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HomeMy WebLinkAboutBLD2000-00698 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 #: BLD00-00698 Received Date 10/19/2000 SITE ADDRESS: 50 MOCKINGBIRD LN Issue Date 10/20/2000 PORT LUDLOW, 98365 Expiration Date 10/20/2001 APPLICANT: MICHAEL D JOACHIMS PHONE: (360)437-9648 SUSAN K JOACHIMS 50 MOCKINGBIRD LN PORT LUDLOW WA 983659759 63 SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot: PARCEL NUMBER: 990500063 Section: 8 Township: 28N Range: 01 E CONTRACTOR: EVERWARM INC PHONE: 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 08/04/2001 OWNER, MICHAEL D JOACHIMS PHONE: (360)437-9648 if different: SUSAN K JOACHIMS 50 MOCKINGBIRD LN PORT LUDLOW WA 983659759 PROJECT DESCRIPTION WOODSTOVE INSERT 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 10/20/2001. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: teyl,'--," 7-C. t,,r i°--- d)n_>) inaIApprov � ,X / . / -- y r 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 #: BLD00-00698 Received Date: 10/19/2000 SITE ADDRESS: 50 MOCKINGBIRD LN PORT LUDLOW, 98365 APPLICANT: MICHAEL D JOACHIMS PHONE: (360)437-9648 SUSAN K JOACHIMS 50 MOCKINGBIRD LN PORT LUDLOW WA 983659759 SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot: 63 PARCEL NUMBER: 990500063 Section: 8 Township: 28 N Range: 01 E CONTRACTOR: EVERWARM INC PHONE: 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 08/04/2001 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: WOODSTOVE INSERT INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural —Proximity - Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 10/19/00 34679 Total: $48.00 is\F_BLD_App_Bld.rpt 10/29/99 I. JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATIONn WOODSTOVE PROPANE TANK PELLET STOVE A,OTHER L c.,,Q_ k(1_ 4--rI- SITE ADDRESS:911#/ROAD NAME ✓c° /W e Ai jn o ,�jl,z O z Syr -P©,..z.7- 4GL O L cae-J l) p a& ZIP b is S' 9 DIGIT PARCEL ID NUMBER 9 ,0 ,U 0 Q 6 3 Legal Description:Subdivision Name Pogrl ` k C/ O.. a .c.> Block Lot(s) (O 3 Section Township North, Range WM APPLICANT 0/ Ae i 4: Sus / /J 0/1-a- i.nS PHONE( VtvO) . /c3 7. 9 /,ii MAILING ADDRESS ----0 /27 c_k`y7 4 67 ,Q Q J xi./ e q ip)0eZ T- L` JoL O l� ZIP / a l?(v S PROPERTY OWNER 64.-y-,4-e. O U — PHONE MAILING ADDRESS ZIP CONTRACTOR E(J Q^x )/9 R rn �� /e.a w ///a2x u2 PHON(? OO) I.5 a .3 ,3 C MAILING ADDRESS c J /S7 /77 )l.1 / O/ C� Pp,gr ny� /PQc - ZIP 0 406( , STATE LICENSE# vEA u.),` - Q e'SNZ,, EXP. DATE er- 4/-O/ • FEDERAL I.D. # Y//-5 'r ? 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 nea—) DATE /0/ /7 / 190 FOR OFFICE USE ONLY 1a l' 6 BASE FEE ;� RECEIPT# ... , - CASH/CK# (-57 TOTAL I__ I_` 31� DATE I C� / / C/ t�� H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99