HomeMy WebLinkAboutBLD11420 Woodstove - BLD Application - 9/15/1981 • BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 J, A'�� /6- lq?l
DATE ISSUED S�C�
PERMIT NO. /6 0
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
L L�
DIRECTIONS
TO JOB SITE 5"�Y 1 Wc2� adz' To 'Towj_ Cam` -eve Ae-\ (- 114t—
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �O'(S c�- 5 PC �`rl •W cX9�
CONTRACTOR
NAME MAIL ADDRE S CITY S STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
t3� 4 2 woa9 c nkAA PvL I caw, — CC 134_,oclz
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT [I NOTICE
BATHROOMS I TOTAL SQ. FT. _. _ GARAGE []
ATTACHED ❑ LSEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT U CONDITIONING.
TOTAL SQ. FT. FIREPLACE I 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 CI SHORELINES I 1
SEASONAL C FLOODPLAIN
Firm
E.D. NO. S.E.P.A. I]
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 in or ance therewith. MOTOR VEHICLE PERMIT
)weer Date. /`/ APPLICATION�.AC EPTED BY PLANS CHECK BY APPROVED FOR
�ISSUANCE BY
N C CK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH