HomeMy WebLinkAboutBLD9328 Wood Stove - BLD Permit / Conditions - 1/19/1981 Romig, Edward #9328
1-19-81
Mason Lake Rd. to Rainbow Lake - 1st house on corner behind
sign
Rainbow Lake, Lot 40
Wood Stove - Olympic Franklin 30" model
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. / a
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
DIRECTIONS n $�
TO JOB SITE as&-?, �►4k G F2 9 to Ra-s r bow L0. �C JV( rS4 6uSe di,, C01-10 -er bC i J�
LEGAL I (n� (❑SEE ATTACHED SHEET)
DESCR. �O �r V �G G
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
j n e �ra✓11L b ,v�c�� n
Valuation of work: $ PLAN CHECK FEE PERMIT FEE /Z—4
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ 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 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. ❑
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 ROAD ACCESS
b onform the h. MOTOR VEHICLE PERMIT
Own Date. l4 �I APP ICATION ACCEPTED BY PLANS CHECK BY APPRO ED FOR ISSUANCE
BY _
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH