HomeMy WebLinkAboutBLD2000-00431 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 #: BLD00-00431 Received Date 6/30/200-°
SITE ADDRESS: 6411 SR20#9 Issue Date 6/30/2000
PORT TOWNSEND, 98368 Expiration Date 6/30/2001
APPLICANT: DOROTHY MOORE PHONE:
4831 S DISCOVERY
PORT TOWNSEND WA 98368
1-14
SUBDIVISION: MOORE'S MOBILE MANOR Block: Lot:
PARCEL NUMBER: 001332015 Section: 33 Township: 30N Range: 01W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2001
OWNER, DOROTHY MOORE PHONE:
if different: 4831 S DISCOVERY
PORT TOWNSEND WA 98368
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 06/30/2001.
REQUIRED INSPECTIONS:
[ l Tank/Lin4,/Appliance: rY ,;;°? "—Li
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[:] FinalApproval: -�01Mk- € 176- ,,✓f.frt>.0'17 rI c_ j- e)D
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 #: BLD00-00431
Received Date: 6/30/2
SITE ADDRESS: 6411 SR20#9
PORT TOWNSEND, 98368
APPLICANT: DOROTHY MOORE PHONE:
4831 S DISCOVERY
PORT TOWNSEND WA 98368
SUBDIVISION: MOORE'S MOBILE MANOR Block: Lot: 1-14
PARCEL NUMBER: 001332015 Section: 33 Township: 30 N Range: 01 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK 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: 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 Ruraloon
Type Amount Paid By: Date: �rReceilpt: Appro ed/Dateons
Propane Tanks/Stoves $48.00 MAM 06/30/01 32116
Total: $48.00
is\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 PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: /O / /`( �e) _q'
911#/ROAD NAME (�{ ( j ��/ice z Q-
I-140 , G� .�. ZIP t i/ 6,O
9 DIGIT PARCEL ID NUMBER :Jo / 3 5)- f/
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT PHONE
MAILING ADDRESS 6 7 /( / � ,��s -, lO
/t--t>?/ 7,--a,�#S(- G(04 4 ZIP �U
PROPERTY OWNER SI PHONE
MAILING ADDRESS
ZIP
CONTRACTOR iZ7C`" ` C! d Ce PHONE 1 � ` C �a S � /o
MAILING ADDRESS � < /(J
G "Ci(i r,g A G1 6ilq ZIP J C('
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.
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 / /
FOR OFFICE USE ONLY
BASE FEE ;T". RECEIPT# ' 2_ ( G
CASH/CK# 1.4
TOTAL DATE (OR O i OO
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