HomeMy WebLinkAboutBLD2000-00656 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 #: BLD00-00656 Received Date 10/6/2000
SITE ADDRESS: 222 FOXFIELD DR Issue Date 10/6/2000
PORT TOWNSEND, 98368 Expiration Date 10/6/2001
APPLICANT: KARL BACH PHONE: (360)344-3658
222 FOXFIELD DR
PORT TOWNSEND WA 98368
103
SUBDIVISION: KALA POINT#4 Block: Lot:
PARCEL NUMBER: 965000097 Section: 27 Township: 30N Range: 01W
CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735
PO BOX 67
HOODSPORT WA 98548
Contractor's License FERRELP055LH Expires 07/31/2001
OWNER, KARL BACH PHONE: (360)344-3658
if different: 222 FOXFIELD DR
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION PROPANE TANK& STOVE
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 10/06/2001.
REQUIRED INSPECTIONS:
nk/Line/Applianc ,:
Fin`Approval e°6
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 #: BLD00-00656 Received Date: 10/6/2000
SITE ADDRESS: 222 FOXFIELD DR
PORT TOWNSEND, 98368
APPLICANT: KARL BACH PHONE: (360)344-3658
222 FOXFIELD DR
PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#4 Block: Lot: 103
PARCEL NUMBER: 965000097 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735
PO BOX 67
HOODSPORT WA 98548
Contractor's License FERRELPO55LH Expires 07/31/2001
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & STOVE
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
—1-1Qximity U dltlons
Type Amount Paid By: Date: Receipt: Approvewuate
Propane Tanks/Stoves $48.00 MAM 10/06/00 34398
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAIV ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE X PROPANE TANK PELLET STOVE OTHER e e_ �A c GA-
SITE ADDRESS:
911#/ROAD NAME f jJ�C e/'(� 4 Zce_
l�Ltl�r-evt(� ZIP 9. .3�P�'
9 DIGIT PARCEL ID NUMBER A'6-0490 oq7
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT 7 1 ] 0CGd,j PHONE 349-- 3 6 5-8
MAILING ADDRESS (W/171-- NiX 7ArL'k6e, 0- ZIP 9(9df,lt�/Op
PROPERTY OWNER ( �2i-o �'� PHONE
MAILING ADDRESS
ZIP
CONTRACTOR �-evre`(, ag PHONE
MAILING ADDRESS c �8 E; i(i19
u / /ei'W jiJ) ZIP 0,S66
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 tot applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE DATE 1,/ 6 / (90
FOR OFFICE USE ONLY
BASE FEE ' RECEIPT# �> :)
CASH/CK#
�7
TOTAL //) C DATE /0 /, ' /
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