HomeMy WebLinkAboutBLD2000-00356 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 #: BLD00-00356 Received Date 6/5/2000
SITE ADDRESS: 30 GOLDFINCH LN Issue Date 6/5/2000
PORT LUDLOW, 98365 Expiration Date 6/5/2001
APPLICANT: ROBERT COMMANDER PHONE: (360)437-2486
30 GOLDFINCH LN
PORT LUDLOW WA 98365
26
SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot:
PARCEL NUMBER: 990500026 Section: 17 Township: 28N Range: 01 E
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 08/01/2000
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK& FIREPLACE INSERT
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 06/05/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval: (r2 6// il60 V-)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
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00356 Received Date: 6/5/2000
SITE ADDRESS: 30 GOLDFINCH LN
PORT LUDLOW, 98365
APPLICANT: ROBERT COMMANDER PHONE:
30 GOLDFINCH LN
PORT LUDLOW WA 98365
(360)437-2486
SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot: 26
PARCEL NUMBER: 990500026 Section: 17 Township: 28 N Range: 01 E
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 08/01/2000
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & FIREPLACE INSERT
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:
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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: —Proximity - NIat Conditions
yp Receipt: Approveae
Propane Tanks/Stoves $48.00 LMB 06/05/00 31610
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
•
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE ../1/ PROPANE TANK PELLET STOVE OTHER f Fte714te %fe„,frt
SITE ADDRESS:911#/ROAD NAME 30 6 64ac'AILe
/L7' �,vI00ow/ a . zIP 183‘,4;
9 DIGIT PARCEL ID NUMBER 970 5e o 026
Legal Description: /
Subdivision Name /o4T Ze1,0404f./ iL,b. 51 Block Lot(s)
Section Township North, Range WM
APPLICANT 7' L G7"1 r1,9.u616 ' PHONE 36(J f37_2786
MAILING ADDRESS 34 oGOL/.vLy Ic'
j e T LU( O4id ('i' . ZIP 983e5
PROPERTY OWNER /Cv,BteY ^2/1/9A/E7ft2 PHONE 3g'o - ?:r7.2*4 'C
MAILING ADDRESS 36 6. ra,ci. 1' Gviti
d2r ,otO & ZIP ,d3a
CONTRACTOR ,r�t�LG�$ i''t //4.-z Aomi,ve 2:944 PHONE 3c0--38S- Gff
MAILING ADDRESS 2/c S S,/ 5 L140y /kr Tcr�,t4s7e.e0/ 4/4/.
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.
further agroe to provide access and right of entry to Jaf`crscn County and it's employees, eprc o cgo:s fo. the purpose of plicctn .ic revia sod 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 [� srsd^ DATE /.� /2‘.71-0
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 1 Le:
CASH/CK # I +v LI
TOTAL
DATE y / / (1) ,_•
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99