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HomeMy WebLinkAboutBLD2000-00499 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 #: BLD00-00499 Received Date 7/31/2000 SITE ADDRESS: 193 SEATTLE DR Issue Date 7/31/2000 PORT LUDLOW, 98365 Expiration Date 7/31/2001 APPLICANT: JOHN KAMP PHONE: (360)437-2793 DEANNE KAMP 193 SEATTLE DR PORT LUDLOW WA 98365 21 SUBDIVISION: TRAILS END 2ND ADDITION Block: 14 Lot: PARCEL NUMBER: 950101417 Section: 16 Township: 27N Range: 01E CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735 PO BOX 67 HOODSPORT WA 98548 Contractor's License FERRELPO55LH Expires 08/01/2000 OWNER, JOHN KAMP PHONE: (360)437-2793 if different: DEANNE KAMP 193 SEATTLE DR PORT LUDLOW WA 98365 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 07/31/2001. REQUIRED INSPECTIONS: �] Tanky /Line/Appliances �% � � 3 lc� r"� r - FinalApproval� 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 #: BLD00-00499 Received Date: 7/31/2000 SITE ADDRESS: 193 SEATTLE DR PORT LUDLOW, 98365 APPLICANT: JOHN KAMP PHONE: (360)437-2793 DEANNE KAMP 193 SEATTLE DR PORT LUDLOW WA 98365 SUBDIVISION: TRAILS END 2ND ADDITION Block: 14 Lot: 21 PARCEL NUMBER: 950101417 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735 PO BOX 67 HOODSPORT WA 98548 Contractor's License FERRELPO55LH Expires 08/01/2000 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: �rReceipt: Ay ppro ec/uateons Propane Tanks/Stoves $48.00 MAM 07/31/00 33379 Total: $48.00 is\F_BLD_App_Bid.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 S Jp SITE ADDRESS: 911ff/ROAD NAME II"3 5,z-AT7(,p DrtU ?®,(2_,( L.Ll ZIP c' 3&�j 9 DIGIT PARCEL ID NUMBER cSQ- /0%- L%!7 Legal Description: Subdivision Name Block Lotls) Section Township North, Range WM APPLICANT Ji-t LA iC .Y1/1e PHONE 360 tr 37-2753 MAILING ADDRESS /'' s „,a -7 7 k )}©( 7 L 9 Li) ZIP PROPERTY OWNER '� �L. �C��,� c- �E'r�l/�L/�� PHONE L(3 7 -)-"7 9 3 MAILING ADDRESS ZIP CONTRACTOR �Yy^ ( re) _ PHONE MAILING ADDRESS 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. 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 ?Gv-7it��+� C G+ DATE 7 / 3/ / U C) FOR OFFICE USE ONLY BASE FEE RECEIPT# CASH/CK# !L Th TOTAL DATE _9 / i / H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99