HomeMy WebLinkAboutBLD11493 Woodstove - BLD Permit / Conditions - 9/29/1981 Tobey, Alv in #11493
9/29/81
Tr. 3 B of Govt. Lot 1, 8-21-1
Grapeview Loop Road, Across from Firehall.
Wood Stove Contr actor
Self
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DING PERMIT IPPLICATION
BUILD
ING
MASON COUNTY
p.0. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED L�9
PERMIT NO. "
ZI PH NE
CITY&STATE .�
NAME MAIL ADDRESS ;
OWNER D t
DIRECTIONS CV49
p (❑ SEE A TTACHED SHEET)
TO JOB SITE ire
C fr��t LJ►e dD iW
LEGAL o VQ1,h � - L�rf' PHONE
DESCR. CITY&STATE
LICENSE NO.
MAIL ADDRESS
NAME
CONTRACTOR
USE OF 5..�.��. Q,
BUILDING CrbGrGV'
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
jkv`
PERMIT FEE
PLAN CHECK FEE _(
Valuation of work: $
SPECIAL CONDITIONS:
NOTICE
BEDROOMS----- DECKS_-------
CARPORT ❑ HEATING, VENTILATING
TOTAL SO. FT.
GARAGE ElSEPARATE PER
ARE REQUIRED FOR PLUMBING,
BATHROOMS- ATTACHED ❑ OR AIR CONDITIONING.
EMENT ❑
BAS DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WO
NO. OF STORIES.- RK OR CONSTRUCTION AUTHO -
TOTAL SO. FT.
FIREPLACE ❑ IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION TIME AFTER
OR WORK IS
CONTRACTOR AFFIDAVIT SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY T
WORK IS COMMENCED.
1 certify that I am a currently registered contractor in FOR O F F C E USE ONLY
the State of Washington and I am aware of the or which
ordinance requirements regulating the work f NT ❑ SHORELINES ❑
PERMANENT the permit is issued and all work done will be in FLOODPLAIN ❑
conformance therewith. SEASONAL❑
S.E.P.A. ❑
E.D. NO• OU7 YES APPROVED NO
Firm Special Approvals IN
By ZONING
Date PLANNING DEPT.
Lic. No.
HEALTH DEPT.
OWNERS AFFIDAVIT PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
BUILDING DEPT.
contract or registration law RCW 18.27, and am aware cements for ROAD ACCESS
of the Mason County ordinance
which this permit is issued and that all work done will MOTOR VEHICLE PERMIT PLANS CHECK BY APPROVED ISSUAN,
be in conformance therewith. _ APPLICATION ACCEPTED BY B
Date.
Owni r CASH
PERMIT VALIDATION K. M.O.
M.O. CASH
N CHECK VALIDATION CK.. w ..,,.,.... �- ... .�.