HomeMy WebLinkAboutBLD2001-00698 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 #: BLD01-00698 Received Date 12/20/2001
SITE ADDRESS: 360 CLEVELAND AVE Issue Date 12/20/2001
PORT HADLOCK, 98339 Expiration Date 12/20/2002
APPLICANT: JAROMIR R BELIC PHONE: (360)379-9770
LANIE BELIC
PO BOX 1142
PORT HADLOCK WA 98339-1142 81
SUBDIVISION: IRONDALE AC TRACTS Block: Lot:
PARCEL NUMBER: 962700085 Section: 7 Township: 29N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, JAROMIR R BELIC PHONE: (360)379-9770
if different: LANIE BELIC
PO BOX 1142
PORT HADLOCK WA 98339-1142
PROJECT DESCRIPTION NO MLA REQ'D - PROPANE TANK& STOVE 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 12/20/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance,:(C DZ ,4.,`(cc, ALg .fl,/ 1 1.1 1Eb.
cS Pet*—7�C-�
5[ ] FinalApproval: nK 5 1 l/ 'l
BUILDING INSPECTION HOT-LINE 3794455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Propane.rpt 10/29/19
00698
BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00698 Received Date: 12/20/2001
SITE ADDRESS: 360 CLEVELAND AVE
PORT HADLOCK, 98339
OWNER: JAROMIR R BELIC PHONE: (360)379-9770
LANIE BELIC
PO BOX 1142
PORT HADLOCK WA 98339-1142
SUBDIVISION: IRONDALE AC TRACTS Block: Lot: 81
PARCEL NUMBER: 962700085 Section: 7 Township: 29 N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK & STOVE 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:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE:
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 Cendition:,
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 12/20/01 43834
Total: $48.00
JE FERSON COUNTY PERMIT CENTER 621 SHERIDAN ST PORT TOWNSEND WA 98368 PH: 360 379-4450
INSTALLATION PERMIT APPLICATION
` -.10 0_0 2_S
WOODSTOVE `- PROPANE TANK PELLET STOVE l f �,
OTHER 4-0
SITE ADDRESS: R•04-'`-9
911#/ROAD NAME � rJ
r I C:-rQ-e-o c ZIP F-33 7
9 DIGIT PARCEL ID NUMBER (p ` 7 D 0 a 8 —
Legal Description:
Subdivision Name
Block Lot(s)
Section Township North, Range WM
APPLICANT i G,� (!�
PHONE Y7 q, j 1 7-°
MAILING ADDRESS 6 10(Z
ZIP
PROPERTY OWNER LJ
PHONE
MAILING ADDRESS ( I
ZIP
CONTRACTOR Sl4.V1 S H I✓1 P20(>$ - _
PHONE 3$�- 579/
MAILING ADDRESS (D g5.3 QI+0
02 .
por1' 1Y3 Lc cac OA .
ZIP 5 cf 33.1
STATE LICENSE # $i.(V1S 0]7QP
EXP. DATE jjO-/ _FEDERAL I.D. # `I I- 1 0 c1 7 &S 7
.
APPLICANT SIGNATURE 4�
DATE
FOR OFFICE USE ONLY
BASE FEE
ECEA IF, � � � R � PT # �j 3 y
D ("__ Cq 2/CK #
TOTAL
DEC 2 0 2001 °J ►z /26/o L
J.:
H:\HOMETLNCNTR\FORMS\INSTALL.D0C4/98 y -
DEPT. OF COMMUNITY DEVELOPMENT