HomeMy WebLinkAboutBLD14997 Woodstove - BLD Application - 12/8/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED —
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE 4 T O ZIP PHONE
L- 5 7^10
DIRECTIONS
TO JOB SITE 6 C t0'a " L L !f '17 a/'Opl
LEGAL (❑ SEE ATTACHED SHE T)
DESCR. _T S C 3 C'�v 12 -D W O FC-7),3—
NAME MAIL ADDRESS CITY 8 STATE ff LICENSE NO. PHONE
CONTRACTOR L ` 0 1;0Qfj �� v� LG & e v
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
VO C J L) C_
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT I i NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE I 1
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED L
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
ONTRACTOR 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
4,CAd
I am a currently registered contractor in WORK IS COMMENCED.
I
f Washington and I am aware of the FOR OFFICE USE ONLY
uirements regulating the work for which
issued and all work done will be in
therewith. PERMANENT i I SHORELINES
SEASONAL [; FLOODPLAIN
Fir �& 4._' � E.D. NO. S.E.P.A.By Special Approvals IN OUT YES APPROVEDNO
i No C Zl d L Date !Z � S� 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
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner __ Date . BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH