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BLD84-16199 W.STOVE - BLD Permit / Conditions - 10/1/1984
#16199 BROTCHE, Charles A. 10-1-84 7Woodland Manor Lot 33 12-20-4 E 130 Woodland Drive 426-1284 Shelton, Wash 98584 7th house on right from Shelton Spring Rd. Contractor_ Self Woodstove .� . v 0 ., \ / t / % { \ c x .. / / �\ § ' \ \ %a4-JbO - axe . \ cc CIO \ . ° ° 0 m e = t e o/ e k\ m/ E & t / § ' \� \ co a / e�/ cn / © ° 0 4 o c J w & a ® °x E & * cn BUILDING PERMIT APPLICATION, F MASON COUNT P.O. Box 186 Shelton, Washingto 98584 426-5593 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER j(_fl14!?L1f.S / , BRet"ca4 . 1;34c (k.cud1AN> ��. S%fEL N (&;' , e66tl DIRECTIONS TO JOB SITE S l'1Cu-Sr" 6A/ %?1�147" 1--licVvl SH/-L%CH ,SrRml !i.!) LEGAL. $ (❑ SEE ATTACHED SHEET) DESCRL"e I a TW P ClY lac " vv Lo I 3 3 \ c J�L•�)Nv A/illY-di? CONTRACTOR NAME MAIL ADD SS CITY 8 STAT LICENSE NO. PHONE USE OF BUILDING �L'$/ D L lYG 1= L�C,�'L�j T�J G/r ec, Class of work: ❑ NEW 011 ❑ REMOVE Describe work: �L)7- /V F_ VV w c c,v S T-c v I- //Y (^% Valuation of work: $ — �_ PLAN CHECK FEE PERMIT FEE _ O SPECIAL CONDITIONS: BEDROOMS-- (DECKS CARPORT LJ NOTICE BATHROOMS_ (TOTAL SO. FT. _ GARAGE C ATTACHED �' SEPARATE PERM( ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT 'L] OR AIR CONDITION NG. TOTAL SO. FT. FIREPLACE ❑ DETACHED L-, THIS PERMIT BECO ES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED IS NOT COMME I CED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR AB 'NDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER I certify that I am a currently registered contractor in WORK IS COMMEN DED. the State of Washington and I am aware of the FOR, O OFFICE USE ONLY rdinance requirements regulating the work for which h the permit is issued and all work done will be in onformance therewith. PERMANENT iJ SHORELINES I I SEASONAL [- FLOODPLAIN I i Firm E.D. NO. S.E.P.A. 'C By Special Approvals IN OUT YES APPROVED NO Lic. — 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 therewith. MOTOR VEHICLE PERMIT � Owner �x Date . LICA N ACCEPT 0 BY PLANS CHECK BY AP/PR VED FOR ISSUANCE (, L,1.�►./� �.— c�.• ;,2j,[ J[�C.�e�G� PLAN CHECK VALIDATION CK. M.O. CASH P .IRMIT VALIDATION CK. M.O. CASH