HomeMy WebLinkAboutMIS94-0203 Final Stage II Vapor Recovery - MIS Permit / Conditions - 5/5/1994 MASON COUNTY �
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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NU 120 HWY (FLUATR
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CONCRETE ME IC L I MOBILE HOME
Footings-Setback date by Uk) Ribbons
date by Gas Pi i -,)- date b
Foundation Walls date L b Set Up
date by INSULATI 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 ' , l date by
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MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
F.O. Box 186 Shelton, Washington 98584
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MASON COUNTY
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Mason County Bldg, III 426 W, Cedar
RO, Box 186 Shelton, Washington 98584
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CONCRETE MECHANICAL MOBILE HOME
i Footings-Setback date :y Ribbons
date by Gas Piping date by
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 b
date by y
p W WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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PIRSUN CUUN-1 Y BLIJG 3 4277798 P. 02
cri� " -03
ermit No. !
MASON COUNTY ! 1
' PLUMBING/MECHANICAL PERMIT APPLICATION
pL EASE PRINT426 W. Cedar/P.O. Box 185, Shelton, WA 98584 - 427-19670 i
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#1 Owner DAVE BEYNON DBA SANDY'S DFLI MART Phone # 206-275-4787
Site Address NE 120, HWY. 300, BELFAIR
City BELFAIR St �A Zip 98528
Directions to Job Site NORTH SIDE OF TOWN ON HWY 300 ( i
Owner Mailing Address P.O. BOX 566
City BELFAIR St WA 96
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Lien/Title Holder
Address — L
City Zip
#2 Contractor Name BECK ENVIRONMENTAL CONTRACTING Contractor Reg. #FRONT FI 14#BM
2823 WEST VALLEY HWY. E.
Address E plratlon dale
City SUMNER C> St WA zip 98390 phone 206-863-2240
#3 Parcel No.
Legal Description T2 %Af, NSF' �
#4 Use of building GAS STATION/MINI—MART Describe work INSTALL STAGE I
VAPOR RECOVERY
#5, Type of Job: New. Add Alt x Repair
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Plumbing Fixtures (,$3 each) each)
No._Toilets CIRCLE FUEL TY E: Gas, Electric,
_Bath Basins Heatpump, Other
—Bath'Tubs 1
—Showers _ Furn BTU j
Hot Water Htr — Heatpumps
i —Laundry Washer \� — Vent Sys ms
_Sinks _ Spot Vent Fans I
_Floor Drains
—Laundry Basins Hp
_DishwasherN-91 Air Handli a Unitsi
—Disposal — cfm#_
Urinal 1� Other !
Oth Gas Outle s
_ Wood,Gas, Pellet Stove
P mit Basic Fee 15.00
TOTAL PLUMBING
Permit Basic Fee 15.00
TOTAL MECHANICAL $
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rNOTI : This permit becomes nulland vol if work or construction authorized is not commenced
thin 180 days or If construction or work Is suspended or abandoned fiA'r a period of 180 days e#any
MASON COUNTY BLDG 3 4277798 P. 03
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NOTEi If this permit application includes the placement of a fuel tank, heat �ump or other unit to be located
outside of the existing structures, a plot plan MUST be submitted as required below: I
Show followingon the site Ian below: Lot Dimensions, Existing Structures Structure Setbacks,p g Water Lines, Septic Syst ms,
Flood zones, Wells, Shorelines, Easements, Name of flanking & Fronting Streets. Indicat directional by N, S, E, W, etc.:
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OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF I CERTIFY THAT I AM� CURRENTLY REGISTERED CO�NTRAC-
THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF ASHINGTON AND I AM AWARE OF THE
AWARE OFTHE MASON COUNTYORDINANCE REQUIREMENTS ORDINANCE REQUIRE v1ENTS REGULATING THE WOAK FOR
FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK WHICHTHEPERMITIS ISSUED AND ALL WORK DONE WI�LBEIN
DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL B MADE
sHALL BE MADE WITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTA N1NG APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTM NT. I I
X OWNER X g
DPTE DATE APR 8, 1994 1
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 . 427-9670/1-800-562-56?8
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FOR OFFICIAL USE ONLY: 'Adpt b�► :.` .. . w. n Date:41.
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R0csio t No. ~F ,.• :. moo, a
p` Referred To 4
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DEPARTMENTAL REVIEW i Proposal Pro�osal
FOR OFFICIAL USE ONLY
Approved Dented
Planning:
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Building:
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Fire Marshal:
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