HomeMy WebLinkAboutBLD9273 Fireplace - BLD Permit / Conditions - 1/9/1981 Hajed Williams #9273
1-9-81
Rt. 10, Box 200
NW NE SW 18-20-4
Fisher - Fireplace Insert
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' BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED J
PERMIT NO. / 3
OWNER ` N ME 1 .
MA DRESS 8 S A E ZIP PHsNE
DIRECTIONS
TO JOB SITE
LEGAL !� (] SEE ATTACHED SHEE
DESCR.
CONTRACTOR NAME MAIL ADDRESS CITY i STATE LICE SE NO. PHONE
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: d a
a
JF
L 42 A 4
�i
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED C] SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. 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 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 1
SEASONAL (] FLOODPLAIN L;
Firm E.D. NO. S.E.P.A. L
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 FtAp ACCESS
be in conformance therewith. OT R VEHICLE PE M11
IT
(CATION A TE Y PLANS CHECK BY AP O D FOR ISSU CE
Owner Date B
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH