HomeMy WebLinkAboutBLD2000-00502 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 #: BLD00-00502 Received Date 8/1/2000
SITE ADDRESS: 81 N MAPLE ST Issue Date 8/1/2000
PORT HADLOCK, 98339 Expiration Date 8/1/2001
APPLICANT: J MICHAEL DOLTON PHONE:
TERESA ANN DOLTON
81 N MAPLE ST
PORT HADLOCK WA 983399615 1,2
SUBDIVISION: HARRISBURG Block: 12 Lot:
PARCEL NUMBER: 956701201 Section: 02 Township: 29N Range: 01W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2001
OWNER, J MICHAEL DOLTON PHONE:
if different: TERESA ANN DOLTON
81 N MAPLE ST
PORT HADLOCK WA 983399615
PROJECT DESCRIPTION PROPANE TANK AND 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 08/01/2001
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[I( FinalApproval: 6!)1 g/$ QCS t7/(91
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
i !
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00502 Received Date: 8/1/2000
SITE ADDRESS: 81 N MAPLE ST
PORT HADLOCK, 98339
APPLICANT: J MICHAEL DOLTON PHONE:
TERESA ANN DOLTON
81 N MAPLE ST
PORT HADLOCK WA 983399615
SUBDIVISION: HARRISBURG Block: 12 Lot: 1,2
PARCEL NUMBER: 956701201 Section: 02 Township: 29 N Range: 01 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 AND STOVE INSTALLATION
TYPE OF WORK
WO K NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: ADD'L: HEAT TYPE: PRO
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
F&W Landslide
Routing Date: Shoreline Aquifer
Forest: Commercial Rural it
Type Amount Paid By: Date: �rReceipt: Approved/Date conditions
Propane Tanks/Stoves $48.00 LMB 08/01/00 32272
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (3601 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER STD ‘it:
SITE ADDRESS:911#/ROAD NAME g I N , M� `1
P _
f (�
o c* t��c oc VV(A ZIP `12: 3c\
9 DIGIT PARCEL ID NUMBER i 5(0 — 7c) \ ac) 1
Legal Description: ,`
Subdivision Name '-\ N RR I S SU fp�l3- Block 1 a Lot(s) ' )\
Section Township North, Range WM
APPLICANT 3 , I '11 c Ii1c : O \AO\A PHONE 353 `} ` 5 3 c
MAILING ADDRESS { I Nj, '1 ACDL
I—o\c\ `\c-\A.\L.`c--c \1V IT_ ZIP t
PROPERTY OWNER PHONE
MAILING ADDRESS (-5C , 1 n /\n q �" (\ bCD IP
�i )/ )"(�/ \' `/ (ZIP
CONTRACTOR PP . l '1 1 0 1 C
. YO 901
V ►\ PHONE 3 s 5 - l y aO
MAILING ADDRESS as Se_k`OV ROC1c.. .
po,a . i ouunse c WA ZIP 9 3 (c
STATE LICENSE # EXP. DATE
FEDERAL I.D. it
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 ora 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 fl'iC 2,, 11X7iL- DATE 3 / ) / 00
FOR OFFICE USE ONLY
BASE FEE RECEIPT#' ,12, ..y�Z
CASH/CK# ( (.0
TOTAL DATE bJ I /
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99
property line
50 ft
120 gal
propane I 10 ft
25 ft
HOUSE front
door