HomeMy WebLinkAboutBLD2001-00310 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 #: BLD01-00310 Received Date 5/31/2001
SITE ADDRESS: 161 W MAPLE ST Issue Date 5/31/2001
PORT LUDLOW, 98365 Expiration Date 5/31/2002
APPLICANT: PATRICK BOWEN SR PHONE: 437-9346
161 W MAPLE
PORT LUDLOW WA 98365
SUBDIVISION: PARADISE VIEW ESTATES Block: F Lot:
PARCEL NUMBER: 984000619 Section: 22 Township: 28N Range: 01E
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPL994BH Expires 12/08/2001
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK 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 05/31/2002.
REQUIRED INSPECTIONS:
[ an-k)L1ne/Appliance: '(( 6///3/ )/
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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 Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00310 Received Date: 5/31/2001
SITE ADDRESS: 161 W MAPLE ST
PORT LUDLOW, 98365
APPLICANT: PATRICK BOWEN SR PHONE: 437-9346
161 W MAPLE
PORT LUDLOW WA 98365
SUBDIVISION: PARADISE VIEW ESTATES Block: F Lot:
PARCEL NUMBER: 984000619 Section: 22 Township: 28 N Range: 01 E
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPL994BH Expires 12/08/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK 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
Routing Date: .� —,
F&W Landslide
3 '� Shoreline Aquifer
3`� Forest: Commercial Rural
Pr ximity Hat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Total:
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360):379-4460
INSTALLATION PERMIT APPLICATION
WOODSTOVE 4 PROPANE TANKVE OTHER
SITE ADDRESS: G l CL) ` lq 1 e
911#/ROAD NAME l
TO rs L��itC� Iv ' ZIP 9Y3 Ca
9 DIGIT PARCEL ID NUMBER g q L,O 6 /
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT T °(-tC 1,� ) e 'n PHONE -4z Q /
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MAILING ADDRESS t VUI,C(,� !
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PROPERTY OWNER o.SaiNt ei PHONE
MAILING ADDRESS
ZIP
CONTRACTOR 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, 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 try to Jefferson County and it's employees, representatives or agents for the purpose of application review and any
required later inspections. Access and right ntr to th applica property or structure shall be requested and shall occur during regular business hours.
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APPLICANT SIGNATURE ( � DATE {/�,,. / ,
FOR OFFICE USE ONLY
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BASE FEE RECEIPT# r _ t
CASH/CK#
TOTAL I C DATE J( /0
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