HomeMy WebLinkAboutBLD12382 Woodstove - BLD Application - 5/6/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 6 �2s
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP /PH�E
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DIRECTIONS �Q X ) /Qoeox k7 OAS beyo�o
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LEGAL /4 ti9 G U.�/O 'Sov? V EE yA H
L EGCR. C v Poe. � 7�' �'1/N/ ,0'1 71
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1 NA MAIL ADDAESS ! CI &STATE LIC N N O� u- 40. R�
CONTRACTOR l- /e
USE OF
BUILDING 1-16 fir) F_
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
i
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
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
SEASONALI : FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. I!
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
be in onforman a therewith. MOTOR VEHICLE PERMIT
4n eZ A PLICATION CC TES BY PLANS CHECK BY APPROV FOR ISSUANCE
ner 7_ _
l s � Date . �'" Y
PL CHECK VALIDATION CK. M.O. CASH U OtRMIT VALIDATION CK. M.O. CASH