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HomeMy WebLinkAboutBLD2003-00693 • 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 #: BLD03-00693 Received Date 11/6/2003 SITE ADDRESS: 7403 BEAVER VALLEY RD Issue Date 11/6/2003 CHIMACUM, 98325 APPLICANT: ROBERT ELDRIDGE PHONE: CAROL A ELDRIDGE 7403 BEAVER VALLEY RD CHIMACUM WA 983258703 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901242009 Section: 24 Township: 29N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 09/06/2004 OWNER, ROBERT ELDRIDGE PHONE: if different: CAROL A ELDRIDGE 7403 BEAVER VALLEY RD CHIMACUM WA 983258703 PROJECT DESCRIPTION: A/G 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 11/06/2004. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: 6N51,u4a- aF 5u PPLig •- 61_0 TA1.3 le- 4 Sit A N -1v ate . ii/03/�3 [ ] FinalApproval: Z2K/ -Cc).- e1, // ®343 fr 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 10/29/19c BLD03-00693 ()BUILDING PERMIT APPLIC ON Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00693 Received Date: 11/6/2003 SITE ADDRESS: 7403 BEAVER VALLEY RD CHIMACUM, 98325 OWNER: ROBERT ELDRIDGE PHONE: CAROL A ELDRIDGE 7403 BEAVER VALLEY RD CHIMACUM WA 983258703 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901242009 Section: 24 Township: 29 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 09/06/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI A/G 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: 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 1/4W`� Streams Total: Total: _ Flood Way W l) Floodplain Routing Date: F&W ,rJ D Landslide Shoreline Nb Aquifer•VS C. Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 CJZ 11/06/03 60324 Total: $47.00 C„aq A<,' JEFFERSON COUNTY COMA,DEVELOPMENI,021 SHERIDAN ST,PORT IOW D WA 98368 PH! J3BO)379-4454 INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION Underground PROPANE TANK* 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): , (,�,2c� ZIP cla6,. 7 � 9 DIGIT PARCEL ID NUMBER t OJ :.9•L. Oo Legal Description: 'yt 1��R v x �&wu t 156r Subdivision NameZak} h C RS1C Ti a&e �th,z. Lt.)v `p B ck LAM_ c3`5( Section iR N Township - f North, Range I V J r 5_ti- WM APPLICANT64*44 ►'l ` �C', � 1(IL ��' PHONE 1?YA— 4.503 MAILING ADDRESS -S " r ZIP 7 _ xs PROPERTY OWNER PHONE MAILING ADDRESS \C ZIP JEFFERSON COUNTY CONTRACTOR ''eiN - PHONE )EPT. OF COMMUNITY OEVEIOPMEN MAILING ADDRESS / l .itu.vvN. r> a7 n `7 �' ZIP 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. My 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 spree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomeye fees and expanses 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 ht 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 ant applicant pn)perty or structure shall be requested and shall occur during regular business hourr;- APPLICANT'S SIGNATURE � �� � W DATE I I I.' 1 L FOR OFFICE USE ONLY a = + , f; p use - , '..00, r,: r ON$IS E"I �t 1�Ir xrr _ w. :kTASI c ( i k q 0 71> • Propane Tank applications require additional information to be submitted. Please contact our office at 360479-4450 If the back of this application Is blank. OVER 4 4 4 G:PermitCenter\FORMS 1BLDG FORMS\instals-revised 10-3D-03-DQC 7R inn nn Tgbbp/FR9P. bT:gT FRR7/bR/TT >1� . . . , • i- i } 1-Jj,,- f! i . 1 I ! I1 .. I I I. , • ! J I :(i4; - (3 jt • f • • I� I r0 _ �' . . i l+ ,i -- y\I ' I • ''-'-'1...-- : ' . l t .ram tr. LeJ L __.,,, . • . _ ( .„,. 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