HomeMy WebLinkAboutBLD2001-00562 t • .
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 #: BLD01-00562 Received Date 10/8/2001
SITE ADDRESS: 71 QUINAULT LOOP Issue Date 10/8/2001
PORT TOWNSEND, 98368 Expiration Date 10/8/2002
APPLICANT: STEVE MINTA PHONE: (360)385-4774
KATHY MINTA
71 QUINAULT LOOP
PORT TOWNSEND WA 98368 14
SUBDIVISION: CAPE GEORGE COLONY DIV 4 Block: 10 Lot:
PARCEL NUMBER: 938701013 Section: 12 Township: 30N Range: 02W
CONTRACTOR: EVERWARM INC PHONE:
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/17/2002
OWNER,
if different:
PROJECT DESCRIPTION NO MLA REQ'D -WOODSTOVE 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 10/08/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: 0 /- _ /O .2 q1 —O r
[ ] FinalApproval: . _. ' . _ /c 2`. tsi
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 df Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00562 Received Date: 10/8/2001
SITE ADDRESS: 71 QUINAULT LOOP
PORT TOWNSEND, 98368
OWNER: STEVE MINTA PHONE: (360)385-4774
KATHY MINTA
71 QUINAULT LOOP
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE COLONY DIV 4 Block: 10 Lot: 14
PARCEL NUMBER: 938701013 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: EVERWARM INC PHONE:
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/04/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D -WOODSTOVE 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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Condition:,
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 10/08/01 41524
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,_621 SHERIDAN ST,_PORT TOWNSEND WA 98368 PH; 13601_379-4450
INSTALLATION PERMIT'APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE V OTHER VV000 E'!
SITE ADDRESS:
911#/ROAD NAME 7' .? -\J( r ,u H.'f our
Poo L I ou,o_seir\(k ZIP 1 03 co e
9 DIGIT PARCEL ID NUMBER 9 3 V 70I 0 1 3
Legal Description: / I
Subdivision Name Co.pe GC'c+,('C�e- c.,.o1 vt vl 1J t'/ Li Block I Lot(e) I
j J .J Li
Section 5 I 2.. Township 3 0 0 North, Range 0 2 W WM
APPLICANT S--t-evev fL Kc..M VA 1 4-Ci PHONE 3$5 - f 77 L
MAILING ADDRESS 1 ! C v l v\(v 1 /.....0o f
Po 1j, n LJ.)A.5,2,4._ ZIP q Y 3 6 E
PROPERTY OWNER 5teVC.J�IC- Mlicta\ KoL'�`j A mot, & PHONE 3.-5 — 7 7L/
MAILING ADDRESS '7( r�-kJ k eta_,J 1 1O p r
Pe, TawvA6-tavI0k- ZIP 9 Y36F
CONTRACTOR � �,�`,,, ,r►� /�VE!'l�f'�Aat 1 PHON� (I)/ 2_"s r-c,
MAILING ADDRESS 2S?( t. i )-) w 10 1E .
PO (`T N&EC v� i V ° / ZIP 62_
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 SIGNATURE DATE r O / ( / 3 1
�U FOR OFFICE USE ONLY
BASE FEE V RECEIPT# 2L/
TOTAL 7V ( V" _._v 71 ib/ /
g ___2/
H:1HO ME\PLNCNTR\FORMS\INSTALL.DOC 10/99 ' etT ...a 2001 1
J_Y..<. JJ �..:
DEPT.OF COMMUNITY DEVELOPMENT