HomeMy WebLinkAboutBLD13137 Fireplace - BLD Application - 10/11/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
MDESCR.
WNAME MAILoADDRESS CITY&STATE ZIP PHONE
� lc... Z Ll/L;' ' 1 �l ��12_��`, 7' d/,-iZ
(❑ SEE ATTACHED SHEET)
CONTRACTOR ^NAME MAIL ADDRESS / ! CITY&STATE LICENSE NO. PHONE 9 i
�, J/ -)
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS �(_r�� CARPORT ❑ NOTICE
BATHROOMS Z TOTAL SO. FT. GARAGE i
il NO. OF STORIES BASEMENT' ATTACHED L SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
TOTAL SQ. FT. �'�' FIREPLACE. ' OR AIR CONDITIONING.
DETACHED L
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
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
Firm
SEASONAL C FLOODPLAIN
-
E.D. NO. S.E.P.A.
By Special Approvals IN OUT YES APPROVED NO
Lic. No.— 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
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 7/'
with.
f� MOTOR VEHICLE PERMIT
( G - - L L� y��— LICATION ACC�TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owne Date
P CHECK VALIDATION CK. M.O. CASH U ORMIT VALIDATION K. M.O. CASH