HomeMy WebLinkAboutMIS94-00950 Cancelled Propane - MIS Permit / Conditions - 2/10/1999 MASON COUNTY
Mason County Bldg. III 426 W, Cedar OP
P.O. Box 186 Shelton, Washington 98584
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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 b
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by dame by date by
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MASON COUNTY
Mason County Bldg, III 426 W, Cedar
RO, Box 186 Shelton, Washington 98584
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O, Box 186 Shelton, Washington 98584
Permit No.
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 • 427-9670
PLEASE PR��T 0
#1 Owner ( C'r. " 4 LJI- n C)()A Lt_)CAJ'(� Phone#
Site Address {�</R1 �r� C6- ✓cl
City �a I C a St CSC' Zip C`I 5';0��
Directions to Job Site
Owner Mailing Address
City St Zip
Lien/Title Holder 11 r.L-0 n _lL c lc.A,
Address I!' t-)��� ' �� -Al,
city St �C )/c S Zip 61I`6
m 3$ 3
#2 Contractor Nae 4►'� 0.S Contractor Reg. # �� K4
Address c LA Expiration date o
City St 6- Zip C7&Sa Phone- 3-7
#3 Parcel No. -
Legal Description c 2 l `l LX OQ
#4 Use of building Describe work
#5 Type of Job: New v"'- Add Alt Repair
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ( 6 each)
No._Toilets CIRCLE FUEL TYPE. Ga •Electric,
_Bath Basins Heatpump, Other
_Bath Tubs No. Units Fees
Showers �' Furn BTU
vHot Water Htr ✓ Heatpumps
_Laundry Washer _ Vent Systems
Sinks _ Spot Vent Fans
_Floor Drains LL Boilers/Compressors
_Laundry Basins HP
_Dishwasher No. Air Handling Units
Disposal cfm#
Urinals Other
_Other_ Gas Outlets
Wood, Gas, Pellet Stove
Permit Basic Fee 15.00
TOTAL PLUMBING
Permit Basic Fee 15.00
TOTAL MECHANICAL $ °-0-
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.
AVOW
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 FEQUIREMENTS OF I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRAC-
THE CONTRACTORS REGISTRATION LAW I3CW 18.27,AND AM TOR IN THE STATE OF WASHINGTON ANC I AM AWARE OF THE
AWARE OFTHE MASON COUNTYORDINANCEREQUIREMENTS ORDINANCE REQUIREMENTS REGULATING THE WORK FOR
FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK WHICH THE PERMIT IS ISSUED AND ALL VV::)RK DONE WILL BEIN
DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE
SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL I ROM 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, Slhelton, WA 98584 • 427-9670/1-800-562-5628
r
FOR OFFICIAL USE ONLY: Accepted by: • l � �— Date:_ %C`
Receipt No. Referred To
DEPARTMENTAL REVIEW Propo al Proposal
FOR OFFICIAL USE ONLY
Approved Denied
Planning:
Building:
Fire Marshal: