HomeMy WebLinkAboutBLD5724 Plumbing - BLD Application - 8/10/1977 1
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MAc#gN COUNTY Ps.-ANNING n PARTM EMT
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.
Owner
CAh n -- --
2.
Contractor
The owner of this building and the under igned agree to conform to all applicable laws of Msson Ceu y and State of Washington
Signature of applicant . lJA7 d7b,
Application date
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LEGAL DESCRIPTION Rd
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Location e,no
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS Gar
BATH TUBS 47Z)
SHOWERS
WATER HEATERS (f�
AUTO.WASHERS U�
SINKS 010
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
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 Permit fee Date pemlt Issued Permit number Receipt No.