HomeMy WebLinkAboutBLD2000-00639 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 #: BLD00-00639 Received Date 10/2/2000
SITE ADDRESS: 415 E MARROWSTONE RD Issue Date 10/12/2000
NORDLAND, 98358 Expiration Date 10/12/2001
APPLICANT: GLORIA THOMPSON PHONE: (360)385-4433
415 E MARROWSTONE
NORDLAND WA 98358
T 56
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921092016 Section: 9 Township: 29N Range: 01E
CONTRACTOR: OWNER PHONE:
OWNER, GLORIA THOMPSON PHONE: (360)385-4433
if different: 415 E MARROWSTONE
NORDLAND WA 98358
PROJECT DESCRIPTION WOODSTOVE 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 10/12/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[_] FinalApproval: t� \ t2 ao
BUILDING INSPECTION HOT-LINE 3794455. 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 #: BLD00-00639 Received Date: 10/2/2000
SITE ADDRESS: 415 E MARROWSTONE RD
NORDLAND, 98358
APPLICANT: GLORIA THOMPSON PHONE: (360)385-4433
415 E MARROWSTONE
NORDLAND WA 98358
SUBDIVISION: Block: Lot: T 56
PARCEL NUMBER: 921092016 Section: 9 Township: 29 N Range: 01 E
CONTRACTOR: OWNER PHONE
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: WOODSTOVE INSTALLATION
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
—Proximity - Plat G ditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 10/02/00 34507
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
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JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNbT34444 .9ES3-68 PH: ,(3F0)„379-4450
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INSTALLATION PERMIT APPLICATIC tt
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS:
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N � f i-f ZIP
9 DIGIT PARCEL ID NUMBER t 2--\ 0 9 2_„ 0 i ((o4 e_ o
Legal Description: I/'Z, 0 S a � W ‘
Subdivision Name / Block Lot(s)
Section Township 1 fit✓ �, o, North, Range - w inn I WM
APPLICANT G l 0 n (-j \ N-r M/G?"�^?fi PHONE 3 fj Q 3 I S 3
MAILING ADDRESS k-I I5--, L . {Y� c^� (� \IJJ���� —fi�5[ _
C\`►�1(C�Ct(`L/ A / S ZIP 9 tl 3 S L�
PROPERTY OWNER PHONE 6i 1 a 12
MAILING ADDRESS
ZIP i,
CONTRACTOR ! ®1.&)IVG k I'1� PHONE 'Mc
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 DATE /2-9 / 0 0
FOR OFFICE USE ONLY
BASE FEE RECEIPT# I-f 5C
CASHJCK# 13
TOTAL DATE
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