HomeMy WebLinkAboutBLD0191 Final Woodstove - BLD Permit / Conditions - 11/9/1989 I
Shorelines:
Setback: Plunbing:
Special Mechanics
Conditions: Interior:
Mobile Home,
Smoke Detector:
ooting: Remarks: g7yil�n �T.
Setback:
Foundation
Walls:
Framing;
Fireplace:
Wood Stove;
TYPE WOODSTOVE ----------------�_—
Permit No. 0191
No. Floors Sq Ftg
Owner HENN
Address P 0 Box 205 Tel 89_Date p�j 9
Contractor Stove & S a Belfair Zips
Address Pt Orchard
Legal Description Tr 5 ip
Direction to project site NW SE 29_23_1
NE 380 Hw 300
Belfair
Plunbing Mechanical
Fireplace D�.k Sewer Wood Stove
Basement — Loft — garage carport
Other —
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. �2,/
NAME MAIL , RESS CITY TATE IP PHONE D—
OWNER � ,. � s � - � 1 -=�/
DIRECTIONSp�rj
TO JOB SITE
16" /V L11 5
PARCEL r �/ 5IIJU��� IDLEEGSACLR.1.
NUMBERA23�V 7� ) lwA) �¢) 1
NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR �h- ,,, S� 1' d d
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE `
WORK c2 0 li k Vla L)
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE CONDITIONING.
NO.OF STORIES _ BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL,
OWNERSFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY s�HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW ROW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREME TS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFO MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING AL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWN t s SATE � �C X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
BY CASH CK MO TOTAL