HomeMy WebLinkAboutBLD15523 Wood Stove - BLD Application - 5/11/1984 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
b T L. c-LUIIVt �� 22.6oZ 14Y 6LL w S2, 75�
DIRECTIONS
TO JOB SITE [ r D W9,-/AY woRr H oj; i4AAS C.Ov T, Z V (O 4U1E S 9L IL;oRr
LEGAL '' 11 (❑ SEE ATTACHED SHEET)
DESCR. �/4f�► Q 'tht�¢ '-tDrnc < <�ccr�_ 'r2 S - 12 B O 't✓a-zit % ;Z 7 — Z—
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
-t STALL �,) ST00
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT L_' NOTICE
BATHROOMS_ ITOTAL SO. FT. GARAGE f 1
� ATTACHED i� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [I OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE Ll 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 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 permit is issued and all work done will be in
conformance therewith. PERMANENT [ SHORELINES
SEASONAL [] FLOODPLAIN L!
Fir
E.D. NO. S.E.P.A. I
By Special Approvals IN OUT YES APPROVED NO
Llc. No. 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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
` LIGATION ACC JTEBYJ PLANS CHECK BY ROVED FO ISSUANCE
Owner Date, S
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH