HomeMy WebLinkAboutBLD13477 Woodstove - BLD Application - 1/7/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �
DATE ISSUED - Dp
3
Sk vtc.11 t 0 0 0- A? /3 q.+�PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
L. n. Barnett EJ60 "ironyuist _to. n11yn,
DIRECTIONS
TO JOB SITE
LEGAL SEE ATTACHED SHEET)
DESC Govt. Lot 2, Section 24;"L, lownsnip 221�, Range 1'Jii
NAME MAIL ADDRESS CITY&STATE LICENSE O. PHONE
CONTRACTOR Dale 0unninE arr r.0. pox. 1015 L�elfair
u 2_7
USE OF
BUILDING rE U iC enc e
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
wood.stove �'_r•epIace Insert
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS__ DECKS_ CARPORT C NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE iJ
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES _ BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE L DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED 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
1 certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES L
SEASONAL FLOODPLAIN u
Firm Chea: l -t
E.D. NO. S.E.P.A. II
By ry Special Approvals IN OUT YES APPROVED NO
Ct� <1r ZONING
Lic. No. /
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
A ICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner -Date.-- 14B
P A HECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH