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HomeMy WebLinkAboutBLD2001-00672 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 #: BLD01-00672 Received Date 12/4/2001 SITE ADDRESS: 20 MARKET ST Issue Date 12/4/2001 PORT HADLOCK, 98339 Expiration Date 12/4/2002 APPLICANT: DOLORES A BECKMAN PHONE: (360)379-0797 20 MARKET ST PORT HADLOCK WA 98339-9616 1-5 SUBDIVISION: HARRISBURG Block: 4 Lot: PARCEL NUMBER: 956700401 Section: 2 Township: 29N Range: 01W CONTRACTOR: MOUNTAIN PROPANE LLC PHONE: 265 CHIMACUM RD PORT HADLOCK WA 98339 OWNER, DOLORES A BECKMAN PHONE: (360)379-0797 if different: 20 MARKET ST PORT HADLOCK WA 98339-9616 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 12/04/2002. REQUIRED INSPECTIONS: [ ] C--- nk)Line pl:: ..e. DrC31.,,.e asp< 42 Ro•mf [ ] FinalApproval: 0 K ;i,,...,06� r D-cD/ BUILDING INSPECTION HOT-LINE 379-4455. 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 • BLD 00672 BUILDING PERMIT APPLICATION Review Type: Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00672 Received Date: 12/4/2001 SITE ADDRESS: 20 MARKET ST PORT HADLOCK, 98339 OWNER: DOLORES A BECKMAN PHONE: (360)379-0797 20 MARKET ST PORT HADLOCK WA 98339-9616 SUBDIVISION: HARRISBURG Block: 4 Lot: 1-5 PARCEL NUMBER: 956700401 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: MOUNTAIN PROPANE LLC PHONE: 265 CHIMACUM RD PORT HADLOCK WA 98339 REPRESENTATIVE(S): PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK & 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 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 12/04/01 43768 Total: $48.00 JEFFENDN COUNTY COMMUNITY QEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 99368 PH: (360}379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE )( PROPANE TANK PELLET STOVE OTHER -Ii— ,--t-r9,h- SITE ADDRESS: 911#/ROAD NAME ZIP 9 DIGIT PARCEL ID NUMBER (,6, 2 Q© 1--/0 Legal Description: Subdivision Name Block LotIsl Section Township North, Range WM APPLICANT ' D oLOR6 S cCtf nI\Av PHONE -379-6 297 MAILING ADDRESS 2,6 7)-)ArZKrr Sr PO,er 1-/Ai9 ocK •1,04 ZIP q)3 3 9 PROPERTY OWNER 00/1 0/(26-7 j 6 Gj7-20 ,Z) PHONE 3 7 5- o 7%7 MAILING ADDRESS Z i, /'l7A/Z.,ei -r S7- /7� 1er l f 7/,o !tiA ZIP 9‹f33"j 'CONTRACTOR 1/[1r?//j i'k'Jr1g7u6-- PHONE _ifs-&9/V MAILING ADDRESS .2 5. C/I//Y//(f/zq , 1 P1er /MOLzCK /A/<-1 cle /32.33‘i 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 far 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 I / t u c :: E USE QNLY .t u t �., c s y, , ems. .sri .t SE t tC..'� sY` • �G 7 ss�v 4 3 ri CEIF'A irF. w`, x y.n". t1''s7a§ , i+. 5 * c rv:r _. 7 ,.. s :'� y a iv ' •4 s 3' }'� 4"Ex tr�7 h.N°,. :' {t + 5k .. ,TOTAL t3 as., ° r .:1 7 rfl`7�5 t A J a,,, t. i A 4 H:IHOMEIPLNCNTR\FORMS1lNSTALL.D0C10/99 DEC - 4 2001 .- 1 I JE.FF-LiiSU'i COUNTY ;' Or ':Y DEA,ELON11Cii