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HomeMy WebLinkAboutBLD0470 Woodstove - BLD Permit / Conditions - 12/3/1986 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED 11 Lz) !E L 75'- .2 PERMIT NO. O L/ / 0 OWNER N E �ADDRESS CITY SSTATE ZIP PHONE ASS asS.4,v /T,C44Q D LOA E5'6'i/ Ww 340 2 .t5'��fi,¢,� 9YS2 DIRECTIONS If TO JOB SITE LEGAL DESCR. 491-YlPlP/G ,S#419 .kr A/ /SDI r TR 16 G ex R14c-1 NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR CL USE OF ��S fA�� BUILDING G� CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ I T DESCRIBE WORK BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES _ BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTALSQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS A IDAVIT CONTRACTORS AFFIDAVIT I CERTIFY AT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRA ON LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIR ENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CO ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAI NG APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X WNER �44"V'��ATE X BY DATE FOR OFFICE USE ONLY DEPARTMENT YES SPPROVENo DEPARTMENT YES No BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT /S C7 a D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP 3 PRE-INSPECTION SHORELINE PLANNING PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY P C �BY APPROV D F R I UANCE PERMIT VALIDATION LGL BY CASH CK MO TOTAL TYPE WOODSTOVE Permit No. 0470 No. Floors Sq Ftg Owner RASMUSSEN, Richard 0. Tel Date 11-25-86 Address E 5511 WY302 Belfair Zip Contractor Self Address - zip Legal DescrTiption Olympic Shores' N 150' Tract 16 Direction to project site Plumbing Mecbanical Sewer Wood Stove Fireplace Deck Garage Carport Basement Loft Other Shorelines: Plumbing: Setback: ical: Mechan Special Interior: Conditions: FINAL: Mobile Hoare: � Smoke Detector: Remarks: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: