HomeMy WebLinkAboutBLD2000-00349 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 #: BLD00-00349 Received Date 5/31/2000
SITE ADDRESS: ORCAS DR BLD 2 UNIT 11 Issue Date 6/1/2000
PORT TOWNSEND, 98368 Expiration Date 6/1/2001
APPLICANT: CHUNG SHIH PHONE:
CHING-ING SHIH
83 FOUR WINDS DR
MIDDLETOWN NJ 077483140
SUBDIVISION: DISCOVERY BAY YACHT& RACQUET Block: Lot:
PARCEL NUMBER: 947500211 Section: 18 Township: 29N Range: 02W
CONTRACTOR: CARL KNAPPLE CONST PHONE: (360)681-8195
173 SUNNY VIEW DR
SEQUIM WA 98382
Contractor's License CARLKC*050NW Expires 08/11/2000
OWNER, CHUNG SHIH PHONE:
if different: CHING-ING SHIH
83 FOUR WINDS DR
MIDDLETOWN NJ 077483140
PROJECT DESCRIPTION GAS LOG SET
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 06/01/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Lijap/Appliance: :W JC. 6 __S'®,(-„
1] FinalApproval: 6? K IC (0-2 3 -00
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 #: BLD00-00349 Received Date: 5/31/2000
SITE ADDRESS: ORCAS DR BLD 2 UNIT 11
PORT TOWNSEND, 98368
APPLICANT: CHUNG SHIH PHONE:
CHING-ING SHIH
83 FOUR WINDS DR
MIDDLETOWN NJ 077483140
SUBDIVISION: DISCOVERY BAY YACHT& RACQUET Block: Lot:
PARCEL NUMBER: 947500211 Section: 18 Township: 29 N Range: 02 W
CONTRACTOR: CARL KNAPPLE CONST PHONE: (360)681-8195
173 SUNNY VIEW DR
SEQUIM WA 98382
Contractor's License CARLKC"050NW Expires 08/11/2000
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: GAS LOG SET
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE: PRO
CODE EDITION: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
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
—Proximity - Nlat conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 LMB 05/31/00 31576
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
LFFERSON,COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379=4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER k$/v Se--/-
SITE ADDRESS:
911#/ROAD NAME
ZIP
9 DIGIT PARCEL ID NUMBER /j ' ;- &Aii/ /7 9.9/7 mod„2--//
Legal Description:
Subdivision Name �r SC cs V((,s/C /�r Block Lot(s)
Section / Township North, Range WM
APPLICANT PHONE
MAILING ADDRESS
ZIP
PROPERTY OWNER Tei'J ,,�c ?t PHONE
MAILING ADDRESS
ZIP
CONTRACTOR PHONE v -- L>S ' �/ r
MAILING ADDRESS /7r.3 /�%- U�rW 'djd..
s�+ "i-'2 ZIP
STATE LICENSE # e/f,1Z/re }TC) EXP. DATE _ts�!l-/i/....Z Dc/
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/ /
FOR OFFICE USE ONLY
BASE FEE RECEIPT# \ `
CASH/CK
TOTAL '"# DATE ") / ")8,I
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC10/99