HomeMy WebLinkAboutBLD2001-00207 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 #: BLD01-00207 Received Date 4/11/2001
SITE ADDRESS: 629 MC MINN RD Issue Date 4/11/2001
PORT TOWNSEND, 98368 Expiration Date 4/11/2002
APPLICANT: MARCIA M MILLMAN PHONE: 360-379-6649
EVAN M MILLMAN
629 MCMINN RD
PORT TOWNSEND WA 98368-9004
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002121001 Section: 12 Township: 30N Range: 02W
CONTRACTOR: OWNER PHONE:
OWNER, MARCIA M MILLMAN PHONE: 360-379-6649
if different: EVAN M MILLMAN
629 MCMINN RD
PORT TOWNSEND WA 98368-9004
PROJECT DESCRIPTION WOODSTOVE 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 04/11/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
['I FinalApproval: C)K `� J�f d
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 #: BLD01-00207 Received Date: 4/11/2001
SITE ADDRESS: 629 MC MINN RD
PORT TOWNSEND, 98368
APPLICANT: MARCIA M MILLMAN PHONE:
EVAN M MILLMAN
629 MCMINN RD
PORT TOWNSEND WA 98368-9004
360-379-6649
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002121001 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: WOODSTOVE INSTALLATION
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:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: 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: /J / Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: —Proximay - Plat conditions
yp Receipt: Approved/pate
Propane Tanks/Stoves $48.00 ZAN 04/11/01 39903
Total: $48.00
.J,,EFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (3601 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: 2�C A/�, /2�
911#/ROAD NAME -" - �
• TV trz,t,L56,1 ZIP /U
9 DIGIT PARCEL ID NUMBER (i L' (, (col
Legal Description:
Subdivision Name Block Lot(s)
Section l� Township CV(/ North, Range o WM
APPLICANT /l (Cb"6,16 M' 't - / 7 1 PHONE ..5'(o0
MAILING ADDRESS 2--1 ,c t i t ,4tA
/ G -{v / tYl 7 � "( ZIP (136,
PROPERTY OWNER /)'Z �nj,A�(7z#-i Gr/GL"•17)/t tui i Val'/f 1 PHONE •_$IOC �••. -&4V:
MAILING ADDRESS L 4i'<l 4117-r-L. iZ•(
TDIA! ZIP -7d ,it'
CONTRACTOR ( /M 6 //21,c+.../4c.-r-c ) 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, reasonablg 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 W4,'p/ 'W "' 1";Z-er DATE --/`r// ' / ,
Qc " FOR OFFICE USE ONLY
BASE FEE RECEIPT#
CASH/CK # •
U U 1
TOTAL 1 DATE ' ' / /
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