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HomeMy WebLinkAboutBLD9169 Wood Stove - BLD Permit / Conditions - 12/8/1980 Nelson, Tim #9169 12-8-80 Colter Creek Road - Nelson - Rathbun Sign, turn right - Blue House N 1/2 S 1/2 NW 1/4, E. of W 800' 9-22-1 Wood Stove BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATEISSUED PERMIT NO. OWNER 2:2 NA 1 MAIL ADDRESS S SS TATE ZIP PHONE -N - U �2 DIRECTIONS /� Ang TO JOB SITE ) SEE ATTACHED j�iEET) DESCR. S/a CONTRACTOR NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 04 Valuation of work: $ V PLAN CHECK FEE PERMIT FEE �--d SPECIAL CONDITIONS: BEDROOMS {DECKS CARPORT ❑ NOTICE BATHROOMS I TOTAL SQ. FT. GARAGE Ll ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ❑ IDETACHED ❑ 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 'i SHORELINES I SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. [.1 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 o registration law RCW 18.27, and am aware BUILDING DEPT. of th ason County ordinance requirements for wh' this permit is issued and that all work done will R AD ACCESS e in conformance therewith. �s (J OR VEHIC E E IT P ICATION ACCEP E BY PLANS CHECK BY APPROVED FOR ISSUANCE �er Date. O V BY A9 PLAN CH CK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH