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HomeMy WebLinkAbout BLD2000-00504 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 #: BLD00-00504 Received Date 8/1/2000 SITE ADDRESS: 50 FIR PL Issue Date 8/1/2000 PORT TOWNSEND, 98368 Expiration Date 8/1/2001 APPLICANT: DEBRA MICHAK PHONE: (360)379-9033 50 FIR PLACE PORT TOWNSEND WA 98368 66 SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: PARCEL NUMBER: 940500065 Section: 13 Township: 30N Range: 02W CONTRACTOR: SUNDANCE SOLAR PHONE: 888-373-1974 3301 HWY 16 PORT ORCHARD WA 98366 Contractor's License SUNDAS*066MG Expires 05/19/2001 OWNER, if different: 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 08/01/2001. REQUIRED INSPECTIONS: [Vr7 Tank/Line/Appli nce: 7/C [ J,FinalApproval: //%, 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 1 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00504 Received Date: 8/1/2000 SITE ADDRESS: 50 FIR PL PORT TOWNSEND, 98368 APPLICANT: DEBRA MICHAK PHONE: 50 FIR PLACE PORT TOWNSEND WA 98368 (360)379-9033 SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: 66 PARCEL NUMBER: 940500065 Section: 13 Township: 30 N Range: 02 W CONTRACTOR: SUNDANCE SOLAR PHONE: 888-373-1974 3301 HWY 16 PORT ORCHARD WA 98366 Contractor's License SUNDAS*066MG Expires 05/19/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK & STOVE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: PRO 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 - Fiat Conditions Type Amount Paid By: Date: Receipt: Approveate Propane Tanks/Stoves $48.00 LMB 08/01/00 32273 Total: $48.00 is\F_BLD_App_Bld.rpt 10/29/99 rS 7 / 4 (/5—r JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE x OTHER rVIO {H n.i G' S-6�- SITE ADDRESS: / / 911#/ROAD NAME © Ft pit,- C(- V a T TO Ld .n S e >J �� CL1 t� Y� ZIP � 3 O 9 DIGIT PARCEL ID NUMBER O ' No() V Legal Description: Subdivision Name ckpe, G Q U'fl I y 1 Block Lot(s) 0 Section Township North, Range WM APPLICANT D ✓✓ - pi �,G �" `�, PHONE -3 71 /03 3 MAILING ADDRESS 5& FI2 r IA-{e- poi { TUW ki (ti DZIP / (y S., PROPERTY OWNER 5f ini:; PHONE MAILING ADDRESS ZIP CONTRACTOR e 0r) PHONE 3/7 - /3 MAILING ADDRESS VI- W ill e 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 againsttfefferson 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 tS> "b--- \' 1 l t), DATE D r/ 0I C/ G }� FOR OFFICE USE ONLY BASE FEE RECEIPT# - . % CASH/CK# 7,7 Viz_.- TOTAL DATE / i f i H:\HOME\PLN C NTR\FORMS\I N STA LL.DO C 10/99