HomeMy WebLinkAboutBLD2000-00726 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 #: BLD00-00726 Received Date 11/9/2000
SITE ADDRESS: 61 SCHOONER LN Issue Date 11/9/2000
PORT LUDLOW, 98365 Expiration Date 11/9/2001
APPLICANT: FRANCIS R MC CLELLAND PHONE: (360)437-7776
SANDRA S MC CLELLAND
61 SCHOONER LN
PORT LUDLOW WA 98365 1
SUBDIVISION: PORT LUDLOW NO. 3 Block: Lot:
PARCEL NUMBER: 990700001 ck Section: 8 Township: 28N Range: 01 E
CONTRACTOR: EVERWARM INC ws C-e.y e �to" \ PHONE: (360)732-4585
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/04/2001
OWNER, FRANCIS R MC CLELLAND PHONE: (360)437-7776
if different: SANDRA S MC CLELLAND
61 SCHOONER LN
PORT LUDLOW WA 98365
PROJECT DESCRIPTION PROPANE TANK AND FIRE PLACE INSERT
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 11/09/2001.
REQUIRED INSPECTIONS:
[ ] CTank/Line/Appliance: 7- 72)11.t: ili�cv( /f),j'—c=-
i r�aAlapr , el e /1/9/ /
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
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BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00726 Received Date: 11/9/2000
SITE ADDRESS: 61 SCHOONER LN
PORT LUDLOW, 98365
APPLICANT: FRANCIS R MC CLELLAND PHONE: (360)437-7776
SANDRA S MC CLELLAND
61 SCHOONER LN
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 3 Block: Lot: 1
PARCEL NUMBER: 990700001 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: EVERWARM INC PHONE: (360)732-4585
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/04/2001
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: " �it,r� '� �' �-.� r�
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
Type Amount Paid By: Date: �rReceipt Apprty oved/pate
Conditions
Receipt: pp ��ate
Propane Tanks/Stoves $48.00 ZAN 11/09/00 34573
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 879-4450
INSTALLA.TION PERMIT APPLICATION
WOODSTOVE X PROPANE TANK PELLET STOVE OTHER I` \r Lct L 4—Yt JET +.
SITE ADDRESS: /
911#/ROAD NAME CQ y/ .SC j a, p /7• . /' ,I' n Y1 /
l Li L L(D La , �!-C/ fi ZIP O"3 6.5.J
q p
9 DIGIT PARCEL ID NUMBER ( / o 7 000 j
Legal Description:
Subdivision Name Block Lotls)
Section 7 Township Z' A. North, Range / E WM
APPLICANT t'("Ct-/'1 ►C_(S al LC.. ie--it6-4rid PHONE C3 60, T 3 7 -7 7 7
MAILING ADDRESS (0 t 3c J(00 Y7 e r I--(I
po ram'" Lu l lo w ` '0.5 74 ZIP 9 87 J 6
PROPERTY OWNER S O._ry) € . PHONE
MAILING ADDRESS
ZIP
CONTRACTOR C`e_.n c OUe.(' u(`( 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 / /
/ FOR OFFICE USE ONLY /
BASE FEE w6J �:._ .�C C)i3
RECEIPT#
CASH/CK It
TOTAL ----W---
DATE /C/ l / 0O
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