HomeMy WebLinkAboutBLD9087 Wood Stove - BLD Application - 11/20/1980 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. �
OWNER NAME AIL A ESS CITY 8 STATE ZIP PHONE
DIRECTIONS
TO JOB SITE !�
LEGAL / (❑ SEE ATTACHED SHEET)
DESCR. Z 9 —3
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING 0 tq�;cr
Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE _ PERMIT FEE 0-0
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS (TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ElOR 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 ❑ SHORELINES ❑
SEASONAL ❑ FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. [-j
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
4beonforma
Mason County ordinance requirements for B ING DEPT.
►�// s permit ' iss d d that all work done will OAD A CESS
e r OTO VEHICLE PERM(
PP CATION ACCE PLANS CHECK BY APP OV D FOR IS NCE
Ow BY
1 i
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALID 10 CK. M.O. CASH
Water-Land Realty & Const. #9087
11-20-80
at Taylortowne
SW corner N 1/2 NW NW 17-19-3
Wood Stove in Office
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