HomeMy WebLinkAboutBLD2002-00109 BLD02-00109
BUILDING PERMIT APPLICATION Review Type:
Jefferson County,Depa4 ment of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00109 Received Date: 3/4/2002
SITE ADDRESS: 31 FORESTER LN
PORT LUDLOW, 98365
OWNER: JOHN F ORSBORN PHONE: (360)437-0670
SALLY M ORSBORN
31 FORESTER LN
PORT LUDLOW WA 98365-9628
SUBDIVISION: PORT LUDLOW NO. 2 AREA 3 Block: Lot: 144
PARCEL NUMBER: 990603144 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIO PROPANE TANK & STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: 1997 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
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 Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 03/04/02 45822
Total: $48.00
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 #: BLD02-00109 Received Date 3/4/2002
SITE ADDRESS: 31 FORESTER LN Issue Date 3/4/2002
PORT LUDLOW, 98365
APPLICANT: JOHN F ORSBORN PHONE: (360)437-0670
SALLY M ORSBORN
31 FORESTER LN
PORT LUDLOW WA 98365-9628 144
SUBDIVISION: PORT LUDLOW NO. 2 AREA 3 Block: Lot:
PARCEL NUMBER: 990603144 Section: 9 Township: 28N Range: 01 E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, JOHN F ORSBORN PHONE: (360)437-0670
if different: SALLY M ORSBORN
31 FORESTER LN
PORT LUDLOW WA 98365-9628
PROJECT DESCRIPTION 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 03/04/2003.
REQUIRED INSPECTIONS:
[ ) Tank/Line/Appliance: c '-
,4 1
[ ] FinalApproval: 0 /1) �w
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
JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: 1360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE A PROPANE TANK PELLET STOVE )( OTHER G P i" lI
C, 0
SITE ADDRESS: /
911#/ROAD NAME 3 ( Fo2e5 l elz_ LA)
()T L -to i_� , Li) . ZIP (1)36,i)
9 DIGIT PARCEL ID NUMBER qqo U ict L"(
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT S p //
L ��C.f.Q_y, ��'�-�' G-.-� PHONE �3 ,- 06 70
MAILING ADDRESS v�
ZIP
PROPERTY OWNER 6rtt,6_6
PHONE
MAILING ADDRESS
ZIP
CONTRACTOR Silo S N I n Q Pee-0 P Ate_ PHONE 5717
MAILING ADDRESS (O 2?S 3 Rt lt 02 .
Povr Hich0Lo cic 04 . zip ! cf 33
STATE LICENSE # Sc.c VI S If P%0 7 7 Q Io EXP. DATE 11 r
FEDERAL I.D. # 91- 1 0 (71 '7 S:-
APPLICANT SIGNATURE a-444'-c, ,Qtf)-% G'• DATE / l / 0�--
FOR OFFICE USE ONLY
BASE FEE 2 � � � Unn � �BPT #
D h - A H/CK # f(p
TOTAL - MAR - 4 2002 3 /
J..,.
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC4/98 DEPT. OF COMMUNITY DEVELOPMENT