HomeMy WebLinkAboutBLD2000-00794 .
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 #: BLD00-00794 Received Date 12/11/2000
SITE ADDRESS: 425 SKYWATER DR Issue Date 12/12/2000
PORT HADLOCK, 98339 Expiration Date 12/12/2001
APPLICANT: JERRY SCHULTZ PHONE: (360)437-1195
425 SKY WATER DR
PORT HADLOCK WA 98339
10
SUBDIVISION: SKYWATER LARGE LOT SUBDIVISION Block: Lot:
PARCEL NUMBER: 921195010 Section: 19 Township: 29N Range: 01E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2001
OWNER, JERRY SCHULTZ PHONE: (360)437-1195
if different: 425 SKY WATER DR
PORT HADLOCK WA 98339
PROJECT DESCRIPTION GAS PIPE/APPLIANCES
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 12/12/2001.
REQUIRED INSPECTIONS:
[�} an /Line/Appliance (���( 6-90
[ inalApprova`t� /� l"`y 'y �-
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 #: BLD00-00794 Received Date: 12/11/2000
SITE ADDRESS: 425 SKYWATER DR
PORT HADLOCK, 98339
APPLICANT: JERRY SCHULTZ PHONE: (360)437-1195
425 SKY WATER DR
PORT HADLOCK WA 98339
SUBDIVISION: SKYWATER LARGE LOT SUBDIVISION Block: Lot: 10
PARCEL NUMBER: 921195010 Section: 19 Township: 29 N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: GAS PIPE /APPLIANCES
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
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 Ruralgrl l
Type Amount Paid By: Date: �rReceipt: Approved/Date
Conditions
Propane Tanks/Stoves $48.00 MAM 12/11/00 35537
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
0
4(� 1r i ERSON COUNTY PERMIT CENTER, 621 SIERIDAN ST, PORT TOWfv'SEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT.APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE l/ UTHER
SITE ADDRESS:
911#/RQAD NAME 1L S so /✓)aZ- Oi
T � 4.d.-0G/ //� tt p
rl C�cJ G.- ZIP L'J Q ��
9 DIGIT PARCEL ID NUMBER q c 1' I q S o / v
Legal Description:
Subdivision Name
Block Lot(s)
Section Township North, Range WM
APPLICANT / r Cc/44,t_t-f2
?HONE l a
MAILING ADDRESS
ZIP
PROPERTY OWNER 8
• PHONE
MAILING ADDRESS
ZIP
CONTRACTOR SUs) S H I b1 Q. 1 a-o P A _
PHONE 3 8T' 579 7
MAILING ADDRESS (D Ij S 3 Ra -O 0 0(Z .
Porr 14,qy3 Lei c le OA . ZIP 4 cf 33
STATE LICENSE # Su V1 S fF A 7
EXP. DATE_______I
FEDERAL I.D. # 9 l- I O g 7 $S 7
APPLICANT SIGNATURE /0 .
DATE / / O O
FOR OFFICE USE ONLY
BASE FEEgji
RECEIPT #
CASH/CK # 732 2
TOTAL
DATE a /o / OD
H:IHOMEIPLNCNTRVORMSUNSTALL.DOC4/98