HomeMy WebLinkAboutBLD2000-00624 •
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 #: BLD00-00624 Received Date 9/25/2000
SITE ADDRESS: 222 FOXFIELD DR Issue Date 9/27/2000
PORT TOWNSEND, 98368 Expiration Date 9/27/2001
APPLICANT: KARL F BACH PHONE: (360)344-3658
222 FOXFIELD
PORT TOWNSEND WA 98368
103
SUBDIVISION: KALA POINT#4 Block: Lot:
PARCEL NUMBER: 965000097 Section: 27 Township: 30N Range: 01W
CONTRACTOR: PLUMBING REPAIR SERVICE PHONE: (360)385-4357
PO BOX 205
PORT HADLOCK WA 98339
Contractor's License PLUMBRSO22BN Expires 01/09/2001
OWNER, KARL F BACH PHONE: (360)344-3658
if different: 222 FOXFIELD
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION PLUMBING
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 09/27/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
nalApproval: ( ti' {�L WU' vver rb'4-66
i
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
' t
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00624 Received Date: 9/25/2000
SITE ADDRESS: 222 FOXFIELD DR
PORT TOWNSEND, 98368
APPLICANT: KARL F BACH PHONE: (360)344-3658
222 FOXFIELD
PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#4 Block: Lot: 103
PARCEL NUMBER: 965000097 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: PLUMBING REPAIR SERVICE PHONE: (360)385-4357
PO BOX 205
PORT HADLOCK WA 98339
Contractor's License PLUMBRSO22BN Expires 01/09/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PLUMBING
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 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
1-,r ximit - Hat G drtrtlons
Type Amount Paid By: Date: Receipt: ApprovedR ate
Permit $48.00 MAM 09/25/00 34374
State Building Code $4.50 MAM 09/25/00 34374 ] a' . ' ID
Total: $52.50 / _
/S
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Jeffersoh County Planning
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JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
•
WOODSTOVE PROPANE TANK PELLET STOVE V'OTHER PI Urn IO I�'t
SITE ADDRESS: ��� � ` D rtva-
911#/ROAD NAME ` ,,/^
�ot 9Lok.ces.cl, +�I` ZIP 988a8
9 DIGIT PARCEL ID NUMBER 616,5000047
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT ear! F. Back, PHONE 3 44- 36 5 8
MAILING ADDRESS •L a,s' alev't
ZIP
PROPERTY OWNER 1644 F. "5 PHONE J 44.• 3(/ 78
MAILING ADDRESS ,,4 4‘ a_S aksv2
ZIP
CONTRACTOR '3(eta' 1`14S OK. G�PHONE 3 / '9-3 57
MAILING ADDRESS ?tab ..- - r Sett,"c.e_..
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 +the applicant's property or structure shall be requested and shall occur during regular business hours.
i i/APPLICANT SIGNATURE ,or 0 DATE / cr
FOR OFFICEUSE ONLY ///
BASE FEET RECEIPT#
' . 'oo, CASH/CK# 3
TOTAL
DATE
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99