HomeMy WebLinkAboutBLD2000-00564 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 #: BLD00-00564 Received Date 8/29/2000
SITE ADDRESS: 121 COURSEY LN Issue Date 8/31/2000
PORT LUDLOW, 98365 Expiration Date 8/31/2001
APPLICANT: NELL COURSEY PHONE: (360)437-2445
141 COURSEY LN
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 821083003 Section: 08 Township: 28N 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 GAS TANK (BY RV)
GAS HEAT STOVE & PIPE (IN CABIN)
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 08/31/2001
REQUIRED INSPECTIONS:
Tank/Line/Appliance: )
FinalApproval: O/c /®Vez„/e? �� �
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00564 Received Date: 8/29/2000
SITE ADDRESS: 121 COURSEY LN
PORT LUDLOW, 98365
APPLICANT: NELL COURSEY PHONE: (360)437-2445
141 COURSEY LN
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 821083003 Section: 08 Township: 28 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
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: GAS TANK (BY RV)
GAS HEAT STOVE & PIPE (IN CABIN)
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
1-'r4xlm.lty - i'lat Conditions
Type Amount Paid By: Date: Receipt: Approvedf ate
Propane Tanks/Stoves $48.00 MAM 08/29/00 34164
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
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JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION / 61>
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Subdivision Name Block Lot(s)
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STATE LICENSE #
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FOR OFFICE USE ONLY
BASE FEE RECEIPT # .Li 1 �LI
CASH/CK # T-ZL(
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