HomeMy WebLinkAboutBLD2001-00447 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 #: BLD01-00447 Received Date 8/7/2001
SITE ADDRESS: 352 DAISY KING RD Issue Date 8/7/2001
SEQUIM, 98382 Expiration Date 8/7/2002
APPLICANT: G W BANDY INC PHONE:
9909 TOPANGA CANYON BLVD
CHATSWORTH CA 913113602
T 6-8
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002273008 Section: 27 Township: 30N Range: 02W
CONTRACTOR: PENINSULA HEAT INC PHONE: 457-2775
502 W 8TH ST
PORT ANGELES WA 98362
Contractor's License PEN NINI*0440W Expires 09/13/2001
OWNER, G W BANDY INC PHONE:
if different: 9909 TOPANGA CANYON BLVD
CHATSWORTH CA 913113602
PROJECT DESCRIPTION NO MLA REQ'D - HEAT PUMP 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 08/07/2002.
REQUIRED INSPECTIONS:
[► - Tan k/Line/Applianc c(C 410/
[ FinalApproval: Q/l /0/1,1P/f z ()It-
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 #: BLD01-00447 Received Date: 8/7/2001
SITE ADDRESS: 352 DAISY KING RD
SEQUIM, 98382
OWNER: G W BANDY INC PHONE:
9909 TOPANGA CANYON BLVD
CHATSWORTH CA 913113602
SUBDIVISION: Block: Lot: T 6-8
PARCEL NUMBER: 002273008 Section: 27 Township: 30 N Range: 02 W
CONTRACTOR: PENINSULA HEAT INC PHONE: 457-2775
502 W 8TH ST
PORT ANGELES WA 98362
Contractor's License PENNINI*0440W Expires 09/13/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - HEAT PUMP 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:
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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 08/07/01 30069
Total: $48.00
08/03/2001 14:37 3603794451 JEFF' CO BCD PAGE 02/02
E i 1 — ELOPR,IN7 f32 s SHrRf RN s7 POPT 'A u
INSTALLATION PERMIT APPLICATION
WOOOSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS:
911#IROAD NAME
66 rdix, �7S33
S DIGiT PARCEL ID NUMBER ()O J 3 OCj' �--^
Legal Description: —�
Subdivision Name Block Lots)
5oction Town#hip North, Range WM
APPLICANT Pen ifs h T PHONE3(,6-4 5"7-a ! /s--
MAILING ADDRESS SO w
•
PROPERTY OWNER at/4_•i34 Co PHONE
MAILING ADDRESS 1--qZ:1411rptiLCste Clcit- led
zip 3
CONTRACTOR PerturksuileA. Peai , G P1-1ONE__q_45_7_7ja .7 7 J
MAILING ADDRESS rya VlJ gjh
! 0 ✓6 ZIP
STATE LICENSE# _Y�i NI N L /4144 v✓ EXP. DATE/ /a 00/
FEDERAL I.D. # _Q Jam-/ 73527/
By signing the application form,the applicant/owner attests that the information provided herein la true and correct to the best of their knowteoge. Any materiel
falsehood OF 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 end holy harmless Jefferson Cinnity against ail iisbiiitici,judgments,court costs,reasonabl attorney's fees and expenees which
may In any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
further agree to provide access and right of entry to Jefferson County and it's nineinynes, rapresenteth,ag or agents for the eurpode of application review end ony
required Itter inspections. AcOoss and rich of envy to the applicant's property or structure shall be requested and shed occur during regular business hours.
APPUCAfa.i SIGNATURE DATE a I(3 ICJ/
r S... n-, t ! i t . t � r lei � j t, -- M i
° FOR QF�IO VS�Ohi'Y °st�i ' {
' t£.r4rsJ f! S.Mi t� ti' d1saJ�
: . 1 r'it t. the ' M— AECCIf>7' t `tt S R •
' itf ~3'I.n St 7f iacl��91r1}tj d etc '' 91i� •• y ^ryyt { � t•:A7��}}�� � 4 t�V i�LF'w'1�i�1� �'+
• t bA°�� �lt �i . rN 10 of
y 1
•
li WOkfriPLNCNTA1FORmayNSTALL,pOC 1 Q/yy
_ AUG -
I
JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT