HomeMy WebLinkAboutBLD2000-00034 aim
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 #: BLD00-00034 Received Date 1/13/2000
SITE ADDRESS: 62 LEWIS AVE Issue Date 1/13/2000
PORT TOWNSEND, 98368 Expiration Date 1/13/2001
APPLICANT: DOUG SOEHL PHONE:
212 GRANT STREET
PORT TOWNSEND WA 98368
SUBDIVISION: IRONDALE
Block: 102 Lot: 11-13
PARCEL NUMBER: 962110202 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 8/1/00
OWNER,
if different:
PROJECT DESCRIPTION__ , HEATER& GAS LINE 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/Appliance:
[ ] FinalApproval: ` — -1 L-1
AMEM
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BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00034 Received Date: 1/13/2000
SITE ADDRESS: 62 LEWIS AVE
PORT TOWNSEND, 98368
APPLICANT: DOUG SOEHL
212 GRANT STREET PHONE:
PORT TOWNSEND WA 98368
SUBDIVISION: IRONDALE
Block: 102 Lot: 11-13
PARCEL NUMBER: 962110202
Section: 34 Township: 30 N Range: 01 W
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: rillaiak HEATER & GAS LINE 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: —
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Wetland Erosion
Exist: Exist: Seismic
Prop: Prop: FloodingStreams
Total: Total: Landslide
F&W Plat Conditions
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $46.00 MAM 01/13/00 23992
Total: $46.00
I:1F_BLD_App_Bld.rpt
10/29/99
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JEFFER N 0 NTY MM NITY DEVELOPMENT 621 SHERIDAN T PORT TOWNSEND WA g PH:
79-445
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE
OTHER
SITE ADDRESS:
911#/ROAD NAME Fff'2 I Eft '7, 4�j�
9 T(�wVs� c ✓,� ZIP ?G I
9 DIGIT PARCEL ID NUMBER ?GA //U 2v L
Legal Description:
Subdivision Name
Block Lotlsl_
Section Township
/ North, Range WM
APPLICANT
PHONE -7 1.71 cr9 y�
MAILING ADDRESS &/ i2>" J,,
fD T- 7'D d W:3
ZIP g, 3tre
PROPERTY OWNER Pa it SAE j, 1
/1 PHONE 7c9-C---_20_2 Z
MAILING ADDRESS oZ/ .Z R
Pa2r 710�,.,�-S��-d ✓ . ZIP d'71(,)'
CONTRACTOR F1=p11.tit G� S�
PHONE ✓� — 6 P
MAILING ADDRESS 2/ S
C �iv� Sn d ZIP
STATE LICENSE# 6 0 j S'S3 S t7t n�
EXP. DATE 9-1/ ,206,a
FEDERAL I.D. # FE �+ �/ V D -a L 11
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 cc:ue Jefferson
"�� against County as a result of or in consequence of the granti
ng 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 l / /rZ/ U U
FOR OFFICE USE ONLY
BASE FEE
-"- RECEIPT# k
TOTAL Lt6, 00 D a 1J L' St l/CK# t'
CIAT i. j a :,r/
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99
JAN 1 3 2000 ,J
JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT