HomeMy WebLinkAboutBLD6019 Fire Place - BLD Application - 3/13/1980 1
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
1
PERMIT NO.
OWNER NAME AJL ADDRESS CITY&STATE 41P PHONE
C� , 'IF
DIRECTIONS -
TO JOB SITE `,b
LEGAL �. ( SEE ATTACHED SHEET)
DESCR. 7b4cf-'s
NAME MAIESS CITY 8 STIjFE) LI NSE NO. PHONE
USE OF
BUILDING 7::�elee 574 {1c6 t /l/ I `� . ` \ q
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATIOIA ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
L�-
Valuation of work: $ O �� PLAN CHECK FEE PEPM EE
J
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT f 1 NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE I
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE [-I DETACHED Li L
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 Li SHORELINES f
SEASONAL i 1 FLOODPLAIN it
Firm
E.D. NO. S.E.P.A. I I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. ate 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. MOT^VEFACLE PERMIT
APPL A O PTE Y PLANS CHECK BY APP F ANCE
Owner _ Date . BY
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION CK. M.O. CASH