HomeMy WebLinkAboutBLD10927 Wood Stove - BLD Permit / Conditions - 7/2/1981 OFFICER, Sherman I. #10927
P. 0. Box 145, Likliwaup 07-02-81
Colony Surf, Lake Surf Drive, Div 3, Block 2, Lot 10
Wood Stove Wood Stove Permit
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{ BUILDING-PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 /7
DATE ISSUED
PERMIT NO. d 9.=,? 7
OWNER AME M I ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS I
TO JOB SITEI 1 t 1- C- 5uAl f✓- —/
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR SCL
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
.INS c� k/o u �. n/ ✓6,
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED 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 FORA 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 Ll SHORELINES LI
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
w 'c this permit is issued and that all work done will ROAD ACCESS
conform a th with. MOTOR VEHICLE PERMIT
N A EPTED BY PLANS CHECK BY AP OVED FOR SUANCE
Own � Date . LIGATIO
u
C/
AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH