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HomeMy WebLinkAboutBLD2001-00324 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 #: BLD01-00324 Received Date 6/6/2001 SITE ADDRESS: 111 LAUREL ST Issue Date 6/6/2001 PORT HADLOCK, 98339 Expiration Date 6/6/2002 APPLICANT: DONALD BURRELL PHONE: (360)385-4624 111 LAUREL ST PORT HADLOCK WA 98339 28 SUBDIVISION: PORTAGE BAY PARK Block: Lot: PARCEL NUMBER: 989100037 Section: 1 Township: 29N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPL994BH Expires 12/08/2001 OWNER, DONALD BURRELL PHONE: (360)385-4624 if different: 111 LAUREL ST PORT HADLOCK WA 98339 PROJECT DESCRIPTION NO MLA REQ'D - 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 06/06/2002. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: [1 FinalApproval: Pc 6 ,�2foC�. 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_Perm it_Propane.rpt 10/29/19 BUILDING PERMIT APPLICATION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00324 Received Date: 6/6/2001 SITE ADDRESS: 111 LAUREL ST PORT HADLOCK, 98339 APPLICANT: DONALD BURRELL PHONE: (360)385-4624 111 LAUREL ST PORT HADLOCK WA 98339 SUBDIVISION: PORTAGE BAY PARK Block: Lot: 28 PARCEL NUMBER: 989100037 Section: 1 Township: 29 N Range: 01 W 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: NO MLA REQ'D - PROPANE TANK 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: 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/pate Propane Tanks/Stoves $48.00 MAM 06/06/01 27428 Total: $48.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE X PROPANE TANK PELLET STOVE OTHER 91 1 ADDRESS: t 1 r F a , } .S 911#/ROAD NAME b l („yV L ZIP T� 4 9 DIGIT PARCEL ID NUMBER CY 1 4 4° v Legal Description: Subdivision Name Block Lot(s) Section Township North, Range T WM APPLICANT DC) q G . l�s� �L L PHOf 38 6/ 3 SS-- �+g MAILING ADDRESS t 1 t. j a ' .L s !! Fo r% t . LO C J • tv4. ZIP 8 111 PROPERTY OWNER DaJi.d I . Ij,Jlike_C( PHON(3 ) J.1'©2 MAILING ADDRESS j�i t! �h!ha��C!tA yo s' 1, 40 C►.Qci W,{ ZIP ! ,?, CONTRACTOR Mao 114 elfr fra PH 40' 35.E t 383 MAILING ADDRESS 2-40 5 L c '`t#rz b,. cv tiet 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. � b APPLICANT SIGNATURE DATE / _ / BA FEE 1 1 4 w TOTAL ,� , y41 � a (al7I H:\HOME\PLNCNTR\FORMS\IN STALL.DOC 10/99