HomeMy WebLinkAboutBLD2000-00033 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 #: BLD00-00033 Received Date 1/13/2000
SITE ADDRESS: 191 BALDWIN LN Issue Date 1/13/2000
PORT LUDLOW, 98365 Expiration Date 1/13/2001
APPLICANT: JACK DASH PHONE:
191 BALDWIN LANE (360)432-9932
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO 2 AREA 1 Block:
Lot: 4
PARCEL NUMBER: 990600104 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: FERRELLGAS
2108 SIMS WAY PHONE: (360)385-6998
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 8/1/00
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK& GAS PIPE 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 1/13/01.
REQUIRED INSPECTIONS:
[ __ Tank/Line/Applianc et:9 d
inalApprov • (/�/C /'
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00033 Received Date: 1/13/2000
SITE ADDRESS: 191 BALDWIN LN
PORT LUDLOW, 98365
APPLICANT: JACK DASH
191 BALDWIN LANE PHONE: (360)432-9932
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO 2 AREA 1
Block: Lot: 4
PARCEL NUMBER: 990600104
Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: FERRELLGAS
2108 SIMS WAY PHONE: (360)385-6998
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 8/1/00
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & GAS PIPE 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:
CONST TYPE: GARAGE: SHORELINE:
DECK: SETBACK:
SEWAGE DISPOSAL: BANK HEIGHT:
WATER SYSTEM:
STORMWATER: YES NO AREA
BEDROOMS: BATHROOMS:
Exist: Wetland Erosion
Exist: Seismic
Prop: Prop: FloodingStreams
Total: Total: Landslide
F&W Plat Conditions
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximit
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $46.00 MAM 01/13/00 23993
Total: $46.00
I:\F_B LD_App_B ld.rpt
10/29/99
NOV-17-1999 12:23 JEFF CO PERMIT CENTER
360 379 4451 P.01
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ifil n r?^ N CpUNTy r OMMLINITY D �1F1 r71sFAchrr �21_SHERIDAN ST, PORT TOWNSEND WA 98368 PH: WO) 3.79.4450
INSTALLATION PERMIT APPLICATION S"l/ k a ✓/LT
WOODSTOVE PROPANE TANK PELLET STOVE OTHER -L..
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SITE ADDRESS:911#!ROAD NAME j 4/ IJ
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(car /tid/0 , Yv, . ZIP Q/' -3 6_J
8 DIGIT PARCEL ID NUMBER 9 ?O 60 ca —/04,
Legal Description: g �.j A i(.a.
Subdivision Marne —i.- "-• : ' .L ,tow �t't Blockf ,
Lot(sl 1'f-
SeCtio' iS Township 2, S North, Range 1 WM
APPLICANT F R A f LL o f PHONE 3 '1
,I',
MAILING ADDRESS .l 0 2 S/At s fl/J 4 y
re:z T— 1'61 vim, .. . .„-- Gam. ZIP Yd 3 i/
PROPERTY OWNER r/4-e: k On- /- PHONE 7 a - 9 7 L
MAILING ADDRESS / 9 I $41 C y"4/1/. L,�v
rii.,, ZIP raP 76(-$
CONTRACTOR F•�Ag 1.-iic_n
PHONE Trr/2—r C, rd.
MAILING ADDRESS ,-i p I _ St,ls W✓4Y
f0i<T— Tvlt,,,, s---7,-ci (WA,
ZIP fl, ("de'
STATE LICENSE# 60 / $S 7 SIA.Z.
EXP.DATE 9 T,/ — -2 v v ,.:-)
FEDERAL I.D.# F. i dE L PP .S•.,1- ./71
By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material
falsehood or any omission of a material fact made by the epplicentlowner with respect to this application packet may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses what,
may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
i further
ree to provide access and
o
erson
nty and it's
rea ed later nspections, Acces. and right
of entry tto the applicant's property or struictu®Sshall beerequtives estedor agents for the and ahail occur r�se of application review and any
during regular busin9SS hours.
��APPLICANT SIGNATURE ,-- 9
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,
fJ' DATE ;C,' j f •4
hlAtNbME1PI.nteNTRtFORNISlINSTALt.p4C t Ot9$
p Ec� E � dE
JAN 1 3 2000
0
TOTAL P.01
JEFFERSON COUNTY
DEPT. OF COMMUNITY DEVELOPMENT