HomeMy WebLinkAboutBLD2000-00148r
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 #: BLD00-00148 Received Date 3/6/2000
SITE ADDRESS: 416 N BAYVIEW DR Issue Date 3/6/2000
PORT LUDLOW, 98365 Expiration Date 3/6/2001
APPLICANT: JEFF KENBOCK PHONE: (360)437-0771
416 N BAYVIEW DR
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921332016 Section: 33 Township: 29N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2000
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK 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 03/06/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
FinalApproval: l< c3 ,9 p a V
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
JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (3601 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE )^ PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: I // J AlJ� j /
911#/ROAD NAME `T C� !'V (�-. / e'GJ
T - �. !//yJL / ZIP 7 O. �
9 DIGIT PARCEL ID NUMBER 3 a / 3 3-Z - (_)/
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT k ACME 7 - O 7 //
MAILING ADDRESS 'f
ZIP
PROPERTY OWNER i PHONE
MAILING ADDRESS `
ZIP
CONTRACTOR Suvl S H I vl PR-0 P PHONE 3 86--- 3 7/7
MAILING ADDRESS to 53 RN-a 1t 02 .
Por•T- 14-Ayj LD cac c,?4 • ZIP 5 cr 33 ct
STATE LICENSE # SLlVIsH-P 077QP EXP. DATE 11 q
FEDERAL I.D. # 9 i- l O =t 7 8 S 7
APPLICANT SIGNATURE ,dJ'l, / e DATE / / �)
FOR OFFICE USE ONLY
BASE FEE . Cry E'CEIPT # 2,5 4-04
i ' SH/CK # T09
TOTAL 14 X 0 _ L��TE 3 / / 0 0
JEFFERSON COUNTY
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC4/98 DEPT. OF COMMUNITY DEVELOPMENT
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00148 Received Date: 3/6/2000
SITE ADDRESS: 416 N BAYVIEW DR
PORT LUDLOW, 98365
APPLICANT: JEFF KENBOCK PHONE: (360)437-0771
416 N BAYVIEW DR
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921332016 Section: 33 Township: 29 N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP`077QP Expires 11/17/2000
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: HEAT BASE: HEAT TYPE:
OCCUPANCY:
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
Shoreline Aquifer
Routing Date: Forest: Commercial Rural
Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 03/06/00 25404
Total: $48.00
I:\F_BLD_App_Bid.rpt 10/29/99