HomeMy WebLinkAboutBLD2001-00003 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 #: BLD01-00003 Received Date 1/2/2001
SITE ADDRESS: 35 OLYMPIC GREENS DR Issue Date 1/3/2001
PORT HADLOCK, 98339 Expiration Date 1/3/2002
APPLICANT: NANCY J NEEDHAM PHONE: (360)379-0188
35 OLYMPIC GREENS DR
PORT HADLOCK WA 983399426
18
SUBDIVISION: OLYMPIC GREENS Block: Lot:
PARCEL NUMBER: 979906118 Section: 2 Township: 29N Range: 01W
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 08/01/2001
OWNER, NANCY J NEEDHAM PHONE: (360)379-0188
if different: 35 OLYMPIC GREENS DR
PORT HADLOCK WA 983399426
PROJECT DESCRIPTION PROPANE TANK 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 01/03/2002.
REQUIRED INSPECTIONS:
r Tank/Line/Appliance: I ` /b—c)I '�
1... t
[ ) FinalApproval: —1(c- l
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.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Propane.rpt 10/29/19
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00003 Received Date: 1/2/2001
SITE ADDRESS: 35 OLYMPIC GREENS DR
PORT HADLOCK, 98339
APPLICANT: NANCY J NEEDHAM PHONE: (360)379-0188
35 OLYMPIC GREENS DR
PORT HADLOCK WA 983399426
SUBDIVISION: OLYMPIC GREENS Block: Lot: 18
PARCEL NUMBER: 979906118 Section: 2 Township: 29 N Range: 01 W
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 08/01/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK INSTALLATION
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: Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: A pro e d bons
Yp Receipt:y pp ��a�e
Propane Tanks/Stoves $48.00 MAM 01/02/01 37200
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/19
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JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND W 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION 4-- 4-1. 4,,a,L,
WOODSTOVE X PROPANE TANK PELLET STOVEig"
SITE ADDRESS: /" - lee�'�'i
911#/ROAD NAME 3 S OJ yi d/ C. C Z Et ,1/ D i ,r / y o�.r /4Ap2ocA , ,v @ 1 ZIP 7.37f
9 DIGIT PARCEL ID NUMBER `I 7 9 ? 06 //X
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT /V4Ne y ,ns aill ii PHONE .) `7 9 — D/d'd�
MAILING ADDRESS 3 S (pi p p p c. 6-&L LA, P ii .
fo2r /Moi0G % ZIP 9/ .731
PROPERTY OWNER S'A ,+►r - A 6 0 V PHONE
MAILING ADDRESS
ZIP
CONTRACTOR Ow FifAKE Li.
/}.$' PHONE 3d'-C — b 7 9v
MAILING ADDRESS 2 / 0i S//h_s WA",
o T t0►v/vs.e"sv d ZIP ger '6d)
STATE LICENSE# 6o l -Cs-3 s/{. . EXP. DATE ?- 31 — a 0 J/
FEDERAL I.D. # FLU Pl ik.et P O ss L H k -/ - Q
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
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 (0 1; � ap.h-t DATE r.Z / 2 7 / 42 Cr
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 73 -0 U
CASH/CK# 7oL(`1
TOTAL I/ , 0 C DATE \ / 2 /o k
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