HomeMy WebLinkAboutBLD16104 Woodstove - BLD Permit / Conditions - 9/11/1984 HOLEMAN, Loren #16104
9-11-84
Rainbow Lake Lot 32
E 17l Evergreen Drive
Shelton, Wash. 98584 426-1780
Contractor
Ralph Jantz
Woodstove
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: o
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:�j,«� %d ,7? y
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 _
DATE ISSUED
PERMIT NO. " , T
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
.CO,�� f�OCE/rIAAI 'f /7/ G,C'F.Ei1/ De CTD
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. ,(67
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
)e,9CP# THNT Z. all A
USE OF
BUILDING Sm�E�r/ QQ E pLf►TFe,em
Class of work: ❑ NEW )4 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
a &GZxC Y
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
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SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT L; NOTICE
BATHROOMS (TOTAL SO. FT. GARAGE L;
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE L DETACHED G
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 ermit is issued and all work done will be in
conf rmance therewith. PERMANENT .- SHORELINES I i
SEASONAL L FLOODPLAIN
Firm E.D. NO. S.E.P.A. L
By Special Approvals IN OUT YES APPROVED NO
Lic. o. 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 ACCESS
be in conformanc therewith. MOTOR VEHICLE PERMIT
AP LIGATION ACCE TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH