HomeMy WebLinkAboutMIS94-1007 Pellet Stove - BLD Permit / Conditions - 12/7/1994 t MASON COUNTY
Mason County Bldg. III 426 W. Cedar �-
P.O. Box 186 Shelton, Washington 98584
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RFQUIRED
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 I by date by date by
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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HAVF Al"f%ROVE D NIIMNF Nei OR AD1,11 1' `;`+1_ti PROV 1 DI D IN c,IiC li A Ilf)k, 1" I 1 1M 61, lot lit III A I Nl "i' V 1 "1 T 111 I
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OFF'ARTMF'N'T REMIf0f `, FNA1 4"1•11 -, fit- C'ompi t' 11 1) rlI I1►tt 111 (.At I IN1; 1 Ok ANY '-wJ I IM'-Ilt 1' I VON`, A
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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 date by
PLUMBING Attic 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
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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P.O. Box 98510• 9515 - 39th Ave. Ct. S.W.
Belcog inc. Tacoma, Washington 98498-0510
(206) 584-2264
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Sales Hours: l
"SERVICE FIRST„ 7:30 a.m. 4:30.P•m.
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Shipping Hours: 1
Since 1978 7:00 a.m.-4:00 P.M. y
Monday-Friday r
1-800-426-7214 • _,206) 581-7649
Toll-Free FAX Line
PerMilt 4, 31),
f. 4' MASON COUNTY ,y ;
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
F E'PRINT
- --- _
#1 Owner r�_ <" Am Phone # 2 7� ✓� Z� E�
Site Address N E 16 Bo oL C) 6a-GL,r W wy'
City _.-----___ "' St lkli- Zip 41, s
Directions to Jo
V1
O v
Llo 01 Q St Zip
Lien/Title H er
Address
City St Zip
#2 Contractor Name �•sA 19 bjAAA9t. 140AX ww ,w, =1-1c. Contractor Reg. # K I t ISA L N 09-3 L-
A D t S- Expiration date Q - zb- °}'—
City W a_ a g3i 2— St (L - Zip Phone ZLXa —H
#3 '
• Legal Descnp
#4 Use of building 6escribe work
#' Type of Job: New )( Add Alt Repair
Plumbing Fixtures ($3 each) Fe& Mechanical Fixtures ($6 each)
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
_Bath Tubs No. ni 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 S vot vot
• Permit Basic Fee 15.00
TOTAL PLUMBING $ _
Permit Basic Fee
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 too be,loca;
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 CONT�
THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I AM AWARE O
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 ALLWORK DONE WILL BE IN
DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
SHALL BE MADEWITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUIL
THE BUILDING DEPARTMENT. DEPARTMENT'.
XOWNER XBY
DATE DATE "A'�M(�rtEYL�-
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 Proposal Proposal
FOR OFFICIAL USE ONLY
Approved Denied
Planning:
Building:
Fire Marshal: