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HomeMy WebLinkAboutBLD7568 Woodstove - BLD Permit / Conditions - 10/6/1980 Burleson, Gary #7568 10-6-80 Springwood, Lot 1Z Wood Stove BUILDING 'PERMIT APPLICATION MASON ,COUNTY P.O. Box 186 .Shelton, Washington 98584 426-5593 /U DATE ISSUED PERMIT NO. 7.sJl0 !J OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE ' r.0 c> -'c c.D© —� DIRECTIONS TO JOB SITE LEGAL � +— � (❑SEE ATTACHED SHEET) DESCR. CONTRACTOR NAME M IL ADDRESe CITY 6 STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEE - ) SPECIAL CONDITIONS: BEDROOMS I DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ❑ 1 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 FORA 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 Ci 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 of the Mason County ordinance requirements for BUI G DEPT. which this permit is issued and that all work done will RO D A CESS be in conformance therewith. M TO VEHI MIT i p A ATION ACCEP BY PLANS CHECK BY APPRO R ISSUA CE Owner ate%� G U BY Cl.G6�'L PLAN C CK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH Permit No. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 •427-9670 PLEASE PRINT #1 Owner e� �/li�T� i �'-� _ Phone# =] Site Address �- city Sty Zip Directions to Job Site "1Spom Lk" Pit. Owner Mailing Address City _�_) V St Zip Lien/Title Holder J%y_�[Ce^rj Address P0130)c /4,04f City 4 MPjj5 St lq-r Zip 9f fD7 #2 Contractor Name Contractor Reg. # Address S piration date City St L�Zip Phone #3 Parcel No. `;Z Dry - Sri - /�— Legal Description rVj_Q Do #4 Use of building Describe work #5 Type of Job: New Add__Alt_.._ Repair Plumbing Fixtures j$3.35 each) Fee Mechanical Fixtures 6.7 each No._Toilets —__ CIRCLE FUEL TYP Ga lectric, —Bath Basins Heatpump, Other Bath Tubs No. Units Fees Showers Furn BTU �� —Hot Water Htr — Heatpumps _Laundry Washer — _ Vent Systems _Sinks Spot Vent Fans —Floor Drains _— ( �l No. Boilers/Compressors —Laundry Basins — HP _Dishwasher No. Air Handling Units —Disposal _ — cfm# _Urinals No. Other _Other Gas Outlets �P r Wood, Gas, Pellet Stove Permit Basic Fee 1 fi.?5 TOTAL PLUMBING $ _ Permit Basic Fee �16.75 G., TOTAL MECHANICAL $: : , `D No Basic Fee for Wood, Gas, Pellet Stove NOTICE: This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction or work is suspended or abandoned foi,a period of 180 days at any Itime after work is commenced. Proof of continuation of work is by means of a oroaress inspection. NOTE: If this permit application includes the placement of a fuel tank, heat pump or other unit to be located outside of the existing structures, a plot plan MUST be submitted as required below: Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY TI iAT I AM EXEMPT FROM THE REQUIREMENTS OF I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRAC- THE CONTRACTORS REGISTRATION LAW RCW 18.27,AND AM TOR IN THE STATE OF WASHINGTON AND I AM AWARE OF THE_ AWARE OFTHE MASON COUNTYORDINANCE REQUIREMENTS ORDINANCE REQUIREMENTS REGULATING THE WORK FOR iE:nQ 1ltulrl4 TiIiQ PRRRAIT IS ICC'!C` AND TLnT nit �'%^^{ y""y'nlV� iiiEt'EliPfil iJIJJl1CDi1iVU{iLLViIUHD�1!`dElVILLB7IiV i1L�.. 1y'./, DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE SHALL BE MADE WITHOUT FIRSTOBTAINING APPROVAL FROM WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O Box 186, Shelton, WA 98584 • 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY: Accepted by: Date:' _ ;Receipt N®. Refemed Tc - DEPARTMENTAL REVIEW Proposal Proposal FOR OFFICIAL USE ONLY Approved Denied Planning: Building: Fire Marshal: