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Home My WebLink AboutMIS94-0349 Exhaust Hood - MIS Permit / Conditions - 7/7/1994 ., ' MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 14I544 0344 11A1 1 I rT; <glri140,110 If01 offl'fkf W 1431 SHFI 1`014--MAItOCK H ) till 11 ON ti1T PHI1 II' G I I I ARO 416- 90911 i ,I 1 PtI l L IP W 611. LAND 4Ib--9098 U117 9117 5t Of 1`1 RIM IS 11434t11 1'1") I t i I fit `,I COMMERCIAL FXtIAttST HOOO 1'Fiit.)[ i I ita A l l ON I hl i�19•. k 1 k)f8 h: �, 4'y.' ,i 4A f J r_p iE t,rY %) I i ► r1E 'i1 Nis. PR.#T. Ptt' $0610 COMP1 CANCF 10 AI IACHED CONDI IIONS JS RC-'gUIRFD CONCRETE MECHANICAL _ MOBILE HOME Footings-Setback date -0� by/Z — ibbons 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 Groundwcrk Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date /—/W.—,jc/ by ate by MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 N i N 1 I A I It I i i 1, 1 M 1 1 1 N I h t I t to I I� 1, o 1 icsI I I it C! 11 PI I I I I I 11 :oN11 14 1 1 1 I I f It ifv,'II I I i 1 1 r, 11 v I i I I i t I 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 d date by ate by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by li MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 I � II 'i i i 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. /Sk/9 3 16 -1k MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670 �;DA"'�o PLEASE PRINT # O� #1 Owner C71116r Phone# -102h SiteAddreps 3 S h Vc C Kd City �S St Zip G Directions to Job Site Owner Mj Ilin ddress 277OU60 City S OV) St C-1 Zip Lien/Title Holder Address City St Zip #2 Contractor Name Contractor Reg. # Address Expiration date City St Zip Phone #3 Parcel No. (vo O- n Legal Description #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. Uak 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 25.00 Permit Basic Fee 15.00 TOTAL PLUMBING $ _ Permit Basic Fee 15.00 TOTAL MECHANICAL $2 I °O No Basic Fee for Wood, Gas, Pellet Stove 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 FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDIN7DRTMENT. ,/ 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 FOR OFFICIAL USE ONLY: Accepted by: Date: Receipt No. Referred To DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Proposal Proposal Approved Denied Planning: Building: Fire Marshal: 5 �� I • "C 1 G•��R� �J�uRE SlA R,,nNS 401; So wP.%aM i a re-4 I Z r l W-774� ��- A _ 16. ip yX I- A�R_v�A R O� v ta4 � 4 10 �w4 10 •DR► a �o R , RED. Range Hood Systems Report SERVICE COMPANY DATE OF SERVICE TIME A.M. I P.M. 1 1/ ANN A EMI-ANNUAL RECHARGE NSTALLATION RENOVATION AmeriSafe L ION OF S TEM YLINDERS 11A / UL 300 3006 29th Ave. SW L P �bC'` IJYES [:]NO Tumwater, WA 98512 FACTURER MODELNUMBER WET DRY CHEMICAL C;7,W�34 ,l CYL D R Z MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE l� � � p n FUSE LtW6 360-F FUSE LINKS 450-F. FUSE LINKS 500'F. OTHER cusTOME Name Ln(AO 1 ��6\ FUEL SHUT-OFF ELECTRIC 'GAlS SIZE Address k v � 1 o C v) SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE city o?1r��' State ZIP _ 10 6 � MANUFACTURER'S MANUAL REFERENCE Telephone Store No. PAGE NUMBER: DRAWING NUMBER: DATE Owner or Manager COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT ` , 1. All appliances properly covered w/correct nozzles r 20. Replaced fuse links y 2. Duct and plenum covered w/correct nozzles �� 21. Check travel of cable nuts/S-hooks 1L 3. Check positioning of all nozzles. Q 22. Piping&conduit securely bracketed �L 4. System installed in accordance w/MFG UL listing �L_ 23. Proper separation between fryers&flame 5. Hood/duct penetrations sealed w/weld or UL device 24. Proper clearance-flame to filters 6. Check if seals intact, evidence of tampering 25. Exhaust fan in operating order 7. If system has been discharged, report same _ 26. All filters in place 8. Pressure gauge in proper range(If gauged) 27. Fuel shut-off in on position 9. Check cartridge weight(If applicable) 28. Manual & remote set/seals in place 10. Hydrostatic test date .i 29. Replace systems covers 11. 6 year maintenance date 30. System operational &seals in place J 12. Inspect cylinder and mount ✓ 31. Slave system operational Q_ 13. Operate system from terminal link 32. Clean cylinder&mount -4 14. Test for proper operation from remote 33. Fan warning sign on hood V 15. Check operation of micro switch _V 34. Personnel instructed in manual operation of system y 16. Check operation of gas valve Ij 35. Proper hand portable extinguishers 17. Clean nozzles J 36. Portable extinguishers properly serviced 18. Proper nozzle covers in place V 37. Service&Certification tag on system J 19. Check fuse links and clean V NOTE DISCREPANICES OR DEFICIENCIES BELOW COMMENTS: Sustew chccjes_ On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual, with the results indicated above. X - RVICETECHNICIAN PERMIT NO. A E: TIME: AM PM �OST A THORIZED AGENT The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. AUTHORITY HAVING JURISDICTION Range Hood Systems Report SERVICE COMPANY DATE SERyJC 1 ' TIME 10 A.M, P.M. 2/VJ_ 7 , �� ,/ / n,� ANNUL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION ill i afe LO� N OF SSY TE CYLIpdDERS �0C �yES L 300 ❑NO 3006 29th Ave. SW /ul V.L Tumwater, WA 98512 MANUFACTURER MODELNUMBER WET DRY CHEMICAL 360-943-5634 �a qj ' *61 CYLINDE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE +- � i C11 FUSE LINKS 360°F. FUSE LIN S 450°F FUSE LINKS 500°F. OTHER (!l CUSTOMER Name w (/ FUEL SHUT-OFF ELECTRIC GAS SIZE Address 1 SWIM v r1C �A SERIAL NUMBR LAST HYDRO TEST LAST RECHARGE DATE City State ZIPq '10 qDATE MANUFACTURER'S MANUAL REFERENCE Telephone Store No. PAGE NUMBER: DRAWING NUMBER: DATE Owner or Manager COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT 2- 1. All appliances properly covered w/correct nozzles 20. Replaced fuse links J 2. Duct and plenum covered w/correct nozzles 21. Check travel of cable nuts/S-hooks 3. Check positioning of all nozzles. J 22. Piping&conduit securely bracketed �L 4. System installed in accordance w/MFG UL listing 23. Proper separation between fryers&flame 5. Hood/duct penetrations sealed w/weld or UL device 24. Proper clearance-flame to filters J 6. Check if seals intact, evidence of tampering 25. Exhaust fan in operating order _ 7. If system has been discharged, report same 26. All filters in place �L 8. Pressure gauge in proper range (If gauged) 27. Fuel shut-off in on position 9. Check cartridge weight(If applicable) 28. Manual&remote set/seals in place �L 10. Hydrostatic test date 29. Replace systems covers J 11. 6 year maintenance date 30. System operational&seals in place 12. Inspect cylinder and mount 31. Slave system operational 13. Operate system from terminal link V 32. Clean cylinder&mount 14. Test for proper operation from remote J 33. Fan warning sign on hood 15. Check operation of micro switch J 34. Personnel instructed in manual operation of system 16. Check operation of gas valve `i 35. Proper hand portable extinguishers 17. Clean nozzles 36. Portable extinguishers properly serviced 18. Proper nozzle covers in place 37. Service&Certification tag on system 19. Check fuse links and clean _T NOTE DISCREPANICES OR DEFICIENCIES BELOW COMMENTS: rX On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicated above. X .1 "r n + _ RVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM CI MER`S AUTH RI E AG NT- The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. AUTHORITY HAVING JURISDICTION