HomeMy WebLinkAboutBLD2001-00077 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 #: BLD01-00077 Received Date 2/6/2001
SITE ADDRESS: 607 MI.DDLEPOINT RD '31KS40AO4- C.51A 9-0 Issue Date 2/6/2001
PORT TOWNSEND, 98368 Expiration Date 2/6/2002
APPLICANT: CHARLES MOORE PHONE:
507 MIDDLEPOINT RD
PORT TOWNSEND WA 98368
1
SUBDIVISION: MOORE SHORT PLAT II Block: Lot:
PARCEL NUMBER: 001061014 Section: 6 Township: 30N Range: 01W
CONTRACTOR:
OWNER,
if different:
PROJECT DESCRIPTION Propane Tank
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:
[Li Ta Line/Appliance: K- / o
[ ] FinalApproval: ;i'G /
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 #: BLD01-00077 Received Date: 2/6/2001
SITE ADDRESS: - 684 M D1 EPO ^ 3�5 (W D# LAS 9-O.
0 0� r.,,�c� o
PORT TOWNSEND, 98368
APPLICANT: CHARLES MOORE PHONE:
507 MIDDLEPOINT RD
PORT TOWNSEND WA 98368
SUBDIVISION: MOORE SHORT PLAT II Block: Lot: 1
PARCEL NUMBER: 001061014 Section: 6 Township: 30 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: Propane Tank
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 - 1-'!at conditions _
Type Amount Paid By: Date: Receipt: Approved/pate
Propane Tanks/Stoves $48.00 PRB 02/06/01 38108
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE ROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: /71 /m .s 911#/ROAD NAME U 1�/
Q (Zr 1,,,iVS'EJ1 f ZIP 9e3a)
9 DIGIT PARCEL ID NUMBER 00 / c2 6/ c7/4-
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
•
•
APPLICANTIIL _ ..._ICE, ,SPHONE 366 36S - e7
MAILING ADDRESS 1) J 670j1 /2_/
t\ r- - • ZIP g t"1 36
PROPERTY OWNER �]QG /,/GiaiR 6 PHONE 3 o0 3 gS
MAILING ADDRESS 2/( �S 7bn
f / _ 1Wi / ZIP / U 3a
CONTRACTOR P7MC//\("Tj�/� f°0,0 P/Fiv 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.
APPLICANT SIGNATURE /2) DATEC) /Q?'/ 0/
n1 s � gib y ,
•
r '�� � _; 'w h `' om'' r,
f c. N wxv 0 e, (,0.� •
H:\HOME\PLN CNTR\FORMS\INSTALL.DOC 10/99