HomeMy WebLinkAboutMIS96-0059 Final Pellet Stove - BLD Permit / Conditions - 2/5/1996 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M 1 :E3 C F 1— 1— A N E t7 U p 1..7 F"t m I 'F FOR I NSPFC'T 1 ONS CALL 427-9670
MI396-0059 PARCEL s 1233i511P10012 PLA1 .BEPL_O DIV : BL.K : L.OT s 12
JOB ADURES'S Y NE 1031 L_ARSON BLVD. RELFAIR
APFI_ I CANT . MIKE JOHN'.:ON 275—82.87
OWNF..R s MIKE JOHNSON 275--828T
LEGAL. s BEARiIS COVE DIV 1 II i LOTs 12
PROJECT I)ESCR I PT I ON s
PELLET STOVE
PROJECT 1. (',CAT I ON :
FROM kt -FAIR TAKE HWY 300 TO SAND HILL. AD. , R I rl-IT ON SAND H 11.L.. TO L..ARSON BLVD, LEFT. ON L ARSON
BLVD. , FOLLOW [ARSON BLVD , FOR 3 i 4 TO i MILE; ME 1031 IS A SALMON COLORED HOUSE ON THE LEFT 31 DE
OF THE. ROAD .
PROJECT NOTES :
TYPE AMOUNT BY DATE RECEIPT
WEST $ 25 00 NJP 02/02/96 08:37
LT
OTAI. 25 .00 OWN R pR A(�E T t)��.TF
NI5_►1Nf, r!�; 11I1I192
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date :Z by date by
I
MASON COUNTY ASS �^�
r �� 9&
MISCELLANEOUS PERMIT APPLICATION /
426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670 0-k Z S
PLEASE PRINT
#1 Owner Phone# Fire District#
Site Address City
Mail Address
City —St Zip -
Applicant Phone #
Applicant Address,,,,
City St Zip / n
Directions to Site:
_Zel? nr pAr 1314 13/1&� />-i& Ali 1031
da sl QZ2 ,l G!1 SIcYG W fhc /nd i
#2 Parcel No. -,r 3 / - -6-f - �Onn 12
Legal Description /of zz, e,ords` �ovc /yo 8� VOL1021 9Of P/A 5 p4s. Z16 1yg
rcc0� S OfMosa Cer,n7y, �stit�:
#3 Indicate by circling the applicable source if any water is on or adjacent to the property site:
saltwater lake river creek stream pond wetland seasonal runoff marsh other
#4 Project Start Date /-3/ �6 Project Completion Date
#5 Use of Buildiing Re-r°s/We"9/S Describe propose Mc�64riA n 2sfio%.oftHn
K%
Jy
A
�w w,
'Depending upon the type of permit,a floor plan and plot plan may be required. •�
'This permit is valid for 180 days from the date of issuance.
a
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON-
MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT-
ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND
IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE-
FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST
WITHOUT FIRST OBTAINING APPROVAL FROMTHE BUILD- OBTAINING APPROVAL FROM THE BUILDING DEPART-
ING DEPARTMENT. MENT.
X OWNER �/� / X BY
DATE DATE DATE
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Wells
Water Lines Shorelines
Drainage Plan Easements
Septic Systems . Name of Fronting Street Indicate directional by
Proposed Improvements Name of Flanking Street N, S, E, W etc.
PLOT PLAN AREA
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY
Planning APP COND APP HOLD
Building
Fire Marshal
Other
Special Conditions Fees
Permit Fee 7W&f-S�vi � � c1'
Plan Check
Other
Other
State Building Fee
TOTAL DUE $ < <>>