HomeMy WebLinkAboutBLD2000-00667 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 #: BLD00-00667 Received Date 10/11/2000
SITE ADDRESS: 35 EVANS LN Issue Date 10/11/2000
PORT LUDLOW, 98365 Expiration Date 10/11/2001
APPLICANT: TONY D RICHARDSON PHONE: 437-9132
35 EVANS LN
PORT LUDLOW WA 98365
43
SUBDIVISION: PORT LUDLOW NO. 1 AREA 3 Block: 3 Lot:
PARCEL NUMBER: 990400343 Section: 8 Township: 28N Range: 01 E
CONTRACTOR: OWNER PHONE:
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK& 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 10/11/2001.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: - 00
[Irv' ..,FinalApproval: ! / '-22— t1 1
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
r a
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00667 Received Date: 10/11/2000
SITE ADDRESS: 35 EVANS LN
PORT LUDLOW, 98365
APPLICANT: TONY D RICHARDSON PHONE: 437-9132
35 EVANS LN
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 1 AREA 3 Block: 3 Lot: 43
PARCEL NUMBER: 990400343 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
IF
PROJECT DESCRIPTION: PROPANE TANK & STOVE 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 - Nlat (:o drtlons
Type Amount Paid By: Date: Receipt: Approved[ ate
Propane Tanks/Stoves $48.00 MAM 10/11/00 34705
Total: $48.00
is\F_BLD_App_Bld.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 �3CJGfg
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SITE ADDRESS: �y'� j `C„
911#!ROAD NAME / , ��G�� /L'V )
/.4). ���I l,,()/f ZIP 7E3&J
9 DIGIT PARCEL ID NUMBER 970
Legal Description:
Subdivision Name Block Lot(s) 7.3
Section Township North, Range WM
APPLICANT _ f ��ilU� /4. PHONE
MAILING ADDRESS �� I- J L,Dr c- ed A-
?S,3 6_5- ZIP
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP
CONTRACTOR 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 applican ' prop rty .r structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE ! DATE / 6
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 4i 5
CASH/CK# I C( A A.,
TOTAL V DATE f-0/ ! ! C (
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