HomeMy WebLinkAboutBLD12043 Woodstove - BLD Application - 2/19/1982 BUILDING PERM. LT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED ! y
PERMIT NO.
OWNER t1NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
CO
LL/- -/V N. f Qa37o ! 4U4 Sa �S�3S/
DIRECTIONS I U
TO JOB SITE N QQ 570 WA4.VV SI'Yl �,e $&t4_ F er�v
LEGAL A (El SEE ATT HED SHEET)
DESCR. .�Ya ^� ✓[mac r 32 6,v.
NAME MAIL ADDRESS CITY d STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING �dy
Class of work: XNNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FE'j/SO
SPECIAL CONDITIONS:
BEDROOMS — DECKS CARPORT [] NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE L]
ATTACHED l '� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [] OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE i DETACHED C;
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
1 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 i SHORELINES I 1
` SEASONAL ❑ FLOODPLAIN L I
Firm—a
E.D. NO. S.E.P.A. i]
By `e �t.ri.i%� �.c�� Q� Q Special Approvals IN OUT YES APPROVED NO
Lic. No. ' 'Date V v �- 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
Ci Ci� A LIGATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner ate / O Q 11
1/ Gt'wL�
PL CHECK VALIDATION CK. M.O. CASH ft.RMIT VALIDATION CK. M.O. CASH