HomeMy WebLinkAboutBLD2001-00108 •
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 #: BLD01-00108 Received Date 2/16/2001
SITE ADDRESS: 30 E MAUDE ST Issue Date 2/16/2001
PORT HADLOCK, 98339 Expiration Date 2/16/2002
APPLICANT: JANEL M CARLSON PHONE:
410 TAFT ST
PORT TOWNSEND WA 983684436
SUBDIVISION: IRONDALE Block: Lot:
PARCEL NUMBER: 961800807 Section: 34 Township: 30N Range: 01W
CONTRACTOR: FERRELLGAS PHONE: (360)385-6998
2108 SIMS WAY
PORT TOWSEND WA 98368
Contractor's License FERRELP055LH Expires 08/01/2001
OWNER, JANEL M CARLSON PHONE:
if different: 410 TAFT ST
PORT TOWNSEND WA 983684436
PROJECT DESCRIPTION PROPANE TANK AND HEATING STOVE
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 02/16/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Li /Appliance: KjT o%
[`1 FinalApproval: 6
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_Perm it_Propane.rpt 10/29/19
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00108 Received Date: 2/16/2001
SITE ADDRESS: 30 E MAUDE ST
PORT HADLOCK, 98339
APPLICANT: JANEL M CARLSON PHONE:
410 TAFT ST
PORT TOWNSEND WA 983684436
SUBDIVISION: IRONDALE Block: Lot:
PARCEL NUMBER: 961800807 Section: 34 Township: 30 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 AND HEATING STOVE
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:
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
Type Amount Paid By: Date: �rReceipt Apprrty o Conditions
Receipt: pp ��ate
Propane Tanks/Stoves $48.00 ZAN 02/16/01 38211
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION ,
WOODSTOVE PROPANE TANK PELLET STOVE OTHER ( J (l\� "z' ��(1 V
SITE ADDRESS: II! ,n
911#/ROAD NAME 3 0 v v`c '. _&
C�Z A.`r`" 8_exsz9 ZIP 9p9
33
[9 DIGIT PARCEL ID NUMBER w 1 d v d.S.(7 7
Legal Description:Subdivision Name --_
v( - cA--QJ.. Block 0 Lot(s) I c/- a
Section Township North, Range WM
APPLICANT '' 1.�1 W' C 0.N(`1, S-N/v_ PHONE �7 7 5-— 1 F
MAILING ADDRESS [ 0 I
7(
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PROPERTY OWNER c_J"\^^-k----Q-raid s-W PHONE 3$ - 3 C--CAS
MAILING ADDRESS L I 1 tD
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CONTRACTOR \F-e „,-,vs e_.I.I GG./> PHONE 3� 5 — 6 / f Y
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MAILING ADDRESS �iJ 0 p U0. S'; ,,,, v
�� � CL ZIP 0 --3G1'.
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.
Cl?tAPPLICANT SIGNATUREVV(....___ t DATE P. / 1 6 / O )
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 3 9//
CASH/CK#
,? d ,,t}�
TOTAL //e C� . DATE ' c1 //Y�/ O/.
H:\H O M E\PLN CNTR\FORMS\INSTALL.DOC 10/99