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HomeMy WebLinkAboutBLD2004-00030 ItUILDING PERMIT APPLICAI TON BLD04-00030 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00030 Received Date: 1/15/2004 SITE ADDRESS: 370 PULALI POINT RD BRINNON, 98320 OWNER: JEFFREY J STEELE PHONE: 370 PULALI POINT RD BRINNON WA 983209774 SUBDIVISION: Block: Lot: T 28 PARCEL NUMBER: 601183012 Section: 18 Township: 26 N Range: 01 W CONTRACTOR: C H S PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 9/6/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr 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: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 PRB 01/15/04 62349 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 PERMIT #: BLD04-00030 Received Date 1/15/2004 SITE ADDRESS: 370 PULALI POINT RD Issue Date 1/15/2004 BRINNON, 98320 APPLICANT: JEFFREY J STEELE PHONE: 370 PULALI POINT RD BRINNON WA 983209774 T 28 SUBDIVISION: Block: Lot: PARCEL NUMBER: 601183012 Section: 18 Township: 26N Range: 01W CONTRACTOR: C H S PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 9/6/2004 OWNER, JEFFREY J STEELE PHONE: if different: 370 PULALI POINT RD BRINNON WA 983209774 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 1/15/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: [ ] FinalApprova 2M-s 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 A:\F_BLD_Permit_Propane.rpt 10/29/19 • ' ---;--..--.. _----_ -- W 2 D C)ll 2 z O D N —_ -o m O ...r Z ly X MO 00 rnZ O , m ZO ZO O Z U) x 101 VIS 300131S�3a wp0�ia3 K t\''Ll5A -'o I '11.*Iire 3d0�_ v / J lla SN1 islx3dtsia \ 7. f ,��--ice r 1 1 i �353j w rn m D 1 d3bd 3x �C 1 0 0-I rn),' / j / pc, co N � (�� u o °'�^v / t 1�4'�- 7< c, • �O II �r�� ZOO /Nj'cI( / n� T -o Dom �� op� / rrO ` D D / (r \t 1 77 I m-,1 U) / mpx i DOZE O Pi moZ rmO ��O imp ®gym / �X / 'f *X Z 1 O .ate / p r:-� mzo r� / \� / � A II �\ / mac / It / 7- 'o 0 0- > tl l - -- -yy ������ FriS�q�� / DRIVEWAY GARAGE �f T� �_._ • �1.0 / o rn 1 m-o l� X (rn®? ��� r N- 4 �� o f\i . // M A o f.--I 0 Z �� < I - �pl0 �C� OC) p J c rn �I — -� ITt L_ r- --I J Z W EXISTING �o ) _-?)� ` sTgT°yam f 200' .�.. / F �a z W . o / -N / ,off .2-,\.,) ► ///ii,. / �,'� / R / / ti JEFFERSON COUNTY COMMUNI•VELOPMENT,621 SHERIDAN ST,PORT TOWNS.WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION f `{ MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION , t � p E G Underground PROPANE TANK* 1i` Above Ground PROPANE TANK* HEAT STOVE •• HOT WA ER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE L OTHER(Please Specify) r r, fefy Is this appliance(htg stove, hot water tank,furnace, etc.)to be installed in a 1ManufacturedJMobJfie lid if tVT YES a NO SITE ADDRESS(911#/Road Name): , 371 4( // 7 J �✓ v Vi ZIP %S� -7 `` 9 DIGIT PARCEL ID NUMBER (©'/ /,5' � Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT ,.,1,W ,d /� 7' PHONE - �� "" ���8 MAILING ADDRESS f D7/'?.-( ; r i(1 ZIP 9g34r� PROPERTY OWNER - �G{J%'� ` PHONE MAILING ADDRESS ZIP CONTRACTOR (Gr;/()C PHONE MAILING ADDRESS 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. 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 DATE FOR OFFICE USE ONLY 2�� Q BASE FEE $48.00 RECEIPT# &Z 34 CONSISTENCY REVIEW $24.00 CASH/CK# SZ TOTAL DATE * r 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. G:\PermitCenter\FORMS\BLDG FORMS\install-revised 10-30-03.DOC