HomeMy WebLinkAboutBLD2000-00707 r 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 #: BLD00-00707 Received Date 10/26/2000
SITE ADDRESS: 101 SEAMOUNT DR Issue Date 10/26/2000
BRINNON, 98320 Expiration Date 10/26/2001
APPLICANT: STEVE DELMORE PHONE:
101 SEAMOUNT DR
BRINNON WA 98320
10
SUBDIVISION: SEAMOUNT ESTATES DIV 3 Block: Lot:
PARCEL NUMBER: 993400010 Section: 32 Township: 25N Range: 02W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTI00088CC Expires 05/01/2001
OWNER, STEVE DELMORE PHONE:
if different: 101 SEAMOUNT DR
BRINNON WA 98320
PROJECT DESCRIPTION PROPANE TANK& GAS LINE 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:
[ ] Tank/Lin 4 Appliance: c/ � --a
['] FinalApproval: /A-&, L-c•a/c .,) 1-1 6 /- 9 H
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 #: BLD00-00707 Received Date: 10/26/2000
SITE ADDRESS: 101 SEAMOUNT DR
BRINNON, 98320
APPLICANT: STEVE DELMORE PHONE:
101 SEAMOUNT DR
BRINNON WA 98320
SUBDIVISION: SEAMOUNT ESTATES DIV 3 Block: Lot: 10
PARCEL NUMBER: 993400010 Section: 32 Township: 25 N Range: 02 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2001
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & GAS LINE 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 - Flat uoO ditions
Type Amount Paid By: Date: Receipt: Approved/vote
Propane Tanks/Stoves $48.00 MAM 10/26/00 34758
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 Nili PROPANE TANK PELLET STOVE OTHER li?S ) r\_s2
SITE ADDRESS:
911#/ROAD NAME i C' ' G� - J — fZ .
C? ,.� ZIPS cZ
9 DIGIT PARCEL ID NUMBER Cam
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT '3 . s- s-' PHONE
MAILING ADDRESS I c I 4c=mb
ZIP
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP
c--- PHONE °"--) ' ` 3 i 6
MAILING ADDRESS ,
�`��✓ i �-- �_s s , 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 u rt' loyees, representatives or agents for the purpose of application review and any
required later inspections. Access a ri ht of entry to the applican perty or structu shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE DATE I
FOR OFFICE USE ONLY
BASE FEE RECEIPT# ' `
jj CASH/CK# j Li
TOTAL `"1 J DATE
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