HomeMy WebLinkAboutBLD82-13154 w.stove - BLD Permit / Conditions - 10/15/1982 #13154
Coleman, Donna Shelton 10-15-82
W 3961 Airport Rd. ,
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8-20-4 Survey 57 Tr. 5, 6, 12 & 13
Second house on left past Correction Center
Contractor
Wood Stove Abitz
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 l �
DATE ISSUED
PERMIT NO. ���
NAME MAIL ADDRESS CITY&STAr ZIP PHONE
OWNER IMIA �/), , L 7 `/�l ,' r S ��/T� �. 5. ,tl
DIRECTIONS
TO JOB SITE �C l rC l� C C' �J C�� C� C� l
LEGAL (❑ SEE ATTACHE SHEET)
DESCR. �C C)
NAME MAIL ADDRESS CITY 8 SLATE LICENSE No , PHONE
CONTRACTOR � f `1
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: _ ,®
Valuation of work: $ PLAN CHECK FEE PERMIT FEE ^.4-�
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLU RING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED
THIS PERMIT BECOMES NULL AND VOID IF WORK R CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IFCONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FORA PERIOD OF 1180 DAYS AT ANYTIME AFTER
I Certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR
OFFICE
r^F I C E U E ONLY
"
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT I l SHORELINES ❑
SEASONAL C I ! FLOODPLAIN 1.1
Firm f.A E.D. NO. S.E.P.A. ❑
By r Special Approvals IN OUT YES APPROVED NO
Lic. No.
," omi IDate G d 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 conformance therewith. MOTOR VEHICLE PERMIT
PP ICATION AC PTED gY PLANS CHECK BY P ROVED FOR SUANCE
Owner Date . Y
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH