HomeMy WebLinkAboutBLD7250 Final Woodstove - BLD Permit / Conditions - 9/8/1980 TM BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 e .2 7_R0
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY STATE ZIP PHONE
WAI A� LICE sTR7 I �oX- c'7 .W.Al 85r32 2756/�2
DIRECTIONS
TO JOB SITE f/QST TO Aeloll y- &,p 111,4E ' 397.
LEGAL ' (❑ SEE ATTACHED SHE T)
DESCR. T2,09c7 3 y E)r 4 eA
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE l�PE l,�R'f /fsidC ( mot R �SZS!/y� 2� ! f
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
ail IC/C C /f1�/6' •0 v E O OI:;(
Valuation of work: $ / PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
j
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
TOTAL SQ. FT. FIREPLACE ElDETACHED ❑ OR AIR CONDITIONING.
CONTRACTOR AFFIDAVIT THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
/ / L�` SEASONAL ❑ FLOODPLAIN ❑
Firm h�f
E.D. NO. S.E.P.A. ❑
ByI Special Approvals IN OUT YES APPROVED NO
Lic. No. "� '�#' st �� Date 'L6" 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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance t rewith. MOTOR VEHICLE PERMIT
Own (CATION ACCEPTED BY PLANS CHECK BY JaR D FO UA
Date.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
i
Kralicek, Ann
#7250
8-27-80
lst road o right up hill at "Y" going to Belfair
Sam B.Vller's Home & Garden Tr. - Tr. 34 ex
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R/W
flood Stove Contaactor
Belfair Fireplace
� /�-/�-d �' --_
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