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HomeMy WebLinkAboutBLD2000-00305 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 #: BLD00-00305 Received Date 5/15/2000 SITE ADDRESS: 1353 THORNDYKE RD Issue Date 5/16/2000 PORT LUDLOW, 98365 Expiration Date 5/16/2001 APPLICANT: JOHN SCHMIDT PHONE: (360)437-0803 1353 THORNDYKE RD PORT LUDLOW WA 98365 34 SUBDIVISION: TRAILS END HOMESITES Block: 3 Lot: PARCEL NUMBER: 950100333 Section: 16 Township: 27N Range: 01 E CONTRACTOR: SUNDANCE SOLAR PHONE: 888-373-1974 3301 HWY 16 PORT ORCHARD WA 98366 Contractor's License SUNDAS*066MG Expires 05/19/2000 OWNER, if different: PROJECT DESCRIPTION PROPANE TANK, PIPE &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 05/16/2001. REQUIRED INSPECTIONS: [Tank/Line/Appliance: [J,,---' FinalApproval: / k 66 et2c 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 #: BLD00-00305 Received Date: 5/15/2000 SITE ADDRESS: 1353 THORNDYKE RD PORT LUDLOW, 98365 APPLICANT: JOHN SCHMIDT PHONE: (360)437-0803 1353 THORNDYKE RD PORT LUDLOW WA 98365 SUBDIVISION: TRAILS END HOMESITES Block: 3 Lot: 34 PARCEL NUMBER: 950100333 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: SUNDANCE SOLAR PHONE: 888-373-1974 3301 HWY 16 PORT ORCHARD WA 98366 Contractor's License SUNDAS*066MG Expires 05/19/1999 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK, PIPE & STOVE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 1997 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: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Flood Plane F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural —Prm xlltyy - flat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 05/15/00 30875 Total: $48.00 i:\F_BLD_App_Bld.rpt 10/29/99 I . c • JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER p fp 5 i- SITE ADDRESS: 911#/ROAD NAME / 5 C. 114c,2 ijc '-t £. f) port T L 0Lc)W W ZIP L S 9 DIGIT PARCEL ID NUMBER tic-© /2i2 3 3 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT `' »-1:.) - , PHONE 4 "7_ i3703 MAILING ADDRESS ( S. -3 '7 6-{c:),2 rp'{t l c. q- L.-LA./�c-�'(�> i i.�/14 ZIP Cl v PROPERTY OWNER 3 A N PHONE MAILING ADDRESS ZIP CONTRACTOR C LA.5 T-p : '1 .A 12 T 1-f- PHONE 3(4) 373 - (332— MAILING ADDRESS `3 3 zj r . I ( , 1- i Ar2 I tA) A- ZIP cY3 &> . STATE LICENSE# SU )J V R S 0 M Cr 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 "- - DATE 5- / I / t2© • FOR OFFICE USE ONLY BASE FEE 3', RECEIPT# -15 CASH/CK# 51 TOTAL DATE 5 iris /oCC', H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99