HomeMy WebLinkAboutBLD2000-00804 . r
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 #: BLD00-00804 Received Date 12/13/2000
SITE ADDRESS: 4 HERON RD Issue Date 12/13/2000
PORT LUDLOW, 98365 Expiration Date 12/13/2001
APPLICANT: DR BERNIE JAY PHONE: (360)437-9859
MARIETTA BROWN
20730 BOND RD NE
POULSBO WA 98370 TH-2
SUBDIVISION: LUDLOW BAY VILLAGE Block: Lot:
PARCEL NUMBER: 968600015 Section: 16 Township: 28N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2001
OWNER,
if different:
PROJECT DESCRIPTION UPGRADING GAS PIPING
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 12/13/2001.
REQUIRED INSPECTIONS:
Tank me Appliance: 2C< 2/23/0/
[1L-- i nalApprova ®/
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 #: BLD00-00804 Received Date: 12/13/2000
SITE ADDRESS: 4 HERON RD
PORT LUDLOW, 98365
APPLICANT: DR BERNIE JAY PHONE: (360)437-9859
MARIETTA BROWN
20730 BOND RD NE
POULSBO WA 98370
SUBDIVISION: LUDLOW BAY VILLAGE Block: Lot: TH-2
PARCEL NUMBER: 968600015 Section: 16 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 11/17/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: UPGRADING GAS PIPING
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: 1997 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: 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: 7/3
0 Shoreline Aquifer
lJ Forest: Commercial Rural
—Proximity - Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 ZAN 12/13/00 35547
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
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INSTALLATION PERMIT APPLICATION
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SITE ADDRESS:
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Legal Description:
Subdivision Name
Block Lot(s)
Section Township North, Range WM
APPLICANT n o 6��
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MAILING ADDRESS 0207 Q v,,I,kci 120,9
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STATE LICENSE # __SL.t S ILE+ p 7 7 Q P
EXP, DATE 1 I C21 FEDERAL I.D. #
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APPLICANT SIGNATURE
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FOR OFFICE USE ONLY
BASE FEE ��
RECEIPT # 3 c Lj7
CASH/CK # -7
TOTAL (JO 3
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