HomeMy WebLinkAboutBLD9005 Final Wood Stove - BLD Permit / Conditions - 11/5/1980 Holman, Doug ], #9005
11-5-80
Rt. 5, Box 366
Rainbow Estates - Rainbow Lake, Lot 48 - 1 mile down Lake
Limerick Road
Rainbow Lake Subdivision - Lot 48
Contractor
Wood Stove Ben Korak
.,
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BUILDING PEWIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL rSS CITY8ST T ZIP PHONE
C e
DIRECTIONS / / 0, 0�I
TO JOB SITE /POLC'K 40W L 77 L6 �P LPat��t
LEGAL L / (❑ SEE ATTACHED SHEET)
DESCR. Z ! ' y (Y �1��'�, l?4/ L r L kC Cu(6 Dc"'Y" cl
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF /
BUILDING -Sir d «C�-
Class of work:/ , NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: _
Valuation of work: $ PLAN CHECK FEE _ P RMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS--- CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
SEPARATE RE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED El OR AIR CONDITION CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ 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 ❑
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
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 conformanc therew't M T R VEHICLE PERMIT
A ATION A E Y PLANS CHECK BY APP E
Owner Date. D
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. CASH