HomeMy WebLinkAboutBLD23228 Woodstove - BLD Permit / Conditions - 1/12/1989 shorelines: Plumbing:
;etback: Mechanical :
)pecial Interior:
;onditions: FINAL: 4tlp�wX
Mobile Home:
Smoke Detector:
Remarks:
looting:
;e tback:
'oundation
,al l s:
Iraming:
sire-)lace:
food Stove:
TYPE WOODSTOVE
'ermit No. 23228 No. Floors Sq Ftg
►weer HARMON, George Tel 27- 130 Date-T-72-7—
Lddress E 80 Halberg Rd Shelton zip
;ontractor one
address zip
,egal Description Ea, SW,SE So of Halberg Rd. )
lirection to project site Turn right on Agate Rd. , take
left on Spencer Lk.Rd.Go 1 -4 mile to Halberg Rd on right
lst house on right.
'lumbing Mechanical Sewer Wood Stove X
'ireplace Deck Garage Carport
lasement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
r/ PERMIT NO. ���
NAME MAILADDRESS CITY BSTATE ZIP PHONE
OWNER L - 5 eL_ C� Q . 1
DIRECTIONS
TO JOB SITE # p
0�3D TPWE L o - R• y -Z VkAL-zER6R.
PARCEL LEGAL 1 �` a�-
NUMBER Ll Q DESCR.C 14 C , P\LZe-RG P,Q
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES _ 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 ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWj RS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQEMENTS 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
INFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTNG APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
E "ATE 1-0-$9 X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENQ BUILDING VALUATION
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
STATESURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
BY CASH CK MO TOTAL �V• O�