HomeMy WebLinkAboutBLD6583 Woodstove - BLD Permit / Conditions - 6/5/1980 Folk, Clifford #6583
6-5-80
Tf. 1-A of Survey 4-53 (16-21-2)
Hwy. 3 to Mason Lake Co. Park Sign, turn left then turn
left at first gravel road, go to stop sign, turn left,
go to Folk mail box, turn right, first houae on right.
Wood Stove Contractor
August Wood Stove Install
I.C.B.O. 3.500
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington P8584
426-5593 _(�•,
n DATE ISSUED d" �
✓ PERMIT NO.
OWNER E , AIL ADDRESS CI &STATE ZIP PHONE _
—;r
DIRECTIONS A/ 3 T-a Mi 50� �,9iC6 c i 1/ /V 7_41eY 4d tVr �/ N y r
TO JOB SITE 97-/ /K'ST .&R07v41n1D. Ga 7=0 5J67P &O;o r e-41 RI4.& 7-
LEGAL (❑SEE ATTACHED SHEET)
DESCR.I WX, ,, y
"7 /_ & 6_16- ;? / -."J
NAME 1 MAIL AD RESS CITY&STATE . LICENSE NO. PHONE
T
CONTRACTOR v Ile po PQ -'P !�/
USE OF Y� 1�S_7qY- 5
BUILDING '
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: _
F
m� v
Valuation of work: $ PLAN CHECK FEE .�— PERMIT FEEI ��_
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT Ll NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED 1 j SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [ ] OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I] DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 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 I_l SHORELINES f
SEASONAL I 1 FLOODPLAIN L;
Firm
E.D. NO. S.E.P.A. I I
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD KCESS
be in co ormance therewith. MOT EHICLE PERM T
��// �GfG APP C ON ACCE LA S K BY APPROVED FOR ISSUANCE
�bwner Date _ , r a` BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ,