gas Furnance - MIS Permit / Conditions - 7/15/1993 I
MASON COUNTY v
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Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584 j
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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
PLUMBING date by OTHER
Groundwork Attic
date by date by
p W WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION,
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date by date by date by
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P,O, Box 186 Shelton, Washington 98584
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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
PLUMBING Attic by OTHER
Groundwork
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
Permit N ��
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670
PLEASE PRINT �-
#1 Owner LA VL Phone#
Site Address E 7/
City :� E�/(/ St Ail ,+ Zip
Directions to Job Site y. L
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Ll
Owner Mailing Address s/7
City St W Zip 9 85-
Lien/Title Holder WZ f/ �/ Zy 4wk
Address
City St Zip
#2 Contractor Name OL�iiy/'i( �'nU��,r /AfF�¢7irv'� Contractor Reg. #
Address s /�/ /l'I rd�°��,�, /E'er Expiration date
City E ZA-1 St ��� Zip Phone 1�—
#3 Parcel No. Y2 OUL
Legal Description Lot If
#4 Use of building Describe work
#5 Type of Job: New Add Alt Repair
Plumbing Fixtures ($3 each) Fee 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 Ng4 Other
_Other _ Gas Outlets
Wood, Gas, Pellet Stove
Permit Basic Fee 15.00
TOTAL PLUMBING $ _
Permit Basic Fee 15.00 U
TOTAL MECHANICAL $�-
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 CONTRA&
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 FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTME T. DEPARTMENT.
X OWNER JP46u. j t� 7 X BY
DATE �,S_ /l 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: 4_
p '
Recei t No, Referred To
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY Proposal Proposal
Approved Denied
Planning:
Building:
Fire Marshal: