HomeMy WebLinkAboutBLD1992-00734 s '
,TEFFER� ON COUNT'f
I N E3 T AL L AT I O N APPLICATION.
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 98368
206-385-9141
PERMIT # •BLD92-0734 DATE RECEIVED. : 11/13/92
SITE ADDRESS : 53 BUCKHORN RD
:PORT TOWNSEND, WA 98368
APPLICANT. . . :CHUCK BARLOW PHONE: 385-3662
MAILING ADDR: 53 BUCKHORN PL
:PORT TOWNSEND WA 98368
PROPERTY OWNER: PHONE:
MAILING ADDR. . :
CONTRACTOR. . :WHITEY JOHNSON PHONE : 598-3308
MAILING ADDR:PO BOX 1110
: SUQUAMISH WA 98392
CONTR. LIC #:WHITEJG159DN EXPIRATION DATE : 03/01/92
PARCEL NO . . . :965000-117 HEALTH:
LEGAL DESC . . : STR 27-30-01 WWM, TAX # BY: DATE:
LOT 120, BLOCK , KALA POINT DIV 4 SHORELINES :
BY: DATE:
DESCRIPTION OF IMPROVEMENT: PELLET STOVE INSTALLATION �!
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 : O HEAT TYPES . : / / DECKS 0 sf
DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf
FRAME TYPE:WOOD MAKE : YR: INDUSTRIAL : 0 sf
EST COST. $ : 0 SIZE: BANK HT . . . : 0 ft
PROJ GRP . . : 2026 SH SETBACK: O ft
Owner/agent FEES
Signature: type amount by date recpt
PRMT $ 25 .00 AK 11/13/92 71814
Date: B.C. $ 4 . 50 AK 11/13/92 71814
Issued By:
Date: 74ZLT
$ 29 . 50 TOTAL
i i
***JEFFERSON COUNTY INS LLATIO PERMIT APPLICATION
YPROPERTY OWNER ME 1744f/V L. S 4 I 34I2L404J PHONE 3' 8,3- jGd
MAILING ADDRESS *37 r oI)( ,e oii) PL /�
:P' 2T C)G 7- te%.fS O ZIP 10 X.s9a1
CONTRACTOR M /`7"/?e 1/ / LJ A/.S eA d GL) 1✓G A
MAILING ADDRESS O ' i /1 / 0 PHONE
4d Q U 4 41 s S 'i^d Vv fC' rf LJ 392 /1/c)
STATE LICENSE NUMBER EXPIRATION DATE
FEDERAL I.D. NUMBER
SITE ADDRESS:
\` ' 911#/ROAD NAME 1 `,j ,, 0 ,i PLf
i PT' 7,7x.viti c I n!D ZIP CODE 9sie6 3
LEGAL DESCRIPTION:
Igh SUBDIVISION NAME LOT BLOCK DIVISION
Nit TAX NUMBER 9 DIGIT PARCEL NUMBER
41
SECTION TOWNSHIP NORTH RANGE WM
DESCRIPTION OF IMPROVEMENT: A
SIGNATURE DATE (// / ��
***************************Y*********,*******:t**************************'k k** *k�Al;*I *****k*********
FOR OFFICE USE ONLY
Planning Area Fire District School District
BUILDING TYPE IM•ROVEMENT TYPE UBC OCCUPANCY
-.SI
❑ NON WOD NEW GROUP
FRAME TYPE
❑ WOOD ❑ MANUFACTURED ❑ STEEL H MASONRY OTHER
i
BASE FEE
PLAN CHECK RECEIPT # 0/
STATE SURCHARGE
'
9
TOTAL 2R1 CASH/CHECK R
h:\HOME\PLNCNTR\FORMS\INSTALL.APP
a
ITEIIPEPEERSON COUNTY WOODSTOVE /
PROPANE TANK INSTALLATION PERM= T
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 98368
206-385-9141
PERMIT # •BLD92-0734 DATE ISSUED. : 11/13/92
SITE ADDRESS : 53 BUCKHORN RD
:PORT TOWNSEND, WA 98368
APPLICANT. . . :CHUCK BARLOW PHONE: 385-3662
MAILING ADDR: 53 BUCKHORN PL
:PORT TOWNSEND WA 98368
PROPERTY OWNER: PHONE:
MAILING ADDR. . :
•
CONTRACTOR. . :WHITEY JOHNSON PHONE : 598-3308
MAILING ADDR:PO BOX 1110
: SUQUAMISH WA 98392
CONTR. LIC #:WHITEJG159DN EXPIRATION DATE : 03/01/92
PARCEL NO. . . :965000-117
LEGAL DESC. . :STR 27-30-01 WWM, TAX #
LOT 120 , BLOCK , KALA POINT DIV 4
DESCRIPTION OF IMPROVEMENT: PELLET STOVE INSTALLATION
THERE IS ONLY ONE INSPECTION REQUIRED. IF THE INSTALLATION DOES NOT COMPLY
WITH THE INSTALLATION REQUIREMENTS, THE INSPECTOR SHALL PROVIDE A LIST OF
NECESSARY CORRECTIONS. PLEASE CONTACT THE BUILDING DEPARTMENT WEHN CORRECTIONS
ARE COMPLETE IN ORDER TO SCHEDULE A REINSPECTION OF THE INSTALLATION.
( ) Final Approval :
CALL 385-9141 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS .
Office Hours 9 a.m. to 5 p.m.
Inspector 's Hours 9 - 10 a.m.
24 Hour Recorder for Inspections .