HomeMy WebLinkAboutBLD2003-00374 •
BUILDING PERMIT APPLICA1ION BLD03-00374
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD03-00374 Received Date: 6/16/2003
SITE ADDRESS: 91 SHIP VIEW CT
PORT LUDLOW, 98365
OWNER: STEVEN B WITTMANN PHONE:
MICHELLE A WITTMANN
91 SHIP VIEW CT
PORT LUDLOW WA 983659557
SUBDIVISION: WHITE ROCK COVE TRACTS DIV II Block: Lot: 11
PARCEL NUMBER: 821265023 Section: 26 Township: 28 N Range: 01 E
CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096
P 0 BOX 989
PORT TOWNSEND WA 98368
Contractor's License SUBURPL044DA Expires 03/12/2005
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION Above Ground Propane Tank
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:
CONST TYPE: OTHER:
GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK:
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
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 CJZ 06/16/03 56399
Total: $47.00
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JEFFERSON COUNTY COMMU)EVELOPMENT,621 SHERIDAN ST.PORT TOWN.WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN`TO THIS INSTALLATION
Underground PROPANE TANK* X Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE
OTHER(Please Specify)
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):
(1 / Oh 1p U1e,() ,—r---
Pon ( Lu /62-U LOq ZIP sq s36 ---
9 DIGIT PARCEL ID NUMBER ?Z (2 .6 5-02_3
Legal Description: ' ll _
Subdivision Name ( ,C�(1 t+ kr 2/( O7 . J7 L Block Lot(s) /
Section Township North, Range WM
APPLICANT 6] EIU ) YYl 161e/le /4, / )i'H1i7/ J PHONE 36 O-Vg7 22_J3
MAILING ADDRESS qh ! p V__/--ELL) �� —
Po r-( L ud l t,Lk) Z--l)4t ZIP q?3,3._,-_
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP �c/�
CONTRACTOR � ge Cr �j��bL/r L� PHONE �'j �-JCJ`((
MAILING ADDRESS
(c)c 7 N S 1 Lt Zk. ZIP 61.S3‘7
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.
APPLICANTS SIGNATURE .? ' 1l1/4-(_-) DATE / /6 / GO
A 7 06 FOR OFFICE USE ONLY RECEIPT# � q
BASE FEE /�
�Q
CONSISTENCY REVIEW •-4-- CASH/CK# Ce 78 c
TOTAL - DATE Co /l(p /cam 3
*Underground Propane Tank applications require additional information to be submitted. OVER
Please contact our office at 360-379-4450 if the back of this application is blank. .1.1.k
H:\H OME\PLN CNTR\IN FOB LDG\FORMS\INSTALL.DOC
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
PERMIT#: BLD03-00374 Received Date 6/16/2003
SITE ADDRESS: 91 SHIP VIEW CT Issue Date 6/16/2003
PORT LUDLOW, 98365
APPLICANT: STEVEN B WITTMANN PHONE:
MICHELLE A WITTMANN
91 SHIP VIEW CT
PORT LUDLOW WA 983659557 11
SUBDIVISION: WHITE ROCK COVE TRACTS DIV II Block: Lot:
PARCEL NUMBER: 821265023 Section: 26 Township: 28N Range: 01 E
CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096
P O BOX 989
PORT TOWNSEND WA 98368
Contractor's License SUBURPL044DA Expires 03/12/2005
OWNER, STEVEN B WITTMANN PHONE:
if different: MICHELLE A WITTMANN
91 SHIP VIEW CT
PORT LUDLOW WA 983659557
PROJECT DESCRIPTION: Above Ground Propane Tank
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 06/16/2004.
REQUIRED INSPECTIONS:
i
[ ] Tank/Line/Appliance: 6jCOPAUp.TA/3 I.Eie j-P`UP Gi'i5 ///)& W ? 03
[ l -
FinalApproval:
Ok to - ( L(14/,5
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