HomeMy WebLinkAboutBLD2001-00319 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 #: BLD01-00319 Received Date 6/4/2001
SITE ADDRESS: 6891 OAK BAY RD Issue Date 6/4/2001
PORT LUDLOW, 98365 Expiration Date 6/4/2002
APPLICANT: FRANCIS T HALL PHONE: 360-385-9353 W
6891 OAK BAY RD .3iro--. i,37—asp IN)
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 821042113 Section: 4 Township: 28N Range: 01 E
CONTRACTOR: OWNER PHONE:
OWNER,
if different:
PROJECT DESCRIPTION PROPAN HOT WATER HEATER, PROPANE RANGE, PROPANE
HEATER
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 06/04/2002.
REQUIRED INSPECTIONS:
[ ] Tank/ ine/Appliance (5 K CSZ--" cvtaz;, rt !-I t'pttc .tOt6 0 4 l
[ ] FinalApproval: r/� {,, �-9--(-)
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
BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00319 Received Date: 6/4/2001
SITE ADDRESS: 6891 OAK BAY RD
PORT LUDLOW, 98365
APPLICANT: FRANCIS T HALL PHONE:
6891 OAK BAY RD
PORT LUDLOW WA 98365
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 821042113 Section: 4 Township: 28 N Range: 01 E
CONTRACTOR: OWNER PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPAN HOT WATER HEATER, PROPANE RANGE, PROPANE
HEATER
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: `/ '/aShoreline Aquifer
( Forest: Commercial Rural
Type Amount Paid By: Date: — 'rkeceipt Approved/Date dons
P �
Propane Tanks/Stoves $48.00 ZAN 06/04/01 28374
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
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WOODSTOVE PROPANE TANK PELLET STOVE OTHER --72_45t'4t Y A IJC.N:
SITE ADDRESS:
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911#/ROAD NAME tlj (1/ OA g 3fti'r &igiD
/ e7 4it17 o /(2,19 ZIP gg335
9 DIGIT PARCEL ID NUMBER 8 G-t ---z.-- //
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT ',-3 � S‘‘' jji 30 5-/953 14. .t-
PHONE ,4„?
MAILING ADDRESS 6g?/ o - /
7 J�/g ri- G45 r N ZIP �CJ J 6 5
PROPERTY OWNER da4441)
PHONE
MAILING ADDRESS
ZIP
CONTRACTOR PHONE
MAILING ADDRESS /4/,PIL
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 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.
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APPLICANT SIGNATURE ,� DATE"' /e ;14'"/ o /
rr FOR OFFICE USE ONLY
(, 6 C�
BASE FEE i RECEIPT# e J
CASH/CK# J L d ,f
TOTAL ' DATE / #
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