HomeMy WebLinkAboutBLD2001-00622 •
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#: BLD01-00622 Received Date 11/2/2001
SITE ADDRESS: 45 BOARDWALK Issue Date 11/2/2001
PORT TOWNSEND, 98368 Expiration Date 11/2/2002
APPLICANT: PHYLLIS A ORTIZ PHONE: (360)379-6464
DONALD M ORTIZ
45 BOARDWALK AVE
PORT TOWNSEND WA 98368 12B
SUBDIVISION: SWALLOW LONG PLAT Block: Lot:
PARCEL NUMBER: 997300004 Section: 34 Township: 30N Range: 01W
CONTRACTOR:
OWNER, PHYLLIS A ORTIZ PHONE: (360)379-6464
if different: DONALD M ORTIZ
45 BOARDWALK AVE
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION PELLET 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 11/02/2002
REQUIRED INSPECTIONS:
[ " -nk/Line/Appliance:
[ FinalApproval: O,4e G- J/�/3—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
i:\F_BLD_Permit_Propane.rpt 10/29/19
00377
BUILDING PERMIT APPLICATION Review Type:
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00622 Received Date: 11/2/2001
SITE ADDRESS: 45 BOARDWALK
PORT TOWNSEND, 98368
OWNER: PHYLLIS A ORTIZ PHONE: (360)379-6464
DONALD M ORTIZ
45 BOARDWALK AVE
PORT TOWNSEND WA 98368
SUBDIVISION: SWALLOW LONG PLAT Block: Lot: 12B
PARCEL NUMBER: 997300004 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE(S): JOHN SWALLOW
PO BOX 417
PORT HADLOCK WA 98339
PROJECT DESCRIPTIO PELLET STOVE 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 PRB 11/02/01 42366
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT. 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: r�
911#/ROAD NAME s &- ALA d WAL 4t'c
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9 DIGIT PARCEL ID NUMBER g 6 1 300 6011
Legal Description:
Subdivision Name Block Lotls)
Section Township North, Range WM
APPLICANT JO/UP-Li iy/ • C1?// PHONE
MAILING ADDRESS /J Z'A-/ /(2JM-L'("
ZIP
PROPERTY OWNER d iciA(GI c f/ /Z_ PHONE 31 F? C'dj V
MAILING ADDRESS S/4/j%L ,4S
ZIP
CONT:%AC T OR -e)Z`/ Irj ° • PHONE
MAILING ADDRESS
ZIP
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 rtge gn Co 's m , peu
requiredfuher later ree inspectiontoprovids.access Access andandri righthtof of entryentry toto Jefferson the applicant'us propertyntyandit or e structureployees shall re be requestedresentativsor andagents shall occurforthe during
p rpose regularof application business hours.review and any
APPLICANT SIGNATURE II312 GCe�j1 � DATE / / L
_' FOR OFFICE USE ONLY
BASE FEE RECEIPT#
CASH/CK#
TOTAL 148 i DATE / /
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