HomeMy WebLinkAboutBLD2000-00209 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 #: BLD00-00209 Received Date 4/3/2000
SITE ADDRESS: 360 CLEVELAND AVE Issue Date 4/4/2000
PORT HADLOCK, 98339 Expiration Date 4/4/2001
APPLICANT: JAROMIR BELIC PHONE: (360)379-9770
360 CLEVELAND ST
PORT HADLOCK WA 983391142 81
SUBDIVISION: IRONDALE AC TRACTS Block: Lot:
PARCEL NUMBER: 962700085 Section: 07 Township: 29N Range: 01E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2000
OWNER, JAROMIR BELIC PHONE: (360)379-9770
if different:
360 CLEVELAND ST
PORT HADLOCK WA 983391142
PROJECT DESCRIPTION PROPANE TANK, GAS PIPE &APPLIANCE 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 O4/04/2001.
REQUIRED INSPECTIONS:
[ Tank/ ine ppliance: )0 7,/Tell- � R 1 Pell _--4://j
[t/ FinalApproval: )k_ eL--- ` C'/
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 #: BLD00-00209 Received Date: 4/3/2000
SITE ADDRESS: 360 CLEVELAND AVE
PORT HADLOCK, 98339
APPLICANT: JAROMIR BELIC PHONE: (360)379-9770
360 CLEVELAND ST
PORT HADLOCK WA 983391142
SUBDIVISION: IRONDALE AC TRACTS Block: Lot: 81
PARCEL NUMBER: 962700085 Section: 07 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, GAS PIPE &APPLIANCE 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: 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
Propane Tanks/Stoves $48.00 MAM 04/03/00 27123
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
i"-% - , t�' i i TER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
RI u t Iu l/ E
DA! TALLATION PERMIT APPLICATION
AFC -
WO DSTOVE PROP NK PELLET STOVE / OTHER P ( a i , �.,L¢
SIT: • •4•E$IFFERSON COUNTY 22 O
911 .• • •' w1UNITY DEVELOPMENfi�
C/1--1-- ` ZIP 9a337
9 DIGIT PARCEL ID NUMBER -f (0 2- 7 0 0 - Oa S
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT V(A. t2 b (h I 6 L f PHONE �"-Pq 977
MAILING ADDRESS3-A
ZIP
PROPERTY OWNER Glare e C-4, PHONE
MAILING ADDRESS
ZIP
CONTRACTOR Suvt s H in Q. Pao P P.4 Q_ PHONE 3 85'- 57y 7
MAILING ADDRESS (D $5 3 R H-D it 02 .
Porr Filckyo L.o u(.._ (-4,4 • " ZIP 5 cf 33
'
STATE LICENSE #
Sc-t OS!}Pic 07 7 Q p EXP. DATE l I /00
FEDERAL I.D. # 91- I o a 7 8 c7
APPLICANT SIGNATURE �.Gl.—c- An, ay ( DATE / 2/ / CAD
FOR OFFICE USE ONLY
BASE FEE RECEIPT # `)-7-1) 3
CASH/CK # Y ! -24
TOTAL DATE .(-1 / j /00
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