HomeMy WebLinkAboutMIS94-0929 Propane - MIS Permit / Conditions - 11/2/1994 MASON COUNTY PERMIT
Mason County Bldg. III 426 W. Cedar NULL 8 VOID BY EX ATION
P.O. Box 186 Shelton, Washington 98584 DATE BY
MTSGF L A AIV [] tJ s f" E= f2MTT 1 0 P IN'tt'F:( tt (?N", V A I i `►!7,-9670
1 01 !
10H E 880 SPENCER RD SHF L TON
APPI I.t'ANI .TERRY RAYMOND 4?6--1010
OWNF I+ • JFRRY RAYMOND 426---1.01 0
t't 6 AIL IN I AF SN St FS 19206:A-1
I•�R 1
F'titil( �:'1" I.Oi:Ail (lN �
TO PIONEER SCHOOL, LEFT ON SPENCER LAKE RD, I 1 /4 M71F , FIRST RIGHT PAS-I %CHOO1. OFF= ROAD 1509
FT TO HOUSE .
PROJECT NWTE.5c
I,YPE AMOUN1 BY DATE RFI'p._If' F
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MCFE 1.8 ..00 kS I /02 !94 3168'1
M(.'8`:; $ 15 . 00 Kti 1 .1 f N1/u4 3/689 ''_ 7
1'0TAI + i . 00 I?t-JNF 0f? (;I"-NI I? Tt
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NJS_FRNI. rev 64/010197 COMPUTANCE 'TO ATTACHED CONDITIONS IS
REQUIRED
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. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
1-1 iph 1 4 N K) N 11 *1' t 1 0 14 t';.;
Chso No , ° M I %. 44-0929
Vor .- AFRRY RAYMOND
Page -, i
1 ) PUW UANT TO 199L HNIFIMM HOI [ DINO COOF , Si: 1: 11flN 301' ( 1' ) (INI) Al 1 f 1 t M IP,
HAW A141RO1/EA1 NIJMfif:R'-, OR ADDf4 ')Sf."'; pRo%/jr)V1*) IN "�IIVH A fm 11 I (IN A'i 1 1) m I'l A 10 1 'V V 1 111 1-
AND [El"i1fiLf I ROM IHF S1RFF. I OR. ROAD flzcmi fwi t t-i v P tt o r)I, I?I y MA i()N f WIN I Y IM I I t, I NO
DFPAR 1104'1 RFQIJTRV THAT THIS 13F COMPI t• I I D PRYOR 10 CAI I IN6 F 0 R A N Y I It I N 11 Pt 1: 1 1 0 N
P E T Ni P 1, 1 ON F F`f , H A")L D ON P A I 1- 11 1 N I A F1 1,1 3 A OF 111 U. 1,19 1-11 11 N I F 1)R M if if I I It I N11 I o(I 1., 1.11 1 1 11 1'-
ASSF S'-[ D\ I OW F R 11-11N YPAC- I OR FA J.I ti 1 1) PW1 I ADDRE' ON `i I I'l Pli 14114 If) I?I IIII I- I I N 1-i
i N s p I r T, 1 N,")
2) The own'- hall hmve a�,,a i.I a b I P on 4. I te f o r i nt;p p c,t i-o n 1)v Ma1e;on iin t,y a 1,e1)(1rt.
i.11 d i C A V V h-.4 rj Amp a n(1 1, 1 t,o n EY o n timb P r of h e i I i'f;t�.-j I I ern llwr moolint of at I"he
t i ml e (o.) I, V t.i n q a n el t.l enrith of te--:,t t, lnte , f h.1 c r p-p c)t- t t7J#a 1 1 lip (In*Ad by I ho pf'a i fson
d t i the F;he PVC,
X
3 ) 1 f t 11 p tm n ci -Yo i s between 1?S and S00 qml lonc, yoij mijc;t I so I w,,o ijl",--' gill (fe. I i n(-S
C %ICRETE 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 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
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
a I._ar11, i t:.c) h- '10 fdt t. fr()r1t Any his idii.r►r1 , fmi� 1 r ., H .1 1i.ne
1 . Itip t:,tnk iC, r4x.pc)�Rd t�n 11rt)hat, ie vehic111 �-it dAmei(10 , 1)1c)vi +i-
r1"o r: �' ,rF> t►�)l.IardF, .
3 ., Ali tt •. d . „ grASt tirtti.,h4 tr1< h Ar►ci r,t.hZrr• c0fl) )rI tihl matcl ) f�
1�4haII 7)o kp F; 1.r1i111tlrt► of 0 f4�Fp a w a r-om tiNI,
4 ) t,a � �i.AI i r► ai heaLtn6 €gt.t;ipitionL i1► si.ngIN fiwiiIy rs�gici('f1vv 'Alm I1 rn,eo t:h re(luirecm�ttt:
1 14!IF'C: . (he fu -nnc e t o bpi ni.tA I l ptd F:11q 1 t nc)1. o%'c*1Frt1 1 1,01; r, 1 t tip h0a,t;i rtcl
G1ft :i (all iai crr i)r,p,& r1 0 r .glji1 metlt!,Ci f?f t:hAl:,l:pr' 1 (`llrllr3r:Gr c tfit`. ) s�rli':y u;tlr� ll hGt rti
AUIJf- of Ii. h0 f1tl,� "r. ha1. 1 h0 ta1)0d aIed And mtkchAisire� l ly i :v t:Niso,d c.3it:1t A mirlimt.im rrf
3 fA: ttt11 .r 1)4+r c, i. C.►toc? t -. �r;h.1I ! ht> in ttlAt0c1 tc) i t3
=iCRETE 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 by date by date by
I Permit NMI s U 9
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584• 427-9670
PLEASE PRINT
#1 o cc Ph ne# �L2
Site Address
City �x� Q S _St Zip
Directions to Job Site %-� ���� �
Owner Mailing Address CIwN
City St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name Contractor Reg. # r eke27��
Address— c Expiration date
City -St—Zip Phone
#3 Parcel No. 7_71i
Legal Description
#4 Use of building Describe work
#5 Type of Job: New_' 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. Units Fees
_Showers j 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 Stove 25.00
Permit Basic Fee 15A0 j 7 An��
o 0
TOTAL PLUMBING $ ( pc,,t Lc---T—
Permit Basic Fee 15.00
TOTAL MECHANICAL $� w
No Basic Fee for Wood, Gas, Pellet Stove
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.
I
1
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, Sepiic Systems,
Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, c`tc.
I
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRAC-
THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE
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 ALL WORK DONE WILL BE IN
DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
SHALLBE 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 Proposal Proposal
FOR OFFICIAL USE ONLY Approved Denied
Planning:
Building: 1 ,
Vv
Fire Marshal:
I