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HomeMy WebLinkAboutBLD2001-00194 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 #: BLD01-00194 Received Date 4/4/2001 SITE ADDRESS: 621 S POINT RD Issue Date 4/4/2001 PORT LUDLOW, 98365 Expiration Date 4/4/2002 APPLICANT: WILLIAM MC NAILL PHONE: 297-1990 Kingsto 12834 NE MARY LOU LN KINGSTON WA 98346-9120 26 SUBDIVISION: SQUAMISH HARBOR BCH Block: Lot: PARCEL NUMBER: 996600026 Section: 4 Township: 27N Range: 01 E CONTRACTOR: ALL SEASONS GAS PHONE:C360) a.ZS—' 11 22619 HWY 3 BELFAIR WA Contractor's License ALLSEG*024L3 Expires 9/6/01 OWNER, if different: 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 4/4/02. REQUIRED INSPECTIONS: [ ] an Line/aplianc 7-.3-0 Af/C V- AA PA'L<4N«- 6,00c5 _3" 7-0 ae' &f' Wt.A©/ei�( ,ass A_(7 YY yam, 4/ [ °] FinalApproval: ) / f'< e-' 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 I:\F_BLD_Permit_Propane.rpt 10/29/99 BUILDING PERMIT APPLICATION • Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00194 Received Date: 4/4/2001 SITE ADDRESS: 621 S POINT RD PORT LUDLOW, 98365 APPLICANT: WILLIAM MC NAILL PHONE: 297-1990 Kingsto 12834 NE MARY LOU LN KINGSTON WA 98346-9120 SUBDIVISION: SQUAMISH HARBOR BCH Block: Lot: 26 PARCEL NUMBER: 996600026 Section: 4 Township: 27 N Range: 01 E CONTRACTOR: ALL SEASONS GAS PHONE: 22619 HWY 3 BELFAIR WA Contractor's License ALLSEG*024L3 Expires 9/6/01 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: Propane Tank and Heating Stove TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: PRO 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: OSS 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: —Proximity Approved/Date e dteons Receipt: pP ��a e Propane Tanks/Stoves $48.00 RAC 04/04/01 38244 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 SITE ADDRESS: 911#/ROAD NAME ( / 'O I'O 1-t,T ZIP 9 DIGIT PARCEL ID NUMBER l_ � O0 ll0 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT LAJP_� /i)-Q (_ PHONE 36 0—- ?q-/ 5 Z> MAILING ADDRESS (( )c(/j //Cr/6e(09.7 1.J !2J f'�, cU, , S/A Lin 9 9 3 ZIP PROPERTY OWNER !'4 4 G sV PHONE c9-5 ) /? G D MAILING ADDRESS 46A,..5 s / t1UL ZIP 10 3 ?f� CONTRACTOR S�4 e )9, (er PHONE(3 2? 'j Z 7 7 MAILING ADDRESS �/ / ZIP STATE LICENSE# 1,0'es J S c_ S'p66, /C'd1"1 EXP. DATE (0 FEDERAL I.D. # 3cl -/(.( -y 2 y 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 .nd 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' .ro ierty . structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE <�. . ( � - � DATE 7/ / f l TCt/ FOR OFFICE USE ONLY BASE FEE t ;. AIP RECEIPT# f "' CASH/CK# TOTAL t DATE //1/ +)/ H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99