HomeMy WebLinkAboutBLD2000-00705 1 r
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 #: BLD00-00705 Received Date 10/24/2000
SITE ADDRESS: 380 POCKET LN Issue Date 10/25/2000
PORT TOWNSEND, 98368 Expiration Date 10/25/2001
APPLICANT: ERNEST W SAUERLAND PHONE: (360)385-6782
380 POCKET LN
PORT TOWNSEND WA 983689667
T 17
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002242028 Section: 24 Township: 30N Range: 02W
CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096
P 0 BOX 989
PORT TOWNSEND WA 98368
Contractor's License SUBURPL044DA Expires 03/01/2001
OWNER, ERNEST W SAUERLAND PHONE: (360)385-6782
if different: 380 POCKET LN
PORT TOWNSEND WA 983689667
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 10/25/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: ;1<_ ��0
[/-j� Fi naTApproval: CD\� �(i km Col 1 l- q'—®0
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 #: BLD00-00705 Received Date: 10/24/2000
SITE ADDRESS: 380 POCKET LN
PORT TOWNSEND, 98368
APPLICANT: ERNEST W SAUERLAND PHONE: (360)385-6782
380 POCKET LN
PORT TOWNSEND WA 983689667
SUBDIVISION: Block: Lot: T 17
PARCEL NUMBER: 002242028 Section: 24 Township: 30 N Range: 02 W
CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096
P 0 BOX 989
PORT TOWNSEND WA 98368
Contractor's License SUBURPL044DA Expires 03/01/2001
ARCHITECT/
ENGINEER :
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 - I-'lat Conditions
Type Amount Paid By: Date: Receipt: Approved) ate
Propane Tanks/Stoves $48.00 MAM 10/24/00 34690
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
' a! t
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE \. PROPANE TANK PELLET STOVE OTHER Neat;;19 s"-Ote
SITE ADDRESS:
911#/ROAD NAME 'g0 p cc E7 LA.)
PT AvS ZIP C'' e 3(D 9'667
9 DIGIT PARCEL ID NUMBER c,c'2 aY 2 G RS
Legal Description:
Subdivision Name Block Lot(s)
Section 5} Township rt North, Range 2 a_ WM
APPLICANT L t2,UG-j T LU'. SAc.«-2 LA vU PHONE 33 o'3e5-a. 7 S Z
MAILING ADDRESS 3€IO 1pcj<T
I?o, T C N c w A, ZIP /a 33 CT e 6
PROPERTY OWNER (_e A 5( . 4 PHONE 3 E, 8-3 8 S- ?8
MAILING ADDRESS �.78 C) rPOc.4<
Foam-- rc c�J ti' S /tl l� C.QJtq ZIP 9 e k. 7
CONTRACTOR J U&C-4t jf4- rieCIA09-1'J6 PHONE ;9j : 0 - `JO p‘,
MAILING ADDRESS ar;25- R_ U
PORT- Ta c-t i rll S & v.) Q c.-cdq , ZIP l 8 3 6 O
STATE LICENSE # EXP. DATE ®3 ^O(- „Zoo
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 ✓6j 3 i, Le, -c DATE / O / '.24t/ ECj'-)
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 3 6 g v
CASH/CK# o ��
TOTAL 0 i DATE ' 6 iZ f/ LO
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