HomeMy WebLinkAboutMIS94-0929 Propane - MIS Permit / Conditions - 11/2/1994 MASON COUNTY PERMIT
Mason County Bldg. III 426 W. Cedar NULL S VOID BY 7ZATION
P.O. Box 186 Shelton, Washington 98584 DATE BY
MT !3CIF_ L L. AP4FOU !:6, RVRMI' T" IOP INd`! I IION'• Chf 1 4Zr. 9670
.111H (h )DRI .', E 880 SPFN . Rn SHFL TON
API}1 If hil1 .TERRY RAYMOND 4 6 -1010
(7LJNf.1 J RRY RAYMOND 426-4010
I 1 6AI 1A 1 11 SY SF FS #9206:A-1
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TO PIONEER SCHOOL . LEFT ON SPENCER LAKE RD. 1 1 /4 M11 F , FIRST RIGHT PAST -CHOOL. OFF ROAD 1600
Ft TO HOUSE .
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NIS Pill, rev! 14191,47 COMP1:IANCE "TO ATTACHFO 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
C A s P No ti 1 4 4-.0 9 9
Fil If PRY RAYMOND
I > P 11 P S I I A N T 14) 4 991 It N I F')R M H 11 1 l 01 N 6 C 0 11 F of i I 1 1)N 3 0 N '• I Al I ':� I I'I. M U'I
RAVE' A 11 t'P 1)V t D N 1)M H F RS OH A L)1)R I S S f.-", P R 0 V 11)F D 4 N S I I CH A 1)O'S I I I N A'; 1 4) ti I I'l ok I N I Y v I !�')I H 1. F
AND I Lli -IHI V f R 0 M I H F c;I R F F 1 0 R R 0 A 0 f P 0 N I I N(i 114 F P R 0 P U R I Y MA!-;OH i,O11NIY W1 I tj I W.'s
W.'PAR11041 kFOUIRFS THAI f111 's HE COMPIt' ITP 11P IOR F0 CAI IINH F'OR ANY N P[- C, T 1,0 N'y A
R F I Ws P 1.0,T\0 N F-F E . IWILD ON PAI'(- S IN TABLE 3A OF 1`14C 1 ')91 HNIFORM HIJIIHIN(, f I f" W-I I I H E
A!;'3FS3J IA I ' O(JNf'R I OR FAII S 10 M CA
N N `11 I I I'li 1 014 1 1) I OtIF I I NO
T N�-,P 1'C T W',>
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The own'- hal 1. have avail able (in �. I. 1'--p for incpoct ion I)v mm ;nrl I '11110Y ' ri r,«?port-
h I(I j CA I- 1-1h� namo anti [ Atl-owp mimber, of i",he tns'talter „ 11w m1folli'll ot At t1w
tifllo ot U�v t. inq andrvnrith of tsy-.-,t. ii me f hi t p p c)t t Ha I I I i (I by 4-1
01.1 d 14(-.t;i I I q� the.
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If thy,Io t m n c-1 A(ld C)OO (jai 1.01.1c, yoll mllc:l 1411 1 ,11-0
-'�`b;RETE 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
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
I T'Ank i to be '10 feet from Atiy boidlAtiq . ptihlir: way o; property o
2 , 'the tank is exposed to prohmble vehictilar dAMatip. , provide
vp hollard-, .
p V, p c *
3 . Al I w , f+q . drays . brush . tri-i4;h At'id other combustible iimforfml
-hall ;)p kp t' nimum of 10 f7per, away from IP contAjnerts
4 ) Twst,'alllal.i n of hpnLinol e(ji.lipment. iii sinq] (o, fmidly rvRjdenc*—� meat: Clip
o f the I I I W&C -1 fie fil rnace to he i rmta I I od F.11.1 I I r1r)1, ovs,*)erl I flol; o I' thy! 110at i n(I
d w;i n '001 C)1- prPs r o V,f?9 11 i r emp-ti t'q (W a �l r f (1r11Ac'q e f f i(- i �;JIA I I be dt
- D11 A F U 1, oi i i h r I Pli Arld 11100 hA11 i C el I I y il%4"R1100(j 1A t.11 A Mi rj i Mill be tApfld
3 1-a t 11 r lij c vJuil I bra I w,ti I A I o(I to P.-H
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
I Permit N61 tl S t U 9`) Q
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASE PRINT
#1 O Ph ne # 6'112� G1 O
Site Address Q G `� Ph
St Zip
Directions to Job Site _7 ►P%��,r� /���� �,t� 0�--
Owner Mailing Address
City St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name Contractor Reg. # r fie
Address Expiration date
City St Zip Phone
#3 Parcel No. 7-24 3 I - LJ3 OZ-1010
Legal Description r1 S`(.r� 5 E,
#4 Use of building V Describe work
#5 Type of Job: New_< —Add 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 Furn BTU L_f��
_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 15.00 j 7-oqr-/< (,
ab
TOTAL PLUMBING $ 1 r)Lt Z_
Permit Basic Fee 15.00
TOTAL MECHANICAL $S'�
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.
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, Septic Systems,
Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, t`tc.
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:
i
Receipt No. Referred To
DEPARTMENTAL REVIEW Proposal Proposal
FOR OFFICIAL USE ONLY
Approved Denied
Planning:
Building:
Vv
Fire Marshal: