HomeMy WebLinkAboutBLD16096 Final Woodstove - BLD Permit / Conditions - 9/11/1984 Peake, Mark #16096
275-3724 9/10/84
9-23-1, Tract 25 of W 1•12, SE 1/4
NE 3111 Old Belfair Highway
Wood Stove No Contractor
$-- Wood Stove Permi
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior: ,
Interior:_
Final:ff/,:f' 5j/ /
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 '1—/0
DATE ISSUED
PERMIT NO. too r
OWNER NAME ke MAIL ADDRESS CITY 8 STATE ZIP PHONE
V� `
DIRECTIONS /A�
TO JOB SITE $� r 1'1c-t�o SGuy�e C res 't )
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
CONTRACTOR NAME MAIL ADDREft CITY 8 9TATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ❑ ADDITIO ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe w
V �\
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS _ CARPORT ❑ NOTICE
BATHROOMS I TOTAL SO. FT. GARAGE 1_1
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE [_I 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 I;
SEASONAL ❑ FLOODPLAIN I
Firm
E.D. NO. S.E.P.A. L:
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OW RS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am empt from the requirements of the FIRE MARSHAL
contract or regi ration law RCW 18.27, and am aware
of the Maso County ordinance requirements for BUILDING DEPT.
which this pe mit is issued and that work done will ROAD ACCESS
be in confo ance therewith. MOTOR VEHICLE PERMIT
dLICATION ACC TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own , e . �u BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. .' M.O. CASH