HomeMy WebLinkAboutBLD12957 Wood Stove - BLD Application - 9/7/1982 BUILDING PERMIT APPLICAT►ON
MASON COUNTY
P.O. Box 186.° Shelton, Washington 98584
-426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME - MAIL ADDRESS CI BSrATE 1 ZIP - PHONE,-
DIRECTIONS -
TO'JOB SITE _ - - - -
LEGAL //�� /� ] JO SEE ATTACHED HEEn
DESCR. 33 '"oG l.. y I r / 'G ..
NAME MAIL ADDRESS CITY STAT - - LICENSE NO. PHONE
CONTRACTOR � �.IO rG" r _ � - S 3
r
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR. ❑ MOVE ,11 REMOVE -
Describe work: t 14 j
1401
Valuation of work: $ PLAN CHECK FEE PE MIT FEE
SPECIAL CONDITIONS: - - - - -
BEDROOMS DECKS CARPORT ❑ . - NOT I C.E °.,-
BATHROOMS TOTAL SO. FT._ GARAGED
ATTACHED ❑ SEPARATE PER MITS•ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES_- BASEMENT ❑ _ OR-AIR CONDITIONING. -
TOTAL S0. FT, .FIREPLACE D DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF�,WORKO P CONSTRUCTION AUTHOR-
CONTRACTOR-AFFIDAVIT - IZEDIS NOT COMMENCED WITHIN,180DAYS,ORIFC NSTRUCTIONORWORKIS
SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANY TIME AFTER
the St Curequirementsg and Ig am aware of In. WORK IS COMMENCED. -
I certify that I am a currently registered contractor - - '
the State of Washington � the
re ulatln the %Workforwhich -- FOR OFFICE�USE ONLY
the permit:Is Issued and all work done will be in
conformance therewith. PERMANENT Cl' SHORELINES ❑
SEASONAL ❑ .FLOODPLAIIN❑
Firm _ E.D. NO.
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 ACW 18,27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
Which thispermit is Issued and that-all work done will ROAD ACCESS
be in conformance therewith. - [MOTOR VEHICLE PERMIT
P ]CATION AC PT E Y PLANS CHECK BY A OVER FOR I SUANCE-.
Owner "Date .
P CHECK'VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. - M.O. CAS