HomeMy WebLinkAboutBLD80-7344 - BLD Permit / Conditions - 9/8/1980 t� Oa q #7344
Gibe.on,
Michael D. 'rr t 9-8 80
ParkWOod - Lot 7
Wood Stove - Orley - Model #F 243
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BUILDING PERMIT APPLICATION
MASON COUN 'Y
P.O. Box 186 Shelton, Washington 98584
426-5593 A
DATEISSUED 9
PERMIT NO. 7 7
MAIL ADDR S ^ CITY 8 ST �g� PHONE
OWNERC9✓� Q �✓
DIRECTIONS
TO JOB SITE Lwo13C ,
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MA L ADDRESS CITY 8 ST LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ N OVE ❑ REMOVE
Describe work: 1 J
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS I TOTAL SQ. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ 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 contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
B Special Approvals IN OUT YES APPROVED NO
Y
Lic. No.
Date ZONING
PLANNING DE .
HEALTH DEPT.
OWNERS AFFIDAVIT
PUBLIC WORK
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEP
of the Mason Coun ordin ce requirements for
which is permit is i u a that all work done will ROAD ACCESS
be7tnfor nce t eUz_
MOTOR VEHICLE PERMIT
A CATION AC ED B� PLANS CHECK BY AP OVE�FOR SUAI
Own
�—f'fate . � `� &
tl
.PLAN CHECK VALIDATION CK,. M.O. CASH PERMIT VALIDATION CK. M.O. ASH