HomeMy WebLinkAboutBLD2000-00042 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 #: BLD00-00042 Received Date 1/18/2000
SITE ADDRESS: 4242 S DISCOVERY RD Issue Date 1/18/2000
PORT TOWNSEND, 98368 Expiration Date 1/18/2001
APPLICANT: WINFIELD D TWEEDIE PHONE:
4242 S DISCOVERY RD
PORT TOWNSEND WA 98368
SUBDIVISION: GOV LOT Block: Lot: 2
PARCEL NUMBER: 001322034 Section: 32 Township: 30 N Range: 01 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2000
OWNER, TWEEDIE WINFIELD PHONE:
if different: EJ LAMBERTON, R/D GIDNER
24566 HOLLYWOOD RD
HOLLYWOOD MD 206362109
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 01/18/2001.
REQUIRED INSPECTIONS:
[ Tank/Lin p
[ l (alApproval: 5 L �7 L/ - 0eA
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
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00042 Received Date: 1/18/2000
SITE ADDRESS: 4242 S DISCOVERY RD
PORT TOWNSEND, 98368
APPLICANT: WINFIELD D TWEEDIE PHONE:
4242 S DISCOVERY RD
PORT TOWNSEND WA 98368
SUBDIVISION: GOV LOT Block: Lot: 2
PARCEL NUMBER: 001322034 Section: 32 Township: 30 N Range: 01 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2000
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: PRO
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: 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
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $46.00 LMB 01/18/00 23131
Total: $46.00
I:\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: 5. v-)'' SG o J r fl� �1 G�911#/ROAD NAME rj� 2__(/2__(/ 2_ /�'
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9 DIGIT PARCEL ID NUMBER C)O I 7 -I? ® 3 y
Legal Description: Z„ T Z
Subdivision Name Block Lot(s)
Section 3 Z Township 30 North, Range ( WM
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APPLICANT 1�5C PHONE g(p 2 65�,
2._MAILING ADDRESS Li (4- Z-�St r)( s CS�I e ( �-
O( &)( ZIP
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PROPERTY OWNER W / ( C L b � j Q PHONE 3G18. 7 .2C, 5
MAILING ADDRESS `'C 2(1 S, Di S'Cc--1,)��`,
t &`n+ l�1tJJn � "`� W1� ZIP 7 3 Gca
CONTRACTOR �P_. j U //mil.' PHONE
Z4
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 6°. V C v�c C� DATE l // / f.�-f 0-0
[�J FOR OFFICE USE ONLY •
BASE FEE i dos - RECEIPT# I \ "
CASH/CK# '
TOTAL tit •CRY DATE 1
H:\HO ME\PLNCNTR\FORMS\IN STALL.DOC 10/99