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HomeMy WebLinkAboutBLD2001-00571 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 #: BLD01-00571 Received Date 10/10/2001 SITE ADDRESS: 1670 KALA POINT DR Issue Date 10/10/2001 PORT TOWNSEND, 98368 Expiration Date 10/10/2002 APPLICANT: RICHARD MAXWELL PHONE: (360)379-1292 LAURA MATWELL 1670 KALA POINT DR PORT TOWNSEND WA 98368 332 SUBDIVISION: KALA POINT#8 Block: Lot: PARCEL NUMBER: 965000292 Section: 27 Township: 30N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPL994BH Expires 12/08/2001 OWNER, RICHARD MAXWELL PHONE: (360)379-1292 if different: LAURA MATWELL 1670 KALA POINT DR PORT TOWNSEND WA 98368 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 10/10/2002 REQUIRED INSPECTIONS: [ ] ine/Appliance: 6(* I © -'4-O 1— [ ] FinalApproval: ),--(--, , 10-H-01- 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 5 BUILDING PERMIT APPLICATION BeDOw Typ e: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00571 Received Date: 10/10/2001 SITE ADDRESS: 1670 KALA POINT DR PORT TOWNSEND, 98368 OWNER: RICHARD MAXWELL PHONE: (360)379-1292 LAURA MATWELL 1670 KALA POINT DR PORT TOWNSEND WA 98368 SUBDIVISION: KALA POINT#8 Block: Lot: 332 PARCEL NUMBER: 965000292 Section: 27 Township: 30 N Range: 01 W 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 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 Conditione Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 10/10/01 41549 Total: $48.00 3t---1 o( —S7 JEFFERSON COUNTY COMMUNITY DEVELOPMENT. 621 SHERIDAN ST,„PORT TOWNSEND WA 98368 PH: (3601 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE�'j TANK PELLET STOVE OTHER • SITE ADDRESS: 911#/ROAD NAME �'f� f l\ ` O, C) l _,L'a_j_, Dr(ve_' v-z f � t. 0;J ') ZIP ��C��'� 9 DIGIT PARCEL ID NUMBER /6 S L/L-' 2 Zj-1.2,._ Legal Description:Subdivision Name kalJ , � _ et �i} /Vi 41. r 9 Block Lot(s)352 Section / Township North, Range WM APPLICANT / ���_�l / L/ (( PHONE06O),.j 7i- 3 MAILING ADDRESS W2f ._ d'1/425 (Lieeli ZIP PROPERTY OWNER 5e"no_ 4.3 l ,` i/e__ PHONE ,1-9T2 MAILING ADDRESS ZIP CONTRACTOR f (/�� ��i . f {r� y2� PHONE MAILING ADDRESS 2.7 g,j /,72C P72- a- �/ �, ) Z . ZIP/ L 3 J 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 r. t of entry to the applicant's property or structure all be requested and shall occur during regular business hours. r APPLICANT SIGNATURE }��'� 1 DATE/6) 1� � l FOR OFFICE USE ONLY BASE FEE RECEIPT# 1 l 5 t°7 CASH/CK# l' TOTAL DATE r� /'fO r H:\HOME\PLNCNTR\FORMS\INSTALL.DOCt 0/99 L