HomeMy WebLinkAboutBLD81-11620 - BLD Permit / Conditions - 10/22/1981 Smith, George D. #11620
10/22/81
Lot 11, Woodland Manor
North on 101 - right on Shelton Springs Rd, left on
Woodland Manor - East 201 Woodland Drive, Shelton.
Fireplace Insert Contractor;
Self
$ Wood Stove Permit
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BUILDING PERMIT APPLICATION
` MASON COUNTY
P.O. Box 186 Shelton, Washin ton 98584
A 426-5593 /� p
DATE ISSUED /V dr;- O
PERMIT NO. /d 0
ADD
OWNER NAME MAIL ADDRESS ZIP PHONE a� CITY& ATE
DIRECTIONS
TO JOB SITE 4/^ /0` lags f
LEGAL
DESCR. (ElSEE ATTACHED SHEET)
CONTRACTOR NAME MAIL ADDRESS CITY&SfATE LICENSE NO. PHONE
�USONG n �
y¢�
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
n
Valuation of work: $ '�i .
. PLAN CHECK FEE ! PERMIT
SPECIAL CONDITIONS:
t t
BEDROOMS I DECKS CARPORT Cl BATHROOMS `TOTAL SQ. FT. NOTICE
GARAGE
NO. OF STORIES BASEMENT [] ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
TOTAL SQ. FT. FIREPLACE C; DETACHED ❑ OR AIR CONDITIONING,
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT CO M ENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR BANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMM LACED.
the State of Washington and I am aware of the
ordinance requirements regulating the work for which FO OFFICE USE ONLY
the permit is issued and all work done will be in
Conformance therewith. RMANENT t I S
PE HORELINES
Firm SEASONAL ❑ FLOODPLAIN El
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
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 herewith.
MOTOR VEHICLE PERMIT
Owner Date i0 ozoZ �'� APPLICATION ACCEP�BYT PLANS CHECK BY APPROVED FOR ISSUANCE
P N CHECK VALIDATION CK,. M.O. CASH RMIT VALIDATION CK. M.O. CASH