HomeMy WebLinkAboutBLD0135 Final Woodstove - BLD Permit / Conditions - 6/29/1989 _ O
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Shorelines: Plumbing:Mechanica
Setback: Interior:
Special FINAL:
Conditions: mobile me:
Synoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls: -
Fr aaming:
Fireplace:
Wood Stove: —
TYPE WOODSTOVE
Permit No. 0135 No. Floors Sq Ftg
Owner JARLOCK Arnold Te1275-8376 DaZi �
Address E 5521 Elfend hl Pac R�' �zAlfair P
Contractor Self Zip
Address T , 2
Legal Description
Direction to project site Above
ec anica ewer oo tove
un ing Deck Garage Carport
Fireplace Other
BasEment Loft
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.jO 3 S
OWNER NAME MAILADDRESS CITY&STATE i ZIP PHONE
3 1 a2 7
DIRECTIONS d /
TO JOB SITE C�pUf� Gt�dY�Jv
.c^
PARCEL
NUMBER � 1� /,6 DD/� DESCR
LEGAL i f
.
CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE
BUILDING
CLASS
WORK O✓ NEW ADDITIkd ALTERATION REPAIR MOVE REMOVE
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FI REPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWN RSAFFIDAVIT CONTRACTORS AFFIDAVIT
I CE IFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGI TRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQ IREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OB INING APPROVAL FROM THE BUILDING DEPARTMENT. // p APPROVAL FROM THE BUILDING DEPARTMENT.
WNER DATE (O-� Z- Q X BY _ DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING ` PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PjA�N�SKBY, APPROVED FOR ISS NCE PERMIT VALIDATION BY � CASH CK MO TOTAL c'90
II I