HomeMy WebLinkAboutBLD16124 Final Woodstove - BLD Permit / Conditions - 9/21/1984 DODGE, Dennis t16124
9-17-84
island Lake Manor Lot 49
E 80 North Haven Court
Shelton, Wash 98584 426-3842
Contractor
Dale Cunningham
Woodstove
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
S
C1y
��}}'' ���,�,, 426-5593 DATE ISSUED _•C. ✓t, Q O
PERMIT NO.
OWNER NAME MAIL AD RESS CITY&STATE ZIP PHONE
,c.7 C-4- 'LV !�' R ark 26- 3
DIRECTIONS
TO JOB SITE
LEGAL \ (❑ SEE ATTACHED SHEET)
DESCR. L G C(- li S (a vke( L,4
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
n a 14-1'u vo w v ti gMI f2 U 13 r! 1 10 13 e tk al v 44- N Fl+A H go—
USE
USE OF
BUILDING \2.A ¢ 1(6 k e -/
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE Cam.
SPECIAL CONDITIONS:
BEDROOMS _ DECKS CARP FIT CJ NOTICE
BATHROOMS---- I TOTAL SQ. FT. GARAGE Ci
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE El 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
I certify that I am a currently registered con ractor in WORK IS COMMENCED.
the State of Washington and I the
away of the FOR OFFICE USE ONLY
ordinance requirements regulating the work or which
the permit is issued and all work done ill be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
SEASONAL i l FLOODPLAIN Ll
Fi Utz
E.D. NO. S.E.P.A. ❑By Special Approvals IN OUT YES APPROVED NO
Lic4E14Ph(-A1R90J- Date 2,lkjZONING
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
f3LIC�T N ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner _-_ Date-__ - ,, BY
PLAN CHECK VALIDATION CK. M.O. C)kSH PERMIT VALIDATION CK. M.O. CASH