HomeMy WebLinkAboutBLD11794 Fireplace - BLD Permit / Conditions - 12/1/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER �O{a- I'-,tiT- i, !F l L- N (�' l :�y I -E: :-
DIRECTIONS
TO JOB SITES--
LEGAL G� (C SEE ATTACHED SHEET)
CONTRACTOR NAME MAIL ADDRESS &STAYIE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION QALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
r-.
Describe work: 77
Valuation of work: $ PLAN CHECK FEE PERMITE
S"
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS ITOTAL SQ. FT. GARAGE
ATTACHED i'J SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED Cl
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 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
SEASONAL ❑ FLOODPLAIN f
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
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
f` AP LIGATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner: ` Lam' ' ._.; � Date .1�, ' /�c� // B tl
t
Pk AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Knight, Richard A. #11794
(275-6305) 12/1/81
Lot 1 - 10 , Block 43, Allyn. tHouse on Lot 10)
131 Wade Street, Allyn.
Wood Stove Contractor:
Belfair Fireplace Shop
�__ Wood Stove Permit