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HomeMy WebLinkAboutBLD2004-00276 • • 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 #: BLD04-00276 Received Date 4/29/2004 SITE ADDRESS: 66 LAUREL ST Issue Date 4/29/2004 PORT HADLOCK, 98339 APPLICANT: MILTON D MORRIS TRUSTEE PHONE: (360) 379-1602 JUDITH E MORRIS TRUSTEE 66 LAUREL ST PORT HADLOCK WA 98339-9720 TX 26 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921063008 Section: 6 Township: 29N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTP198306 Expires 09/26/2004 OWNER, MILTON D MORRIS TRUSTEE PHONE: (360) 379-1602 if different: JUDITH E MORRIS TRUSTEE 66 LAUREL ST PORT HADLOCK WA 98339-9720 PROJECT DESCRIPTION: 120 GAL 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 04/29/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance( 4/ /'a ef r [ ] FinalApprovaI: 7 c -O L-J 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 0UILDING PERMIT APPLIC ON B Review Type: y pe: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00276 Received Date: 4/29/2004 SITE ADDRESS: 66 LAUREL ST PORT HADLOCK, 98339 OWNER: MILTON D MORRIS TRUSTEE PHONE: (360) 379-1602 JUDITH E MORRIS TRUSTEE 66 LAUREL ST PORT HADLOCK WA 98339-9720 SUBDIVISION: Block: Lot: TX 26 PARCEL NUMBER: 921063008 Section: 6 Township: 29 N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2004 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: 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 Bv: Date: Receipt: Approved/Date Permit $48.00 KAS 04/29/04 64297 APPROVED Total: $48.00 APR 2 9 2004 Jefferson County Planning & Building Department 711//-dlit4nr- ft( ffi (SC .RSON COUNTY COMMUN EVELOPMENT,621 SHERIDAN ST,PORT TOWN,WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION cMS BELOW THAT PERTAIN.TO THIS INSTALLATION rground PROPANE TANK* V Above Ground PROPANE TANK* SIZE OF PROPANE TANK I2 U fZ 6 (//a/';'#l»•t F _AT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE LOOKING STOVE OTHER(Please Specify) its appliance (woodstove, htg stove, hot water tank,furnace,etc.) to be installed in a Manufactured/Mobile jme? YES ✓ NO SITE ADDRESS(911#/Road Name): APR 2 9 D04 64 L4ce', 1, S l Yq / i LDcd A- ZIP fg334' 9 DIGIT PARCEL ID NUMBER ?Xi 4,4 3 4070 Q Legal Description: .S4. ZA, 1/�4'/ �r 4� ex7-4 ( ) Subdivision Name � Block Lot(s) , Section Township North, Range WM APPLICANT /W/Zr—/4 �1�/ �0/Q/�'/S PHONE b� '"3 7' 16 2 MAILING ADDRESS 66 G,4 'ge'L 1Qc1l GUp ZIP Id 3 9 PROPERTY OWNER J i�!'n PHONE MAILING ADDRESS ZIP CONTRACTOR 7,?/V rl 7O,d s S, T /� PHONE go°%I/S i183 MAILING ADDRESS ///Ol///477¢r�✓ F o 6.5" cd,.44 A N/ �� Niar 4 6i' e(/ - ZIP q(J 3?.9 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 /t,,(g /1 .) DATE V / GQ6- / 41 FOR OFFICE USE ONLY /y BASE FEE $48.00 RECEIPT# ✓4-aq G� CONSISTENCY REVIEW $24.00 CASH/CK# 1 to TOTAL DATE /ay/ 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. 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