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HomeMy WebLinkAboutBLD0235 Final Woodstove - BLD Permit / Conditions - 11/9/1984 GASS, Robert W. Y #0235 11-6-84 20-23-1 NE 60 New Kirk _Road Belfair 98528 275-3075 Contractor Self Woodstove Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: 0 k- // 9 .V-,` 07 Stop Work: Mobile Home: Smoke Detector: Remarks: BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 ,, /� DATE ISSUED //L L _ PERMIT NO. CP�,? 35 NAME MAIL ADDRESS CITY STATE ZIP PHONE OWNER w. SS NH, �o ck �(c .� �4 w s `1 Z� i 7 DIRECTIONS y— _ TO JOB SITE �L 0 � �ti;.V Sk e T � 1 L,J �- LEGAL (❑SEE ATTACHED SHEET) DESCR. NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR 5 1-- USE OF BUILDING Class of work: ❑ N ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe rk: O o U 'Q— Valuation of work: $ PLAN CHECK FEE PERMIT FETE �5 SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE L] NO. OF STORIES BASEMENT C7 ATTACHED L SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE [IDETACHED ❑ 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 ermit is issued and all work done will be in C fOrmance therewith. PERMANENT SHORELINES SEASONAL '; FLOODPLAIN Firm E.D. NO. S.E.P.A. By Special Approvals IN OUT YES APPROVED NO Lic. o. 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 of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT /Owner Date. APPLICATION ACCEPTED BY PLAN ECK BY APPROVED F R ISSUANCE ���� �� PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH