HomeMy WebLinkAboutBLD11228 Final Fireplace Insert - BLD Permit / Conditions - 8/25/1981 4 V
-BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED-
PERMIT NO. r��O
OWNER NAME MAIL ADDRESS , LJ�CITY 8 STATE ZIP PHONE
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DIRECTIONS 1••
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DES 4,2 7
NAME MAIL ADDRESS CITYA STATE LICENSE NO. PHONE
CON ACTOR ABITZ CUSTOM FURNISHIN01
I
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USE OF Shelton,WA 90584
BUILDING (206) 426-1928
Class of work: X NEW DDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Put I, i Rujoicam4in Fireip laae0
AdAd
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [I ATTACHED AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ I 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 am 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
ormance therewith. PERMANENT ❑ SHORELINES ElABITZ 69TOM FURNISHINGS SEASONAL ❑ FLOODPLAIN ❑
FirRt• I, Box 185 Fredson Rd.
D. NO. S.E.P.A. ❑
By ,1 AAt_-426-1928 Special Approvals IN OUT YES APPROVED NO
Lic. No.$C-I 1'Z C F fa 1,/ M I( Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT
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
ICATION AC PTED Y PLANS CHECK BY APPROVEDjQ41SS6UANCEOwne Date. ,7Y/—�
PLAN CHECK VALIDATION CK.. M.O. CASH V PERMIT VALIDATION �,M.O. CASH
Hawks, Carl _ #11228
8-17-81
Phillips Lake Div. 5 ITs. 26 & 27
YBS 2250 Phillips Lake Loop, Shelton
Fireplace Insert Contractor
Abitz Const
9
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