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HomeMy WebLinkAboutBLD2001-00075 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 #: BLD01-00075 Received Date 2/6/2001 SITE ADDRESS: 393 BLOSSOM LN Issue Date 2/6/2001 PORT TOWNSEND, 98368 Expiration Date 2/6/2002 APPLICANT: SHARON DEMBRO PHONE: (360)385-4045 MARK DEMBRO PO BOX 1072 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001203004 Section: 20 Township: 30N Range: 01W CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420 PO BOX 1031 PORT TOWNSEND WA 98368 Contractor's License PETTIOCO88CC Expires 05/01/2001 OWNER, if different: PROJECT DESCRIPTION PROPANE HEATER& GAS LINE INSTALLATION (INSIDE GREENHOUSE) 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 02/06/2002. REQUIRED INSPECTIONS: [ } ine/Appl. ©tC 43 f, (2)/7z&(c v e% P.Qll-,T- [ i nalApproval: X Se" :2,/�3/0 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 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00075 Received Date: 2/6/2001 SITE ADDRESS: 393 BLOSSOM LN PORT TOWNSEND, 98368 APPLICANT: SHARON DEMBRO PHONE: (360)385-4045 MARK DEMBRO PO BOX 1072 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001203004 Section: 20 Township: 30 N Range: 01 W CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420 PO BOX 1031 PORT TOWNSEND WA 98368 Contractor's License PETTIOCO88CC Expires 05/01/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE HEATER & GAS LINE INSTALLATION (INSIDE GREENHOUSE) TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 1997 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 Floodplain F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural —Proximity - Fiat C d tions Type Amount Paid By: Date: Receipt: Approve��ate Propane Tanks/Stoves $48.00 MAM 02/06/01 38162 Total: $48.00 • JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE Y OTHER 'ei'o1AkG ` t 1 AT E _ 4 c21)19911#/ROAD NAME 3 SITE ADDRESS: 13LJ �SQI 1 C� V I`f1.� j i%C�U1�►L fOI ( I OLJ 5Gl\tl/ WA ZIP 19)36, 00 9 DIGIT PARCEL ID NUMBER Q® I a 2.03 i 004- Legal Description: I p l Subdivision Name I IY O V V �i' 6414 v i Block Lot(s) Section TownshipO North, Range WM APPLICANT AM Cjt/ ¼T , Aat4 iT ecr PHONE 3100" 3 -j ' i l i MAILING ADDRESS 2,3 SAL P r-, f / 1 o �DIf� SC/IVO WA ZIP gs5U152j PROPERTY OWNER GSA-ro f 4 MAi K- 1E Y` 13 PHONE ' s 4o4 c MAILING ADDRESS rQ 'DO)( 1 0 72�" 2o2-T 1P4U SEN 0 ; W ZIP 6136,62) CONTRACTOR W rY 1 V 0 I lam-' PHONE MAILING ADDRESS ZIP STATE LICENSE# 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 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 to the applicant's property or structure shall be requested and shall occur during regular business hours. 41 APPLICANT SIGNATURE ii/lI /—/) t DATE v " /6)6/ of �s FOR OFFICE USE ONLY. BASE FEE ".g RECEIPT# I(o CASH/CK# � ..6 TOTAL V DATE ! 10 l 0 H:\HOME\PLN CNTR\FORMS\IN STALL.DOC 10/99