HomeMy WebLinkAboutBLD2000-00716 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 #: BLD00-00716 Received Date 10/31/2000
SITE ADDRESS: 736 SOMERVILLE RD Issue Date 11/15/2000
PORT HADLOCK, 98339 Expiration Date 11/15/2001
APPLICANT: KEN MERRITT PHONE: (360)385-5031
PO BOX 884
PORT HADLOCK WA 98339
T 59+
SUBDIVISION: SOMERVILLE Block: 19+ Lot:
PARCEL NUMBER: 996200002 Section: 3 Township: 29N Range: 01W
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 08/01/2001
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK 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 11/15/2001.
REQUIRED INSPECTIONS:
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BUILDING INSPECTION HOT-LINE 3794455. 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 #: BLD00-00716 Received Date: 10/31/2000
SITE ADDRESS: 736 SOMERVILLE RD
PORT HADLOCK, 98339
APPLICANT: KEN MERRITT PHONE: (360)385-5031
PO BOX 884
PORT HADLOCK WA 98339
SUBDIVISION: SOMERVILLE Block: 19+ Lot: T 59+
PARCEL NUMBER: 996200002 Section: 3 Township: 29 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK 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
�r xlmlty - t-'iat Uo anions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 10/31/00 34624
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: 13601 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS:
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9 DIGIT PARCEL ID NUMBER ,! 6 • 2 c v U C'a
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT 4G>1- d--e / /`"/ G,�.,4((c,"c PHONE Tel(j S ,c) 2/
MAILING ADDRESS i'/ 14 Toe 7 ?(J
ZIP
PROPERTY OWNER J-1f'16' PHONE
MAILING ADDRESS
ZIP
CONTRACTOR PHONE
MAILING ADDRESS
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 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�G/ / ��/ l'
FOR OFFICE USE ONLY
BASE FEE 1i RECEIPT# 3 � r
CASH/CK#
j
, DATE / / / LI'�
TOTAL
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