HomeMy WebLinkAboutBLD81-9312 - BLD Permit / Conditions - 1/16/1981 #9312
Olsen, Stanley H. 1-16-81
Island Lake Drive - 14 Cherry Park
Cherry Park - Lot 14
Fireplace Insert in living room fireplace
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w BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 ��
DATE ISSUED
PERMIT NO. �
OWNER _NAME MAIL ADDRESS CITY&STATE ZIP PHONE
fcr !-e C15cw, 1_q Gljerr Park SA e oo yfs5 57({ 14:tfo %2�r
DIRECTIONS
TO JOB SITE
? ([ISEE ATTACHED SHEET)
LEGAL
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: LL / /7
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Valuation of work: $ C/�' �. PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS f DECKS CARPORT ❑ NOTICE
BATHROOMS— (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 ANYTIME 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. ❑
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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. M TOR VEHICLE PERMIT
/ A I ATION A E ED BY PLANS CHECK BY PPR VED F U�
Owner Date. 1'/�°— �/ - BY �✓fl�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH