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HomeMy WebLinkAboutBLD2001-00131 • 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 #: BLD01-00131 Received Date 3/2/2001 SITE ADDRESS: 1155 E MARROWSTONE RD Issue Date 3/2/2001 NORDLAND, 98358 Expiration Date 3/2/2002 APPLICANT: GREGORY G LALISH PHONE: 1101 E MARROWSTONE RD NORDLAND WA 983589677 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921043028 Section: 4 Township: 29N Range: 01 E CONTRACTOR: OWNER, GREGORY G LALISH PHONE: if different: 1101 E MARROWSTONE RD NORDLAND WA 983589677 PROJECT DESCRIPTION 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 03/02/2002. REQUIRED INSPECTIONS: ank/Line/Ap'plian :(�,� �l�/p [I,] a Approva 7/ 44, //44 /© / r 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 i BUILDING PERMIT APPLICATION Jefferson County Department'of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00131 Received Date: 3/2/2001 SITE ADDRESS: 1155 E MARROWSTONE RD NORDLAND, 98358 APPLICANT: GREGORY G LALISH PHONE: 1101 E MARROWSTONE RD NORDLAND WA 983589677 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921043028 Section: 4 Township: 29 N Range: 01 E CONTRACTOR: PHONE: PHONE: ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural `proximity - Fiat Uonditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 PRB 03/02/01 38139 Total: $48.00 . JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (3601 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE 1 PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: 911#/ROAD NAME I(O ( £- MARR()u).ST?)N� (� NQQ 0 8 oRpLAND a ZIP 18 2 l�O 9 DIGIT PARCEL ID NUMBER "l Z ( O 4 3 2- Legal Description: Subdivision Name Block Lotls) S/e'ction p Township /� North, Range WM u APPLICANT Re-(' D( ?�'U Li L-,L-I S I I PHONE MAILING ADDRESS As tr ZIP PROPERTY OWNER SAME PHONE MAILING ADDRESS SAM� ZIP CONTRACTOR 5 reRREL_L G]\ S PHONE MAILING ADDRESS ,� 11 Lt(je2LT nf[� A L-1 �GQT/ , MD ZIP 1/-.v(5-e0 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 cy DATE CD / 0 Z- / 0 (f � " FOR OFFICE USE ONLY " BASE'FEE Zs RECEIPT# '�2E1 • CASH/CK# ^" TOTAL } .. r DATE �Ii2.1 �l H:\HOME\PLNCNTR\FORMS\IN STALL.DOC 10/99