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HomeMy WebLinkAboutBLD2003-00638 • 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 #: BLD03-00638 Received Date 10/9/2003 SITE ADDRESS: 2260 HASTINGS AVE W Issue Date 10/9/2003 PORT TOWNSEND, 98368 APPLICANT: ALAN HIGHTOWER PHONE: LEE ANN HIGHTOWER 2260 HASTINGS AVE W PORT TOWNSEND WA 983689639 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001054016 Section: 5 Township: 30N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 9/6/2004 OWNER, ALAN HIGHTOWER PHONE: if different: LEE ANN HIGHTOWER 2260 HASTINGS AVE W PORT TOWNSEND WA 983689639 PROJECT DESCRIPTION: PROPANE TANK 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 10/9/2004. REQUIRED INSPECTIONS: [ ] Tan ine/Appliance: j r l...6#4 , J 0_t3-0-c [ ] FinalApproval• , 10`13 0 3 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 I:\F_BLD_Permit_Propane.rpt 10/29/19 • BUILDING PERMIT APPLICA B �N Review 0638 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00638 Received Date: 10/9/2003 SITE ADDRESS: 2260 HASTINGS AVE W PORT TOWNSEND, 98368 OWNER: ALAN HIGHTOWER PHONE: LEE ANN HIGHTOWER 2260 HASTINGS AVE W PORT TOWNSEND WA 983689639 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001054016 Section: 5 Township: 30 N Range: 01 W CONTRACTOR: CENEX SUPPLY & MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 9/6/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP PROPANE TANK 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: 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: n n F&W Landslide (® 16 � Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 PRB 10/09/03 60255 Total: $47.00 JEFFERSON COUNTY COMMUtEVELOPMENT,621 SHERIDAN ST,PORT TOWND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION Underground PROPANE TANK* Above Ground PROPANE TANK VHEAT 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): PO A-% Ti7 -9�s fT ZIP r O 3 f' ( 9 DIGIT PARCEL ID NUMBER ✓ © 1h Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT //I?n Z/fr AA.>+6 z-- PHONE -FjS-6 72-5 ' MAILING ADDRESS 2 -.2- 14457.'/7�.5 ,uv� r-- c /s'—/ a`5 ,ac/ ZIP PROPERTY OWNER PHONE MAILING ADDRESS ZIP CONTRACTOR ) ( PHONE MAILING ADDRESS ZIP STATE LICENSE# C)-4 c J t I V � ©E- 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 struct a requested and shall occur during regular business hours. APPLICANTS SIGNATURE Cirri— ---'' DATE / / / v—j FOR OFFICE USE ONLY BASE FEE 4-7-00 RECEIPT# ��7 CONSISTENCY REVIEW CASH/CK# a-C 1 5 TOTAL 17.�r� DATE l D / *Underground Propane Tank applications require additional information to be submitted. 0 V E R Please contact our office at 360-379-4450 if the back of this application is blank. g:\permitcenter\forms\bldg forms\install-revised 10-23-02.doc