HomeMy WebLinkAboutBLD9662 Plumbing - BLD Application - 3/28/1978 MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton, Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT — Complete ALL items. Mark boxes where applicable.
Name Mallingaddress—Number,street,city,and State Zip code Tel.No.
1.
Owner
2.
Contractor
The owner of this buildind and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature Is plicant Address Application date
/7 7&
LE
DESCRIPTION Or�
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS I
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
M LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
ko s- /D•
(Show Street Names & Property Lines)
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INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
' ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.