HomeMy WebLinkAboutBLD2001-00164 i
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 #: BLD01-00164 Received Date 3/22/2001
SITE ADDRESS: 1861 OLD GARDINER RD Issue Date 3/22/2001
SEQUIM, 98382 Expiration Date 3/22/2002
APPLICANT: RICK CLENDANIEL PHONE: (360)797-7510
LAURA CLENDANIEL
1861 OLD GARDINER RD
GARDINER WA 98382 T 60
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002341037 Section: 34 Township: 30N Range: 02W
CONTRACTOR: PENINSULA HEAT INC PHONE: 457-2775
502 W 8TH ST
PORT ANGELES WA 98362
Contractor's License PENNINI*0440W Expires 09/13/2001
OWNER, RICK CLENDANIEL PHONE: (360)797-7510
if different: LAURA CLENDANIEL
1861 OLD GARDINER RD
GARDINER WA 98382
PROJECT DESCRIPTION HEAT PUMP 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 03/22/2002.
REQUIRED INSPECTIONS:
[Tan k/Li. .i! in r, e 1`/C4,/,‘,/ Aerddr2.
[�y , ;�-;-...� �.. : �1
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 #: BLD01-00164 Received Date: 3/22/2001
SITE ADDRESS: 1861 OLD GARDINER RD
SEQUIM, 98382
APPLICANT: RICK CLENDANIEL PHONE: (360)797-7510
LAURA CLENDANIEL
1861 OLD GARDINER RD
GARDINER WA 98382
SUBDIVISION: Block: Lot: T 60
PARCEL NUMBER: 002341037 Section: 34 Township: 30 N Range: 02 W
CONTRACTOR: PENINSULA HEAT INC PHONE: 457-2775
502 W 8TH ST
PORT ANGELES WA 98362
Contractor's License PENNINI*0440W Expires 09/13/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: HEAT PUMP INSTALLATION
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 - Flat Conditions
Type Amount Paid By: Date: Receipt: Approved/Cate
Propane Tanks/Stoves $48.00 MAM 03/22/01 38862
Total: $48.00
r
03/19/2001 10:23 3602794451 JEFF CO DOD PAGE 02/02
v -.
A 98368 Plj; 1380} 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE 1 OTHER 1--/e4 f"13.,y iktf 2v l /
th—el *
SITE ADDRESS:
911#IROAD NAME / ,? / /J (���. _�/ f 191
_ 6 e 7 /;(,r e /,y7 ZIP 9Y33,r rT
8 DIGIT PARCEL ID NUMBER Q O) • ' 0 3'
Legal Description:
Subdivision Name
— Block Lot(s)
Section Township_ North, Range
WM
APPLICANT Pete t i f Sl e/ t /ref _y1/
PN+3NE57 J1
MAILING ADDRESS seS t
r • /1/1✓4— ZIP 9' z.
PROPERTY OWNER RI ek._ a'ri danke J PHONE -- 7 /
MAILING ADDRESS % rc jn —
_ e G//yYj _�... ZIP ;•
CONTRACTOR Pt°,1: n S -'i/a 1 u t� PHONE / d1 7�
AAALLING ADDRESS _Q 1' O rr
e0--�l^.J.t t` / —" ZIP
STATE LICENSE# /` /1 i/f.h�- {)1/VO�/ EXP. DATE J •
FEDERAL I.D. # 6//—/ 735 • / ���/ �C
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By signing the application form. the applicant/owner attests that the information provided herein la true and correct to the beat of their knowledge. Any materiel
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.attomey'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
require#later inspections. Access and right of entry to the applicant`s pmperty or structure shall be requested and shall occur during regular business flours,
APPLICANT SIGNATURE yi, )
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