HomeMy WebLinkAboutMIS95-0176 Woodstove - MIS Permit / Conditions - 3/22/1995 MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M I S C:E L_ L A N E CO L)�S P P H M f FOR INSPECTIONS CALL 427-9670
MIS95-0176 PARCEL. s420187500040 t'E_A ! . DIV :? BLKs? L.OTc?
JOB ADDRESS : W 131 PYRAMID CT SfIr s Tnf•'
APPLICANT : DAN HOLMAN 42.6-2990
OWNER : DAN HOLMAN 426-2990 M�� p10Q0
LEGAL . TIA0 2 1! 91-A 19459 p�Fl y �*?%1
PROJECT DESCRIPTIONS
VO�O 8
WOODSTOVF novV�G
�NI
PROJECT LOCATIONS
SHELTON—MATLOCK ROAD TO LiTTLF EGYPT ROAD TORN LEFT TO
PROJECT NOTES :
TYPE AMOUNT BY DATE RFCEIPT
WDST $ 25 .00 KS 03/22/95 38622
TOTALs 25 .00 OWN : R GENT ATE
IisPINT, rent 14111 i 22 COMPLIANCE TO ATTACHED CONDITIONS IS
illil 1 R E D
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
PLUMBING date by
Attic OTHER
Groundwork
date by
date te by WALLBOARD NAILING
D.date by date by
Water Line FINAL INSPECTION
date by date by date by
04
f �m
i
i
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
PF. RM I I" CC->NC') 1 T 1 0Nc:�
Case No . : MIS95-0176
Fort DAN HOI MAN
Page : 1
1 ) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 306 (C ) AND SECTION 513 , ALL SITES MUST
HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE
AND I.EGIBLE FROM THE STREET OH ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING
DEPARTMENT" REQUIRES THAT THIS RE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
RE INSPECT 1 ON FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM 13011 D 1 NG CODE WILL BE
ASSESSED IF OWyI�/C TR TOR FA11l.$ TO POST ADDRESS ON SITE PRIOR TO REQUESTING
INSPECTIONS . I ff
X
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
Permit Nom
MASON COUNTY
.—PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670
PLEASE PRINT
#1 Owner Phone#
Site Address ( P Cv T
City lc/ St Lam/ Zip
Directions to Job Site
>o
UVk
Owner Mailin Ad s O
City 6 St Zip
Lien/Title Holder Ge
Address 01M2
oe
City St Zip
#2 Contractor Name M1*1- ,P,G 0/0 Contractor Reg. #
Address G Expiration date
City b ^7d1 St AlAzip 4 cc� Phone
#3 Parcel No. aO 1 5- D lac
Legal Description Y
#4 Use of building 0-le— Describe work wm&IP
#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. Unlia 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 _
1 Wood Gas, Pellet Stove
Permit Basic Fee 15.00
TOTAL PLUMBING $ _
Permit Basic Fee 15.00
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, Sep-re, 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 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 FIRST OBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. 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: