HomeMy WebLinkAboutBLD1994-00534 JEFFERSON COUNTY WOODSTOVE/
PROPANE TANK INSTALLATION/REMOVAL PERMIT
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
206-379-4450
PERMIT # •BLD94-0534 DATE ISSUED. : 08/04/94
SITE ADDRESS:223 FIR CIR
:PORT HADLOCK, WA 98339
APPLICANT. . . :ROBERT NORDBERG PHONE: 385-0866
MAILING ADDR:PO BOX 532
:PORT HADLOCK WA 98339
PROPERTY OWNER: y PHONE:
MAILING ADDR. . :
•
CONTRACTOR. . : PHONE:
MAILING ADDR:
CONTR. LIC #: EXPIRATION DATE: / /
PARCEL NO. . . :932300031
LEGAL DESC. . :STR 02-30-01 WWM, TAX # 211
LOT 31 , BLOCK , BISHOP ACRES
DESCRIPTION OF IMPROVEMENT: Install Pellet Stove
THERE IS ONLY ONE INSPECTION REQUIRED. PLEASE CONTACT THE PERMIT CENTER IN
ORDER TO SCHEDULE YOUR INSPECTION. IF THE INSTALLATION DOES NOT COMPLY WITH
THE INSTALLATION REQUIREMENTS, THE INSPECTOR SHALL PROVIDE A LIST OF NECESSARY
CORRECTIONS.. PLEASE CONTACT THE BUILDING DEPARTMENT WHEN CORRECTIONS ARE
COMPLETE IN ORDER TO SCHEDULE A REINSPECTION OF THE INSTALLATION.
( ) Final Approval: 2 ,,wf 2 , /2 )
CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9 a.m. to 4:30 p.m.
Inspector's Hours 8 - 10 a.m.
24 Hour Recorder for Inspections
JEFFERSON COUNTY
INSTALLATION/DEMOLITION/REMOVAL APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
206-379-4450
PERMIT # •BLD94-0534 DATE RECEIVED. :08/04/94
SITE ADDRESS:223 FIR CIR
:PORT HADLOCK, WA 98339
APPLICANT. . . :ROBERT NORDBERG PHONE: 539-90-0219
MAILING ADDR:PO BOX 532
:PORT HADLOCK WA 98339
PROPERTY OWNER: 510 PHONE:
MAILING ADDR. . :
CONTRACTOR. . : PHONE:
MAILING ADDR:
CONTR. LIC #: EXPIRATION DATE: / /
PARCEL NO. . . :932300031 ALT: CON: NA _
LEGAL DESC. . :STR 02-30-01 WWM, TAX # 211 WATER: DATE:
LOT 31 , BLOCK , BISHOP ACRES SHORELINES:
BY: DATE:
DESCRIPTION OF IMPROVEMENT: Install Pellet Stove
BUILDING TYPE. . . . . . :WOD BEDROOMS--- BATHROOMS-- MAIN FL. . . : 0 sf
TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 0 sf
GARAGE/CARPORT PROP. . : 0 PROP. . : 0 HTED BSMT. : 0 sf
WOODSTOVE • TOTAL. : 0 TOTAL. : 0 UNHT BSMT. : 0 sf
UBC OCCUPANCY GROUP: SEWAGE DISP. . : CARPORT. . . : 0 sf
TYPE OF CONST. . . . . . : WATER SUPPLY. : GARAGE. . . . : 0 sf
UNITS. : 0 STORIES:0 HEAT TYPES. : / / DECKS. . . . . : 0 sf
DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf
FRAME TYPE: MAKE: YR: INDUSTRIAL: 0 sf
EST COST.$: 0 SIZE: BANK HT. . . :0 ft
PROJ GRP. . : 2873 SH SETBACK:0 ft
Owner/agent ---------------- FEES --------------
Signature: type amount by date recpt
PRMT $ 25. 00 AK 08/04/94 95929
Date: I B.C. $ 4.50 AK 08/04/94 95929
Issued By:
Date:
$ 29.50 TOTAL
9,
'JEFFERSON COUNTY INSTALLATION PERMIT APPLICATION
APPLICANT NAME I 1 I Q.V
,..:(_)0 �a. PHONE
90-031e
MAILING ADDRESS RD )( ✓32._. n ��
Pori- HacIL.t-Y-K WA zip 61S3`l"1
PROPERTY OWNER NAME 3(., ) L L PHONE
MAILING ADDRESS GO.,,ale
K
ZIP
CONTRACTOR r‘
MAILING ADDRESS PHONE
STATE LICENSE NUMBER EXPIRATION DATE
FEDERAL I.D. NUMBER
=====aa=======a========------------.....------------......-----------.....---------..........
------xae=:
9111/RORD NA1E CW ) /reuide. /l�rdLc ( a)1IP CODE "l g
LEGAL DESCRIPTION:
4-3 )SUBDIVISION NAME LOT'I BLOCK DIVISION
TAX NUMBER 9 DIGIT PARCEL NUMBER 4,t5c /
73
SECTION TOWNSHIP NORTH RANGE / WM
DESCRIPTION OF IMPROVEMENT: l2i.I!P 6/U
xxxxxxaxxxxxxa==xxxxaxxxaxxcx.-xxxcxxxxx:aaxx-zw=cxxos..xca=-:=xxx-caxxcxxff== al==-==-=s t/! xxx=ax=a
SIGNATUR ' i2'?GLS DATE_ g'
FOR OFFICE USE ONLY
Planning Area Fire District School District
BUILDING TYPE IMPROVEMENT TYPE UBC OCCUPANCY
❑ NON ❑ WOO ❑ NEW GROUP
FRAME TYPE
0 WOOD 0 MANUFACTURED 0 STEEL 0 MASONRY OTHER
BASE FEE
PLAN CHECK RECEIPT # Q549Ce
STATE SURCHARGE
167?TOTAL CASH/CHECK #
h:\HOME\PLNCNTR\FORMS\INSTALL.FRM