HomeMy WebLinkAboutBLD2000-00769 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 #: BLD00-00769 Received Date 11/30/2000
SITE ADDRESS: 81 SIMCOE RD Issue Date 11/30/2000
PORT TOWNSEND, 98368 Expiration Date 11/30/2001
APPLICANT: ANITA M SCHMUCKER PHONE: 385-0705
JON SCHMUCKER
81 SIMCOE RD
PORT TOWNSEND WA 98368 T 29
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001324012 Section: 32 Township: 30N Range: 01W
CONTRACTOR: EVERWARM INC PHONE:
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/04/2001
OWNER,
if different:
PROJECT DESCRIPTION WOODSTOVE 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 11/30/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[-� 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
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00769 Received Date: 11/30/2000
SITE ADDRESS: 81 SIMCOE RD
PORT TOWNSEND, 98368
APPLICANT: ANITA M SCHMUCKER PHONE: 385-0705
JON SCHMUCKER
81 SIMCOE RD
PORT TOWNSEND WA 98368
SUBDIVISION: Block: Lot: T 29
PARCEL NUMBER: 001324012 Section: 32 Township: 30 N Range: 01 W
CONTRACTOR: EVERWARM INC PHONE:
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/04/2001
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: WOODSTOVE 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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
}rQxlmlty - Nlat Uonditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 11/30/00 35609
Total: $48.00
i:\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-445Q
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: �/ S+iv►�eoe. Roark
911#/ROAD NAME 'PO V- Wei�Se-- ��Q14C V"' ' ZIP gf 36k
9 DIGIT PARCEL ID NUMBER CO 01 Z
Legal Description: �L
Subdivision Name AYj�y j) �6' (ip✓LD T ! Block Lotls)
Section 3 2- Township .,3-O North, Range / WM
APPLICANT 411- 4- All l �a- 'C%4 PHONE
MAILING ADDRESS Si St el/1 C..4)e / � Q
Pdr+ To-Lvvl.,ce ce/ , wM" ZIP [g3b r
PROPERTY OWNER aw1e QS a'V0V'e- PHONE
MAILING ADDRESS t(
ZIP
1-0
CONTRACTOR ZVe'r-t vaV i l„ f' "� t 1 V� PHONE
MAILING ADDRESS 2.S71 S 1 1-htdi 1,0 /
P e�V(41"I 14 z
ZIP `143e
STATE LICENSE # EVE-RV/I- 013E3 Al i S" EXP. DATE $ O
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 o the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE DATE 7/ / 27 DU
FOR OFFICE USE ONLY !�
BASE FEE RECEIPT# ��_� /• / �C
CASH/CK# (-4 0-?
4 �TOTAL DATE f / 3`_
� OD
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