HomeMy WebLinkAboutBLD18040 Woodstove - BLD Permit / Conditions - 10/8/1985 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. 'Izd�D
OWNER NAME MAIL ADDRESS CITY 3 STATE ZIP PHONE
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DIRECTIONS
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LEGAL 1 (❑SE ATTACHED SHEET)
DESCR. Lo r I 1 1 SI
CONTRACTOR NAME(► MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF t
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
1
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
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SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
NO. OF STORIES BASEMENT ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
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
ordi ance requirements regulating the work for which
the permit is issued and all work done will be in
co formance therewith. PERMANENT ❑ SHORELINES ❑
SEASONAL❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. 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
AP (CATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner,.. 1 0 h Date.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. Cj6H
CHRISTMASTOWN PRINTING
MASON COUNTY
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.
1.
Owner
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicant Address Application date
LEGAL DESCRIPTION
Location
Of
Building
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS
BATH TUBS
SHOWERS
WATER HEATERS
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 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 Reoelpt No.
$
/�040
CHRISTMASTOWN PRINTING
TYPE WOODSTOVBMOM
Permit No. 18040 No. Floor$ Sq Ftg
Owner BAKER, Donald Tel 275-4251 Date 10-8-85
Address NE 120 Larson Lake Rd. Belfair Zip
Contractor Self
Address Zip
Legal Description Beards Cove Div, 2. Lot
Direction to project site Down North Shore left on Larson
Lake up to first blue house on right
Plumbing X Mechanical Sewer Wood Stove X
Fireplace Deck Garage Carport
Basement Loft Other
Installing new water heater in order to run pipes through
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