HomeMy WebLinkAboutBLD16046 Final Woodstove - BLD Permit / Conditions - 10/3/1984 BUILDING PERMIT APPLICATION-
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 fJ
DATE ISSUED —
PERMIT NO.
OWNER NAME pp MAIL&DDR3SS� 1I�PL, & TAKE � ZIP PHONE
741,j '48
DIRECTIONS ,Aw Cam,
TO JOB SITE �5 `�7Ut /�Y r 32'� In.J�( �0
(❑SEE ATTACHED SHEET)
LEGAL ,
11 DESCR. �S(J Yl O/� 1 V i 5l ) I 2 6 I .' IL
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR J r '
D
USE OF {{��
BUILDING fc,$S 011? G
Class of work: ❑ NEW ❑ ADDITION VAL EIRATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
t
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
CPO
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SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE El THIS
❑
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 FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in SHORELINES ❑
conformance therewith. PERMANENT ❑
SEASONAL ❑ FLOODPLAIN ❑
Fir E.D. NO. S.E.P.A. El
Special Approvals IN OUT YES APPROVED
By NO
L . No.
Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT 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 ' c nformajcethhorewith. fOR VEHICLE PERMIT
IC N ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
�Wner Date. BY
- VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
BISHOP, Victor H. #16O46
8=27-64 ,
Stetson Resort subdivision Block 4, Lot 2
6333 125th Place S E
Bellevue, Wash. 98006 746-1748
Contractor
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Woodstove
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