HomeMy WebLinkAboutBLD2000-00370 ,
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 #: BLD00-00370 Received Date 6/7/2000
SITE ADDRESS: 8194 SR20 Issue Date 6/12/2000
PORT TOWNSEND, 98368 Expiration Date 6/12/2001
APPLICANT: RICHARD TWIGGS PHONE: (360)385-0118
8194 SR20
PORT TOWNSEND WA 98368
T 5&7
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001213010 Section: 21 Township: 30N Range: 01W
CONTRACTOR: SUNDANCE SOLAR PHONE: 888-373-1974
3301 HWY 16
PORT ORCHARD WA 98366
Contractor's License SUNDAS*066MG Expires 05/19/2001
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK& HEATING 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 06/12/2001.
REQUIRED INSPECTIONS:
[! ] Tank/Line/Appliance:
[ 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
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BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00370 Received Date: 6/7/2000
SITE ADDRESS: 8194 SR20
PORT TOWNSEND, 98368
APPLICANT: RICHARD TWIGGS PHONE: (360)385-0118
8194 SR20
PORT TOWNSEND WA 98368
SUBDIVISION: Block: Lot: T 5&7
PARCEL NUMBER: 001213010 Section: 21 Township: 30 N Range: 01 W
CONTRACTOR: SUNDANCE SOLAR PHONE: 888-373-1974
3301 HWY 16
PORT ORCHARD WA 98366
Contractor's License SUNDAS*066MG Expires 05/19/2000
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & HEATING STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 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
�roximlty Plat Coo d Ions
Type Amount Paid By: Date: Receipt: Approved/Date
Total:
I:\F_BLD_App_Bld.rpt 10/29/99
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JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: 1360) 379-4450
INSTALLATION PERMIT APPLICATION
•
WOODSTOVE X PROPANE TANK PELLET STOVE �-.OTHER 4 J l----U J J -
SITE ADDRESS:
911#/ROAD NAME /9 l - <- .6
r `` -9, 1. �i . ZIP �/3d
9 DIGIT PARCEL ID NUMBER r 3°1 ''2_1 3 ` 010
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT
,�J PHONE O�j�OQ-�d S=d//g
MAILING ADDRESS i 9y ate, v'Zd !/
ZIP qg. 49/
PROPERTY OWNER c: PHONE g//i.—,kS --02/
MAILING ADDRESS d 1
ZIP �1-'Y34 Q/
CONTRACTOR Lel,t. „Z PHONE (— 7 7 -/33 j
MAILING ADDRESS Air737 4 127P177 „WV .....- 5
ZIP
STATE LICENSE# 5//Al V79
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 C„ DATE Z? / 7 /
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 1 uj q 3
Jy
CASH/CK# �-i L137-.)
TOTAL DATE (1) /1i ct
H:\HOME\PLN CNTR\FORMS\INSTALL.DO C 10/99