HomeMy WebLinkAboutBLD2000-00712 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 #: BLD00-00712 Received Date 10/26/2000
SITE ADDRESS: 86 N BAYVIEW DR Issue Date 10/30/2000
PORT LUDLOW, 98365 Expiration Date 10/30/2001
APPLICANT: DAVID HOLT PHONE: (541)382-4040
1539 NW SUMMIT
BEND OR 97708
1-3
SUBDIVISION: GAINER SHORT PLAT Block: Lot:
PARCEL NUMBER: 921332028 Section: 33 Township: 29N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2000
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK, GAS PIPE &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 10/30/2001.
REQUIRED INSPECTIONS:
[G an!Line/Appli-
p provalT
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
e i
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00712 Received Date: 10/26/2000
SITE ADDRESS: 86 N BAYVIEW DR
PORT LUDLOW, 98365
APPLICANT: DAVID HOLT PHONE: (541)382-4040
1539 NW SUMMIT
BEND OR 97708
SUBDIVISION: GAINER SHORT PLAT Block: Lot: 1-3
PARCEL NUMBER: 921332028 Section: 33 Township: 29 N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2000
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK, GAS PIPE & 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
roximity - flat G ditions
Type Amount Paid By: Date: Receipt: ApprovedR a e
Propane Tanks/Stoves $48.00 MAM 10/26/00 34764
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE X PROPANE TANK PELLET STOVE OTHER gi40 p��y�QSITE ADDRESS:
911#/ROAD NAME g Dr 1 _ � ,(4)7) -
•
- 1-4 9 -t- ZIP
9 DIGIT PARCEL ID NUMBER c� ( 33)- o 8
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT CGtJC.1/432_ `f _ PHONE s T l 38L- o1710
MAILING ADDRESS 'S 3 9 ,(,J Sw o-,
6 � ( Oa , ZIP
PROPERTY OWNER A P D) (C f Vvi-
1 PHONE kipla.P,
MAILING ADDRESS
ZIP
CONTRACTOR S.&vl S H I n e P20 p _
PHONE 3 8c 7
MAILING ADDRESS (0 Q S 3 Q F4-c b y 02 .
Parr N-j L.o U( 04 . ZIP 5 cf 33 `1
STATE LICENSE # StA Vl S If P 07 7 Q to EXP. DATE I I /Off?
FEDERAL I.D. # 91_ (O Q 7 8 s 7
APPLICANT SIGNATURE
'Orly` alel DATE /0 / / clo
FOR OFFICE USE ONLY
BASE FEE RECEIPT #
CASH/CK # 'TL 1
TOTAL
DATE 1 Zj/
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC4/98