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HomeMy WebLinkAboutBLD9969 Final Wood Stove - BLD Permit / Conditions - 10/7/1982 BUILDING PERMIT APPLICATION MASON COUNTY ' P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME 6 YNJ MAILl�DDRES$,R 7 CI /� C .- 0 ', ! ZIP L PHONE OWNER DIRECTIONS 1iCr'77 ��!!V W TO JOB SITE J❑ S),E ATTACHED SHEET) LEGAL DESCR. AIL Aal— DDRESS CITY 3 STATE LICE NO. PHONE 'M� NAME CONTRACTOR USE OF BUILDING Class of work: KNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEE O 1 SPECIAL CONDITIONS: v 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 SO. 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 FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in PERMANENT ❑ SHORELINES ❑ Conformance therewith. SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No. 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 conforman, a therewith. MOTOR VEHICLE PERMIT C Q APPLICATION ACCEPTED BY PLANS iECK BY APPROV FOR ISSUANCE Owner Date, 3 T P N CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH HLmilton,' A. C. #9959 275-3596 10/5/82 Lot 3, Division 8, Lakeland Village Allyn Wood Stove Insert Contractor: Cheap Heat Wood Stove Permit 6 c y a o ' lu a � w w �cc Hw � �" � w