HomeMy WebLinkAboutBLD16543 Cancelled Woodstove - BLD Permit / Conditions - 3/1/1985 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �
DATE ISSUED '�
PERMIT NO.
CITY 8 STATE ZIP PHONE
NAME MAIL ADDRESS _
OWNER
DIRECTI
TO JOB SITE
35; 34:; 36/9 0.. 37 (C SEE ATTACHED SHEET)
LEGAL _
DESCR. ` .- PHONE
NAME
MAIL ADDRESS CITY 8 STATE LICENSE _ ?73_
CONTRACTOR d''.
O - O/ �- 9� -22
USE OF
BUILDING
Class of work: SEW ❑ AD ITION ❑ ALTERA ❑_REPAIR_ C MOVE_ C,R_
Describe work:
Valuation of rk: $
PLAN CHECK FEE PERMIT FEE /`...
SPECIAL CONDITIONS:
BEDROOMS— — IDECKS CARPORT NOTICE
BATHROOMS _ - TOTAL SO. FT. GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING. VENTILATING
NO. OF STORIES_ BASEMENT fl
ATTACHED OR AIR CONDITIONING.
TOTAL SO. FT.- - FIREPLACE C
DETACHED C 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 FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
WORK IS COMMENCED.
I cer fy that am a currently registered contractor in
the late of Washington and I am aware of the FOR OFFICE USE ONLY
ord ante requirements regulating the work for which
th permit is issued and all work done will be in PERMANENT I SHORELINES '.
c nformance therewith. SEASONAL [ FLOOOPLAIN -
E.D. NO. S.E.P.A.
Firm '
J � Special Approvals IN OUT YES APPRO
ByVED NO
- Date _/�' ZONING
Lic. o.— 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 conformance therewith. MOTOR VEHICLE PERMIT
LICAT ACCEPTED By PLANS GHECK BY APPROVED FOR ISSUANCE
Owner_ —_ Date . - /Z`E .
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK. M.O. CAS
JOHNSON, Jack #16543
3-1-85
Sam B. Thelers Home & Garden Tracts
Tracts 35,06 36-A & 37
NE 23221 Hwy 3
Belfair 98528 275-8112 Contractor
Cheap Heat
Woodstove
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