HomeMy WebLinkAboutBLD2001-00545 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 #: BLD01-00545 Received Date 9/27/2001
SITE ADDRESS: 270 PIONEER DR Issue Date 9/27/2001
PORT LUDLOW, 98365 Expiration Date 9/27/2002
APPLICANT: KARL H SONTOWSKI PHONE: (360)437-0659
270 PIONEER DR
PORT LUDLOW WA 98365
124
SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot:
PARCEL NUMBER: 990603124 Section: 9 Township: 28N Range: 01 E
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPL994BH Expires 12/08/2001
OWNER,
if different:
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 09/27/2002.
REQUIRED INSPECTIONS:
[ ] Line/Appliance: aQ/c.(- /O f `'f-j
[ FinalApproval: OK 7— i✓ic /0' --/—v(
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 #: BLD01-00545 Received Date: 9/27/2001
SITE ADDRESS: 270 PIONEER DR
PORT LUDLOW, 98365
OWNER: KARL H SONTOWSKI PHONE: (360)437-0659
270 PIONEER DR
PORT LUDLOW WA 98365
SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot: 124
PARCEL NUMBER: 990603124 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPL994BH Expires 12/08/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK 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: UNHEATED: #OF STORIES:
OCCUPANCY: 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 plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 09/27/01 30396
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE f�,„ PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: �
911#/ROAD NAME �/P / /b,7/L--c,e--- ] ',/L-4
a,TQ�H./�G �
. e) h./r4 ZIP 9g3ges
g
9 DIGIT PARCEL ID NUMBER 1 - ,o &o ' l Zc+
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT / 1/ .C,//A-if)S'f3/ PHONE3/0 --5/37 4ZI
MAILING ADDRESS �t27, ���/&-�:/L _i/Q.
/ IP/L7-- / >'( I ) / 1 4 ZIP 9cc36s
PROPERTY OWNER 4,/ i V( )/ ,U/, ---5;71 /p 'A-/ PHONE 34- ,7____ a41 1
MAILING ADDRESS (32 7 A0�k, ®t,., .2/2 ���� ,
i0-� �i//, /-AiJ W/� ZIP ti f(1"-
CONTRACTOR �Oy.,Z //L®,j�G� PHONE SS '<at-3
MAILING ADDRESS .26-) CA,J/Gll.., AQ
�1,.-T-///9../) ,cl� 4/ ZIP 15 /
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 t applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE DATE 9/ 27/6)/
..."
FOR OFFICE USE ONLY
BASE FEE RECEIPT# �1 ;7
TOTAL =. /� 41 SATE I Cl 11�f U
W27ass .:,...if
H:\HOME\PLNCNTR\FORMS\lNSTALL.DOC 10/99
_:1
4'r'.' jJ'i .. �,9vY
DEPT.OF COMMUNITY DEVELOPMENT