HomeMy WebLinkAboutBLD11819 WoodStove - BLD Application - 12/7/1981 BUILDING PERMIT APPLICATION
- MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 -7 87
DATE ISSUED L
PERMIT NO.
OWNER NAME / MAIL ADDRESS CITY 8 STATE ZIP PHONE
DIRECTIONS <GY04.
TO JOB SITE Ej c. lud41�-, C'-it"vz C
LEGAL / L`I❑ SEE ATTACHED SHEET))
DESCR. 7S /�O SC - �fl `� .S/7 C � U ale
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR �-
USE OF
BUILDING C-re L y c y V
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
�-
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FE
SPEC!,AL CONDITIONS:
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS (TOTAL SO. FT._ GARAGE [7
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED 11
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 ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. 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 i{n` conformance ther with.
- t MOTOR VEHICLE PERMIT
% �l`�2 y 1 "Z � LIGATION ACC PTE V�
BY PLANS CHECK BY APPROQ FOR ISSUANCE
Owner Date
[Lf CHECK VALIDATION CK. M.O. CASH PE MIT VALIDATION K. M.O. CASH