HomeMy WebLinkAboutBLD81-11599 - BLD Permit / Conditions - 10/16/1981 Fitzthum, Randglph #11599
10/16/81
Woodland Manor, Lot #13
Spring Road to Wood land Manor, East 221 Woodland Drive.
Fireplace Insert Contractor:
Self
$__ Wood Stove Permit
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• BUILDING PERMIT APPLICATION
MASON COUN Y
P.O. Box 186 Shelton, Washingt, n 98584
426-5593 �
DATE ISSUED
PERMIT NO. J
NAME MAIL ADDRESS ZIP PHONE
OWNS cITY&srA
DIRECTIONS
TO JOB SITE
LEGAL JJ (❑ SEE ATTACHED SHEET)
DESCR. �J60i/'41A/Q ANo ®�
CONTRACTOR NAMES r MAIL ADDRESS CITY&STA rE LICENSE NO. PHONE
USE OF
BUILDINGas
Class of work: ❑ NEW K ADDITION ❑ ALTERATION ❑ REPAIR ❑ MQI E ❑ REMOVE
Describe w rk:
Valuation of work: $ PLAN CHECK FEE
PERMIT FEE r tj Ca
SPECIAL CONDITIONS:
BEDROOMS {DECKS_ _ CARPORT ❑ NOTICE
BATHROOMS f TOTAL SQ. FT.__ GARAGE ❑
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ SEPARATE PERM[ ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
OR AIR CONDITIO I G.
TOTAL SQ. FT. FIREPLACE ElDETACHED ❑
THIS PERMIT BECOVIES 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 FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
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 ' nformance therewi h.
MOTOR VEHICLE PERMIT
Own Date
APPLICATION ACCEPTS BY PLANS CHECK BY APPROVED FOR ISSUANCE
� . / � _
-Fz BYIVA
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PL CHECK VALIDATION CK. M.O. CASH PE MIT VALIDATION CK. M.O. CASH