HomeMy WebLinkAboutBLD9329 Woodstove - BLD Permit / Conditions - 1/19/1981 Allen, Jay H. #9329
1-19-81
8/10 of mi. no. of Belfair, lst driveway on left across
from 4-plex apartment house.
E 427.39' of W 641.09' along N. line of So. 15 Acres
SW SE 20-23-1
Wood Stove
I Z -YU
�Ar moo/
r BUILDING PERMIT APPLICATION
• MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED J�
PERMIT NO.
NAME a MAIL ADDRESS �) ITY 8 STATE ZIP PHONE
OWNER 7 [ 4 —
DIRECTIONS _ %.S o yt j<
TO JOB SITE `!� C, ;::; 4 i• 4.. r •� / ' LN,IiEWt4+ ' F'Y'c-K ' :f f , ,r - 'k-A
LEGAL �1 (❑ SEE ATTACHED SHEET)
DESCR. �� [�/ p /� o c Q r
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHO
CONTRACTOR
;1 t1.>
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
I
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS 1 TOTAL SO. 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 ❑ SHORELINES ❑
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
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 rbAD ACCESS
be in conformance therewith. OT R VEHICLE PERMIT
CATION ACCEPT BY PLANS CHECK BY A R D FOR IS NCE
Owner ' —Date. /
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.o CASH