HomeMy WebLinkAboutBLD9123 Woodstove - BLD Application - 12/1/1980 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 Z) _
DATE ISSUED
aO/a -55-DDD 18 PERMIT NO. �?/�
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
2 all, 6 cJ 1 —M SK
DIRECTIONS INN OFF 113't—S St ONTO Prm-go. 6oimgTtG+RO W(ooScRmL 6o It.I wti le S om SPRNVG
ED-
TO JOB SITE A<4035 FROM TIM "S MAILVeRS IWAI &t: OW (40C 6"VE1 AMD 60 .ZA4 5 -ow L t.
LEGAL tq,7b'0 FT.OF TFt& (,rJ.. ( 0 FT. OF TNT E.2W FT. OFTtft 1J,E'_ (El SEE ATTACHED SHEET)
DESCR. 0P THE N. W•J' F SEf,l T-Z� C �. (N.M. f
CONTRACTOR NAME MAIL ADDRESS tITY 8 STATE LICENSE NO. PHONE
USE OF
BUILDING 4"e3 f') a56' 5'-Mi l46 C= C'At- kl
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
'I Describe work:
FILM-SCE
Cweyod_ v
1 Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHEq,ZS. SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ 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 am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is issued and all work done will be in
conformance therewith. PERMANENT [- SHORELINES I I
SEASONAL [] FLOODPLAIN L]
Firm
E.D. NO. S.E.P.A. lJ
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
eify 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 i onformance therewith. MO OR VEHICLE PERMIT
ZAPATION AC E BYJ PLA ECK BY A ROVED FORISSLIANCE
Owner Date !IV
PLAN CHECK VA kfDATION CK. "- M.O. CASH PERMIT VALIDATION CK. M.O. CASH
y w �
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX Shelton,Washington 98584 /�4-2 O0�
PLUMBING PERMIT
G�LT APPLICATION
IMPORTANT— Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel.No.
,.
Owner
2. Ccl vim' ccif7P4i?�
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Slgn u of applicant Address Application dare
LEGAL DESCR TION N•75z FT. to F �. L1. do Ff, 6 9' F-200Fr v F 7d�e /J.0_
Location °l /J 0 �3 Sfi d t� !2$ _
Of � � fJTa Ji �.- �o�N(, '1jw;��v ! /�' Sc�hfa•,,�._ +C�e� //�.,.. � o.�!
Building - - � ra't 1�1� � [rii)C GpdtltC-
� A4 PH Sl flit 0.4 2 icwr— GO ,L 1,,,:1 e5 4*p -melv 1 rr I
NO. PLUMBING FIXTURES FEE
WATER CLOSETS _
BASINS A —
BATH TUBS
SHOWERS
WATER HEATERS
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
DISH WASHER
DISPOSAL
URINAL
--------- (Show Street Names 8 Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT -- SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
_—_ ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Approved by Permit fee Date pemit issued Permit number Receipt No.