HomeMy WebLinkAboutBLD13403 Wood Stove - BLD Application - 12/20/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
6� 7tN OOWNER MAIL ADDR SS CITY 6 STATE ZIP 6ONE� oSh
DIRECTIONS ��*eP- CP05SIkIP 614i a 10-0 1 ice!-STPitG
TO JOB SITEI hey- f Strop fct.Kc it Ko+ketr a&tJ 9,0 L *V 041 kekSee
LEGAL �/C / (❑SEE ATTACHED SHEET) ~'
DESCR. ��i /Y L I IV 4 �l W er 2`T�/ —� o Z
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING /-(O NN- 1✓
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
woo id s-ro ve, h ea t, Y('c k c
Valuation of work: $ PLAN CHECK FEE PERMIT FEE*/6. oa
i U
SPECIAL CONDITIONS:
I
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ 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
WORK IS COMMENCED.
I certify that I am a currently registered contractor in
the State of Washington and I am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
s the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm 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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in onformance therewith. MOTOR VEHICLE PERMIT
Zo 8 Z LIGATION ACCF�jFyE 8Y PLANS CHECK BY APPROVED SUANCE
Owner Date. v7X1/U BY
PL N CHECK VALIDATION CK. M.O. CASH RMIT VALIDATION 6K-,l M.O. CASH
MASON COUNTY PLANNING DEPARTMENT
P.O.BOX 186 Sheltgn,'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.
�. ass, E. I&SO #,%1-f X . S. qZ 6 72
Owner
e ,Eo �v
2.
Contractor N c Ke—
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature applicant Address Application date
E. /bSD
EGAL DESCRIPTI
arceI W 3 Tie we t- NE
Location
Of
Building Al.W. S�e L, , . 2,0 N Z 2 WA
NO.. PLUMBING FIXTURES FEE
WATER CLOSETS ty'A
BASINS
/ BATH TUBS Q'a
SHOWERS CU► y R d• N
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
t
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer �f
dl
DISH WASHER
DISPOSAL A. TaL µ
URINAL it Mw ION
s shwtoFi:
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s•Tahk�►
TJra,`H
F�et�lh
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT db SKETCH IN SEPTIC TANK 3 DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
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DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
i A roved -- Permit fee Date pamit Issued Permit number Receipt No.