HomeMy WebLinkAboutBLD11269 Final Wood Stove - BLD Application - 8/25/1981 McMA$TER, M. E. #11269
SE. 1700 Crescent Dr. , Shelton 0 -21-81
South Side Fawn Lake, Div. 4, Lot 17
Wood Stove Contractor - Self
R-0- Wood Stove Permit
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER ME C MAIL ADDRESS CITY 8 STATE ZIP PHONE
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ASl6ee
DIRECTIONS t �l, (� l
TO JOB SITE ���/ 7 of
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ 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
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the F 0 R OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
SHORELINES ❑
conformance therewith. PERMANE
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
BY Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
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{fy that I am exempt from the requirements of the FIRE MARSHAL
act or registration law RCW 18.27, and am aware BUILDING DEPT.
e Mason County ordinance requirements for
h this permit is issued and that all work done will ROAD ACCESS
nforman r O VEHICLE PERMIT
AP I ON EPTED PLANS CHECK BV APPR F SU CE
Date.
BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH