HomeMy WebLinkAboutBLD13160 Final Fireplace Insert - BLD Permit / Conditions - 10/21/1982 Ulberg, Cal ;ii316�
P. 0. Box 113, Belfair 10-15-82
275-300? --
NE 3404 Old BElfair Highway (Green house, shake roof)
9-23-1 Tr. 2 E 1/2 SE
Contractor
Fireplace Insert Cheap Heat
Shorelines:
Setback:
Special Conditions:
Footings
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: d /o/5j Af 5
Stop Work:
Mobile Home:
Smoke Detector:
Rem,qrks:
J
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED ZO oldF�
PERMIT NO. f 8 / 4 U
NAa MAIL AD RESS CITY 8 STATE ��ZZIP PHONE
OWNER �+- , `t I �/^ , D. �O X /3 Ir
DIRECTIONS r
TO JOB SITE NEB O / l a;t 01��wAy C6 Teen h04'0, .54Ae teeT
LDEGAL 9 �&—j � �J � � ��� (❑ SEE ATTACHED SHEET)
NAME Y/JI tvI MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR Daf.e C kd R r I(� 1 C �# L�A- 1'� 14 0
USE OF
BUILDING Res,,A e ►te_e
Class of work: ❑ NEW ❑ ADDITION Pk ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
I-f, fa fY( lace I nsel^f
Valuation of work: $ PLAN CHECK FEE PERMIT FEE 00
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE []
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [J f OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I 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 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 ,J SHORELINES L1
SEASONAL ❑ FLOODPLAIN 17
Firm Q oZ
E.D. NO. S.E.P.A. ❑
By 1 Special Approvals IN OUT YES APPROVED NO
Lic. No. G�� Date I L) l 12 fR 2 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
be in conformance therewith. MOTOR VEHICLE PERMIT
CATION ACC TED Y PLANS CHECK BY PROVED FOR SUANC
Owner _ Date .
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI CK. M.O. CASH