HomeMy WebLinkAboutBLD2001-00345 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 #: BLD01-00345 Received Date 6/13/2001
SITE ADDRESS: 120 RAINIER LN Issue Date 6/13/2001
PORT LUDLOW, 98365 Expiration Date 6/13/2002
APPLICANT: WAYNE W ANDERSON PHONE: (360)437-1022
KATHY WILSON JRWROS
120 RAINIER LN
PORT LUDLOW WA 98365 7
SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot:
PARCEL NUMBER: 990600207 Section: 8 Township: 28N Range: 01E
CONTRACTOR:
OWNER, WAYNE W ANDERSON PHONE: (360)437-1022
if different: KATHY WILSON JRWROS
120 RAINIER LN
PORT LUDLOW WA 98365
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 06/13/2002.
REQUIRED INSPECTIONS:
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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_Perm it_Propa ne.rpt 10/29/19
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BUILDING PERMIT APPLICATION BRD9-00483
eview Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00345 Received Date: 6/13/2001
SITE ADDRESS: 120 RAINIER LN
PORT LUDLOW, 98365
APPLICANT: WAYNE W ANDERSON PHONE: (360)437-1022
KATHY WILSON JRWROS
120 RAINIER LN
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: 7
PARCEL NUMBER: 990600207 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: PHONE:
PHONE:
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: 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 - Hat conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Total:
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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 / dO /,C)f rt_
POC4:1 AV P z_OW/ ZIP 96. &5
9 DIGIT PARCEL ID NUMBER O f,1s (p00 a 0 7
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT K' V r- 5o,u PHONE ' 7 /(7
MAILING ADDRESS 10-/1/24)/Ul '/A/U
Pog- AeDt_o& / • ZIP cie
PROPERTY OWNER . cft '2€: PHONE
MAILING ADDRESS
ZIP
CONTRACTOR /f CUOMO() Pg0P144 PHONE
MAILING ADDRESS 401-0 04. ZIP qd 3
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.
APPLICANT SIGNATURE1C:)C C DATE 67 / /310/
FOR OFFICE USE ONLY
BASE FEE RECEIPT#
CASH/CK#
TOTAL DATE / /
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