HomeMy WebLinkAboutBLD2000-00758 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 #: BLD00-00758 Received Date 11/27/2000
SITE ADDRESS: 124 NESS' CORNER RD Issue Date 11/28/2000
PORT HADLOCK, 98339 Expiration Date 11/28/2001
APPLICANT: LEONIDAS INMAN PHONE: (360)385-2297
124 NESS' CORNER RD
PORT HADLOCK WA 98339
1-6
SUBDIVISION: CHALMER'S 2ND ADDITION Block: 36 Lot:
PARCEL NUMBER: 942903601 Section: 3 Township: 29N Range: 01W
CONTRACTOR: NORTHWEST FIREPLACE PHONE: (360)373-4631
4207 WHEATON WAY
SUITE A
BREMERTON WA 98310
Contractor's License NORTHFG044K0 Expires 05/07/2001
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 11/28/2001.
REQUIRED INSPECTIONS:
L1- L-rIGAppliance `�7e f './ ( -4") ./y -7 (1-1-(-
( Fi Approval e'/ /.=''/ k;/�°" ---- --ir
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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
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00758 Received Date: 11/27/2000
SITE ADDRESS: 124 NESS' CORNER RD
PORT HADLOCK, 98339
APPLICANT: LEONIDAS INMAN PHONE: (360)385-2297
124 NESS' CORNER RD
PORT HADLOCK WA 98339
SUBDIVISION: CHALMER'S 2ND ADDITION Block: 36 Lot: 1-6
PARCEL NUMBER: 942903601 Section: 3 Township: 29 N Range: 01 W
CONTRACTOR: NORTHWEST FIREPLACE PHONE: (360)373-4631
4207 WHEATON WAY
SUITE A
BREMERTON WA 98310
Contractor's License NORTHFG044K0 Expires 05/07/2000
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & STOVE 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
1-'r xlmlty - Plat C; d tlons
Type Amount Paid By: Date: Receipt: Approved/vote
Propane Tanks/Stoves $48.00 MAM 11/27/00 35552
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) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE *, PROPANE TANK PELLET STOVE OTHER Sr e) U e_
SITE ADDRESS:
911#!ROAD NAME /a it mess At) r/ij e le Rd.
PO rr f/f30,l/dcX (,,r� - ZIP 91(339
9 DIGIT PARCEL ID NUMBER .f y Z 9O 3 6 0 /
Legal Description: �ji/ 'f'i.O
Subdivision Name CA4/IM e hS �N aL ,�a�y"C'�1�',a.�'i' ,-f� Block 3 6 Lot(s) /—
Section Township North, Range WM
APPLICANT L. QC) Al I d 5 I() . _1.--A,f /N)J�}A) PHONE 3 �-0a? "
MAILING ADDRESS /VP S S �Q {� N c I- Rd
Pe FT Hi J/oc i it)c ZIP ri q'339
PROPERTY OWNER S At-ni S 4,66 (f €_ PHONE
MAILING ADDRESS
ZIP
CONTRACTOR N O )• to w 4,S r F. 'e o /4 C ecl PHONE C3 CO") 3 >3 '4/63/
MAILING ADDRESS lido h it) , QC Th 1d WA-V.) S f Le A-
�al L--t SuF,MtZ ,d hepti.e r 1-6,0 LCJ c. f Z3/0 ZIP
CSTATE LICEN-Si-D 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 whicn
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 �/• 7 DATE JJ '.L "470
FOR OFFICE USE ONLY
BASE FEE +? °C) RECEIPT#
CASH/CK# C D
TOTAL q--g.00 DATE I( /27/`,Ga"" pa6
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