HomeMy WebLinkAboutBLD2002-00026 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 #: BLD02-00026 Received Date 1/15/2002
SITE ADDRESS: 201 WINDROSE PL Issue Date 1/15/2002
PORT LUDLOW, 98365 Expiration Date 1/15/2003
APPLICANT: KENNETH G MC CONNELL PHONE:
DARLENE M MC CONNELL
201 WINDROSE DR
PORT LUDLOW WA 98365
SUBDIVISION: BAYVIEW VILLAGE DIV 1 Block: Lot:
PARCEL NUMBER: 931900035 Section: 16 Township: 28N Range: 01 E
CONTRACTOR: LEWIS PLUMBING LLC PHONE: (360)385-4957
PO BOX 141
PORT HADLOCK WA 98339
Contractor's License LEWISPL011P0 Expires 02/21/2002
OWNER, KENNETH G MC CONNELL PHONE:
if different: DARLENE M MC CONNELL
201 WINDROSE DR
PORT LUDLOW WA 98365
PROJECT DESCRIPTION GAS PIPING 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 01/15/2003.
REQUIRED INSPECTIONS:
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[ ] FinalApproval: OK 2---,--7-0 2r
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
BUILDING PERMIT APPLICATION BRDOWOOpe6
Jefferson County Department of Cbmmunity Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00026 Received Date: 1/15/2002
SITE ADDRESS: 201 WINDROSE PL
PORT LUDLOW, 98365
OWNER: KENNETH G MC CONNELL PHONE:
DARLENE M MC CONNELL
201 WINDROSE DR
PORT LUDLOW WA 98365
SUBDIVISION: BAYVIEW VILLAGE DIV 1 Block: Lot:
PARCEL NUMBER: 931900035 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: LEWIS PLUMBING LLC PHONE: (360)385-4957
PO BOX 141
PORT HADLOCK WA 98339
Contractor's License LEWISPL011PO Expires 02/21/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIO GAS PIPING 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 01/15/02 45526
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 (; PI 016
Is this appliance(htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911#/Road Name):
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- L t td i6ti ZIP 6 S.62 5
9 DIGIT PARCEL ID NUMBER "1 31 - 6-1 lam) - U
Legal Description:
Subdivision Name Block Lot(s)
Section tr ,n Township North, Range WM
APPLICANT s ! ZJt3 Y2 ji u 1�n Lb i ► PHONE 2l/O 30i�
MAILING ADDRESS t D. 15 X HMI/
ZIP I S 6
PROPERTY OWNER Pt cC v16 PHONE
MAILING ADDRESS 20l W tfd r USC
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CONTRACTOR I--�vI� � `"V { rt0Il t') L� PHONE` +)(Q�' .z7,5%• 7CP�
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MAILING ADDRESS I •0. 1:3 /�i1tI A� s�
Iga106 ZIP ei(�J 36)
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 tt VIA ( 11flq'ji DATE [ / r /
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FOR OFFICE USE ONLY ) -�
BASE FEE RECEIPT#
J Q CASH/CK# l VC7 6
TOTAL DATE /I /C-5-1
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