HomeMy WebLinkAboutMIS94-00296 Final Propane - MIS Permit / Conditions - 5/3/1995 MASON COUNTY
Mason County Bldg. 111 426 W, Cedar
P.O. Box 186 Shelton, Washington 98584
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Footings-Setback date �C by. Ribbons
date by Gas Pipin date b
Foundation Walls date 7' b 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
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date 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
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
RO. Box 186 Shelton, Washington 98584
I
Permit No 1S
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
• 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASE PEINT
#1 Owner ? Phone#
Site Address F 1 e-
City 5 / A. St Zip
Directions to Job Site �L-Z& e�
Owner Mailing Address / r
City -S , St Zip � �, �-
Lien/Title Holder
Address
City St Zip
#2 Contractor Name "-/MXe « � Contractor Reg. #
Address ,�, ,n 5 z,n Expiration date
City —� _ St Zip Phone ZZ 7 '� .31//
#3 Parcel No. - -
Legal Descri io Mlt SE u�.
TGildi �..L.,.
#4 Use of bung Describe work 1_2-? !Z�)a C'
y
#5 Type of Job: New v 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. Unija 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
0 Other e _� -- 'f Gas Outlets v�V
Wood Ga Pellet Stove 25.00
Permit Basic Fee
TOTAL PLUMBING $�
Permit Basic Fee IZ.00
TOTAL MECHANICAL
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
ime 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 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, etc.
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
AWAREOFTHE 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
SHALL BE MADEWITHOUT FIRST OBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDIN E ARTMENT. DEPARTMENT.
X OWNER W l X BY
DATE Vam I DATE
Return permit : Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 . 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY: b Accepted : Date:
P y-
Receipt No. Referred To
DEPARTMENTAL REVIEW Proposal Proposal
FOR OFFICIAL USE ONLY Approved Denied
Planning:
Building:
Fire Marshal: