HomeMy WebLinkAboutBLD12876 Final Wood Stove - BLD Permit / Conditions - 9/1/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
NAME �� L MAIL ADDRESS CITY 3 ST T€ 21P PHONE
o as d T Ir �sf 574
S 7` ! I85
OWNER
DIRECTIONSdF
TO JOB SITE
LEGAL (❑SEE ATTACHED SHEET)
DESCR. 7 d PTO rJ L. �- 2"V
CONTRACTOR
NAME MAIL ADDRESS CITY 3 STATE LICENSE O, PHONE
USE OF
BUILDING res /Q e n c a
Class of work: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
Describe work:
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I
AU MA-
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Valuation of work: $ PLAN CHECK FEE PERMIT FE, , uv
SPECIAL CONDITIONS:
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 [ZED IS NOT COMMENCED WITHIN 180 DAYS,ORIF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
u aware of the FOR OFFICE ■ ■SE ONLY
ordinance requirements regulating the work for which
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. ❑
j By Special Approvals IN OUT YES AP ROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
1 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 conformance t ewith. MOTOR VEHICLE PERMIT
`/6 / ICAT(ON CCr6daJ
ED BY PLANS CHECK BY AP RO OR ISSUANCE
Owner �— ate,D `,v
PL CHECK VALIDATION CK.. M.O. CASH RMIT VALIDATION CK M.O. CASH
Dayton,-Douglas #12976
426-3054 8/16/82
Tract 19 a& D, Sheltons DLC 37
I
307 West H Street
ftod Stove/Chimney Contractor:
Self
Wood Stove Permit
II
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