HomeMy WebLinkAboutMIS96-00906 Final Propane - MIS Permit / Conditions - 1/14/1997 MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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MIS96-0906 11Ar,rr.i ?�t1-4r,m mn,i Al Ai- -RAPLO DIVt BLK : LOTS
JOBR!1DRESS ' .'; ['``Q; �b Pj
APPi. I CANT : A; GsE I ER ( 426-4 i.. 1
OWNEP, : AL.AN OE 1E'.R 4.26--4591
LEGAL. t RAINBOW IAIE TO 51
PROJECT DESGP I PT I ON .
PROPANE: TANK, GAS STOVE
PROJECT LOCATION t
HWY 3, LEFT ON MASON LAKE. RD. LFF-T' ON RAINBOW LAKE (I?AkNPOW DR) , FOL.I.OW ROAD -FO SPLIT "Y", TAKE
THE RIGHT TO ADDRESS . SLUE ANr) WII I TE HOl1SF
PROJEC i" NOTES t
TYPE AMOUNT PY DATE RFCFIPT
...^.-x:F.ncliT.vc•:$aea'.'1�T:%Rt=Rzb:c".$'Jex»_ars.9e".�:..r^x:ra�laes.•z:.:lmva'sa:.aV'.ls
MCFC 5' 45 .00 KS 12l2319f, 43681
lv1GHS g 1fi F 12/23/96 4,1681 �.
TOTAL : 61 .25 OWNEF OR AGENT DATE
NIS_PIMT, reu; 441/IIS2 COMPLIANCE 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 FRAMING by date by date by
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 /-/!r- F 7 by date by
JAF
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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3 . AI Gaye No . i MIS96.-0906
sha 11 For : AL.AN (alp I k R
_ Page r 1
1 ) PUHSLIANT 1'0 1991 UN 1 f'"OPM BO I L D I NG CODE , SLCT I ON 305(C) AND SECT 1 ON 513 , ALL SITES MI_S t
HAVF APPROVED NUMBERS OR ADDRESSES PROV I DEf) IN SUCH A POSITION AS TO BE PLAINLY VISIBLE
A ► CONST� AND LEGIBLE FROM THE. `}'TREF l OR ROAD FRONTING THE PROPERTY . MASON COUNTY BU i LR 1 NG
DE Pfi,Rj DE PARIMENT REOU I RES THAT THIS BE COMPLETED PRIOR 1`O CALLING FOP. ANY SITE INSPECTIONS , A
RE I NSPE CT I ON FFE . ERASED ON RATES IN TARI. F "A Of' THE 1994 UNIFORM BUILDING CODI WILL HE
ASSF 5 Ef3 1 F OWNER/CONTRACTOR CONTRACTOR FAILS TO POST AL1DRC;SS ON SITE PRIOR TO REOUEST I NG
i NSPEt,"f IONS .
X
2. ) The owner shall have ava l l ,+b l e can site for inspection by Mascorl County , a report
Indicat Ing the name and 1 lcense numbor of the instal lar , the amount or pressurf! at the
time of to># I nc1 and the length of test t ime . This report sha 1 I be signed by the pernon
conduct i ng the test .
M'-i"No.
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASE PRI!�T
#1 Owner f��cia Zr /z!f Phone#
Site Address Asa 'Z,,7�,�,
City SL,e 17'0,--) St 4'Zq. Zip 9BS8��
Directions to Job Site - a -
w c✓ ac�
Owner Mailing Address
City St Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Name Q/vn,o,a r�o�ae e Sjv,o 1,4 / .�cmG ���/ Contractor Reg. #
Address Expiration date
City St Zip Phone
#3 Parcel No.qaI314
Legal Description Lk
#4 Use of building Describe work fT�(�q
#5 Type of Job: New Add Alt Repair
Plumbing Fixtures ($3.25 each) Fee Mechanical Fixtures ($6.50 each
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
Bath Tubs No. Units 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
_Other Gas Outlets
Wooc�as,,Pellet Stove 32.00
Permit Basic Fee 16.25
TOTAL PLUMBING $
Permit Basic Fee 16.25
TOTAL MECHANICAL $- Ui-��
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.
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.
Ni U
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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 WITH UT FIRST OBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEP TMENT. DEPARTMENT.
X OWNER / �> X BY
DATE �G. /�/7 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:
Fire Marshal: