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HomeMy WebLinkAboutBLD2000-00702 PROPANE/PELLET/WOOD STOV TANK INSTALLATION PERMIT Jefferson CountyDepartment of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360) 379-4450 FAX (360) 379-4451 (800)831-2678 PERMIT #: BLD00-00702 Received Date 10/24/2000 SITE ADDRESS: 50 BRIGHTON ST Issue Date 10/26/2000 PORT HADLOCK, 98339 Expiration Date 10/26/2001 APPLICANT: INGRID MUSSON PHONE: (360)379-1373 MARTIN MUSSON PO BOX 288 PORT TOWNSEND WA 98368 1 SUBDIVISION: SHOLD'S ADDITION Block: 4 Lot: PARCEL NUMBER: 994800401 Section: 2 Township: 29N Range: 01W CONTRACTOR: NORTHWEST CHIMNEY SERVICE PHONE: 510 DEKALB SUITE D PORT ORCHARD WA 98366 Contractor's License NORTHCS101CB Expires 01/24/2001 OWNER, INGRID MUSSON PHONE: (360)379-1373 if different: MARTIN MUSSON PO BOX 288 PORT TOWNSEND WA 98368 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 10/26/2001. REQUIRED INSPECTIONS: [ //L ine A arkce: (41%/r /i :47/1 S 47.(70 1 [ a Approva. 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 #: BLD00-00702 Received Date: 10/24/2000 SITE ADDRESS: 50 BRIGHTON ST PORT HADLOCK, 98339 APPLICANT: INGRID MUSSON PHONE: (360)379-1373 MARTIN MUSSON PO BOX 288 PORT TOWNSEND WA 98368 SUBDIVISION: SHOLD'S ADDITION Block: 4 Lot: 1 PARCEL NUMBER: 994800401 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: NORTHWEST CHIMNEY SERVICE PHONE: 510 DEKALB SUITE D PORT ORCHARD WA 98366 Contractor's License NORTHCS101CB Expires 01/24/2001 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: WOODSTOVE 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 1-'rQximlty Fiat conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 10/24/00 34753 Total: $48.00 is\F_BLD_App_Bid.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION 2/7-0 ys / WOODSTOVE PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: 911#/ROAD NAME /rly (YA' X)v•e.= 6,6 P©/ /Y•"'�L-0CI ZIP 4 A 9ss3I cf 9 DIGIT PARCEL ID NUMBER � �/ `� 7O 4'o/ Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT ///./2_ llif9/T/� /j4USSdir/ PHONE O MAILING ADDRESS p-® •3OX 2 15767z•— > (13, ZIP eef>fI PROPERTY OWNER 4/,// PHONE MAILING ADDRESS ZIP CONTRACTOR '4 1.X/ S ( vc 2? 5,4 //1/c PHONE 3.467 6 g' z MAILING ADDRESS Lv�/L�/9Lc te..)4/' //C.(] /LLcic.2)."9G ZIP /.tj/9 Pg323 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 /ej / .2 y / O O FOR OFFICE USE ONLY BASE FEE RECEIPT# ~> CASH/CK# TOTAL L- , _ DATE / / L,C H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99