Loading...
HomeMy WebLinkAboutBLD2000-00496 . 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 #: BLD00-00496 Received Date 7/28/2000 SITE ADDRESS: 110 N BAY WAY Issue Date 7/28/2000 PORT LUDLOW, 98365 Expiration Date 7/28/2001 APPLICANT: DAN TIMIDAISKI PHONE: 2603 185TH AVE E SUMNER WA 98390 31 SUBDIVISION: OAK BAY WATERFRONT TRACTS Block: Lot: PARCEL NUMBER: 976800016 Section: 29 Township: 29N Range: 01E CONTRACTOR: FERRELLGAS STOVE-SUNDANCE PHONE: 888-373-1974 PO BOX 67 SUNDAS*066MG HOODSPORT WA 98548 Contractor's License SUNDAS*066MG Expires 05/19/2001 OWNER, JEFFERY MC GINTY PHONE: (360)779-9538 if different: 19710 22ND AVE NE POULSBO WA 98370 PROJECT DESCRIPTION PROPANE TANK& GAS 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 07/28/2001. REQUIRED INSPECTIONS: [' J Tank/Line/Appliance: FinalApproval: ,-Y/< g 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 #: BLD00-00496 Received Date: 7/28/2000 SITE ADDRESS: 110 N BAY WAY PORT LUDLOW, 98365 APPLICANT: DAN TIMIDAISKI PHONE: 2603 185TH AVE E SUMNER WA 98390 SUBDIVISION: OAK BAY WATERFRONT TRACTS Block: Lot: 31 PARCEL NUMBER: 976800016 Section: 29 Township: 29 N Range: 01 E CONTRACTOR: FERRELLGAS STOVE-SUNDANCE PHONE: 888-373-1974 PO BOX 67 SUNDAS*066MG HOODSPORT WA 98548 Contractor's License SUNDAS*066MG Expires 05/19/2001 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK & GAS STOVE 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: 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 Type Amount Paid By: Date: —Proximity ipt - ApprHiao Conditions Receipt: PP ��a e Propane Tanks/Stoves $48.00 MAM 07/28/00 33368 Total: $48.00 is\F_BLD_App_Bld.rpt 10/29/99 JEFFEPSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE 7.-- 6PANE TANK PELLET STOVE -----`ETHER 68 c S S SITE ADDRESS: 911#/ROAD NAME 1 / 0 /I/, 6 Cr Pori- LHd/ L(/ ZIP . 9 DIGIT PARCEL ID NUMBER c1 ( - U D 0 - Legal Description: Subdivision Name Block Lot(s) Section /` Township North, Range WM APPLICANT y L, fire R � C 6i :� '� Gj PHONE J O 77 5�` MAILING ADDRESS /j 7/ ��� .2n0/ Ave /W, Pocrl3bc) 1694 ZIP 9F-37o PROPERTY OWNER S�h-j e CX S' G �® ye PHONE MAILING ADDRESS ZIP CONTRACTOR Gt.5 40 �CQiYl/ Fe,r'L/9 Qs PHONE MAILING ADDRESS V7 ZIP STATE LICENSE # .5 L/`11 D 4S *0 C 4 /71 6- 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 Q� DATE 2' / 42k/ 0 C) FOR OFFIC USE ONLY BASE FEE RECEIPT# 333 CASH/CK# CAsH TOTAL '-t ' DATE / ©c H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99