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HomeMy WebLinkAboutBLD2000-00002 PROPANE/PELLET/WOOD STOVE & TANK INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360) 379-4450 FAX (360) 379-4451 (800)831-2678 PERMIT #: BLD00-00002 Received Date 12/30/1999 SITE ADDRESS: 211 STRAWBERRY LN Issue Date 1/7/2000 NORDLAND, Expiration Date 1/7/2001 APPLICANT: JOE RUSSELL PHONE: (360)385-0196 211 STRAWBERRY LANE NORDLAND WA 98358 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921043027 Section: 04 Township: 29 N Range: 01 E CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420 PO BOX 1031 PORT TOWNSEND WA 98368 Contractor's License PETTIOCO88CC Expires 05/01/2000 OWNER, if different: PROJECT DESCRIPTION PROPANE TANK &STOVE INSTALLATION THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 01/07/2001. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: OK [ ] FinalApproval: CA 2 / . 0.0,7/- BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. - 4:30 p.m. Inspector's Phone Hours 8:00 a.m. -9:00 a.m. SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY I:\F_BLD_Permit_Propane.rpt 10/29/99 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00002 Received Date: 12/30/1999 SITE ADDRESS: 211 STRAWBERRY LN NORDLAND, APPLICANT: JOE RUSSELL PHONE: (360)385-0196 211 STRAWBERRY LANE NORDLAND WA 98358 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921043027 Section: 04 Township: 29 N Range: 01 E CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420 PO BOX 1031 PORT TOWNSEND WA 98368 Contractor's License PETTI00088CC Expires 5/1/00 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK & STOVE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: STORMWATER: YES NO AREA BEDROOMS: BATHROOMS: Wetland Erosion Exist: Exist: Seismic Streams Prop: Prop: Flooding Landslide Total: Total: F&W Plat Conditions Shoreline Aquifer Routing Date: Forest: Commercial Rural Proximity Type Amount Paid By: Date: Receipt: Approved/Date Permit $46.00 MAM 01/03/00 23099 Total: $46.00 I:\F_BLD_App_Bld.rpt 10/29/99 .JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 321 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: 1360) 379-4450 INSTALLATION PERMIT APPLICATION \,1 WOODSTOVE R PROPANE TANK PELLET STOVE OTHER C� e SITE ADDRESS: t ( CS+(C� of If 911#/ROAD NAME V ZIP 9 DIGIT PARCEL ID NUMBER �., O 4 ' ©�.7 Legal Description: Subdivision Name Block Lotls) /7/)�/ Section r � � 1 Township iq North, Range 1 F WM K447 '76- APPLICANT 0 e II PHONE 3 MAILING ADDRESS HOr7L" J-14 VI/1 ZIP q g PROPERTY OWNER PHONE • MAILING ADDRESS ZIP CONTRACTOR /e / r r✓, C 7 PHONE MAILING ADDRESS ZIP STATE LICENSE# EXP. DATE FEDERAL I.D. # By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE FOR OFFICE USE ONLY BASE FEE a" �° §�"'.� .' RECEIPT# }� CASH/CK # ., TOTAL 41p DATE 1, I' H:\HOME\PLN CNTR\FORMS\INSTALL.DOC 10/99