Loading...
HomeMy WebLinkAboutBLD15133 Woodstove - BLD Permit / Conditions - 1/30/1984 CROUCH JR. , Robert & Lorinda #15133 1-30-84 'Tract 3 of Survey 7/99 Off Bloomfield Road. New development SE 62 Arabian Rd. Shelton Wn. 98584 Contractor Lumbermans Woodstove S 1 l /lam l CZ)-D-3 D Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Fr ami ng: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior : Interior : Final: Stop Work: Mobile Home: Smoke Detector: Remarks: PERMIT DATE Y BUILDING PERMIT"APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED 1�G Iq 10 — r15 — OW30 PERMIT NO. OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE S• E' .� � S Et To GJ 9 z6- f�� DIRECTIONS TO JOB SITE e/ 0 LEGAL �l 'F �/ (❑SEE ATTACHED SHEET) DESCR. /a / 3 1 f}CT /- Su/�vC-1 719 .9 NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE CONTRACTOR F -3 USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Z,j)00 CJS TG'UfJ Valuation of work: $ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: BEDROOMS {DECKS CARPORT [' NOTICE BATHROOMS (TOTAL SO. FT. GARAGE ❑ ATTACHED I I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE ❑ DETACHED Lj 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 f FLOODPLAIN Firm E.D. NO. S.E.P.A. L. 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 ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT APKICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owner __ Date . L BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH