HomeMy WebLinkAboutBLD10121 Final Wood Stove BLD2146 SFR BLD19492 Final Garage/Workshop - BLD Permit / Conditions - 3/2/1981 Please make check BUILDING PERMIT APPLICATION
payable to Mason Co.
T u you.
Thank you. MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
MAIL ADDRESS CITY&STATE ZIP PHONE
NAME Q
OEO
A) A O
NS
^hy/le so. o Y" AlA�eSTd'vca IS-Ctc�9�° - TuR�v .L a fT
ITE e Cie e da wa 7'
(❑SEE ATTACHED SHEET)
' ,,, PHONE
fit.
NAME
MAIL ADDRESS CITY 8 STATE LICENSE NO.
TOR
Class of work: ElNEW ElADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Wood Stove
PLAN CHECK FEE PERMIT FEE
Valuation of work: $ _0_ $15.00
D / j
ox- NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIONING.
(� THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
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
WORK IS COMMENCED.
FOR OFFICE USE ONLY
'ERMANENT ❑ SHORELINES ❑
/l FLOODPLAIN ❑
f (J '.D. NO. S.E.P.A. ❑
/ Special ApMDEPT.
OUT YES APPROVED NO
BONING
)LANNIN
-IEALTH`3! � ��/ PUBLIC v'� 6� =IRE MA
BUILDING DEPT.
ROAD ACCESS
MO OR VEHICLE PERMIT
APP ICATION ACC PT D BY PLANS CHECK BY APPR ED FOR IS
BY
1
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BUILDING PERMIT APPLICATION
MASON COUNTY
/7,P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO. YIe
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
F• o J
DIRECTI S w
TO JOB SITE /, s-
LEGAL (❑SEE ATTACHED SHEET)
DESCR.
, &"-f44 &A)
NA E MAIL ADDRESS CONTRACTOR CI 8 STATE f LICENSE NO. PHONE
USE OF
BUILDING
Class of work: IN NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE ib
l 7 01 o
SPECIAL CONDITIONS: - �
ou
APPLICATION ACCEPTED BY PLANS CHECK BY APP8OIVED FQR ISSUANCE Type of Occupancy Division
BY \)Qd'(If Const. Group
Size of Bldg. No. of Max.
(Total)Sq. Ft. 7 S6 0 Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I Certify that I am a currently registered contractor in RESIDENCE x
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be;Lnformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
"f(/ SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner ` ` ��� Date. y / O WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT—Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
Owner yyJ p S e >2 . 98yoy Co 7
2. S� F
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature,91 applicant Address Application date
LEGAL DESCRIPTION
LocationOf
9 /�
Building `s
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS �.•—
BATH TUBS
SHOWERS
J WATER HEATERS a,
J AUTO.WASHERS _
SINKS _
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT s SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.
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