HomeMy WebLinkAboutBLD2004-00612 •
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 #: BLD04-00612 Received Date 9/28/2004
SITE ADDRESS: 7715 FLAGLER RD Issue Date 9/28/2004
NORDLAND, 98358
APPLICANT: VINCENT P ZODIACO PHONE:
JOYCE L ZODIACO
PO BOX 77
NORDLAND WA 98358 T 9
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 021294017 Section: 29 Township: 30N Range: 01 E
CONTRACTOR:
il
OWNER, VINCENT P ZODIACO PHONE:
if different: JOYCE L ZODIACO
PO BOX 77
NORDLAND WA 98358
PROJECT DESCRIPTION: NO MLA REQUIRED-
REPLACING 500 GALLON 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 09/28/2005.
REQUIRED INSPECTIONS:
[ ] an ine/Appliance:___ P �_� �D�ZE��
FinalApproval: 'tSztL Tlvsa.1__OLZ _
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_PermitPropane.rpt 10/29/195
•UILDING PERMIT APPLICAPON BLRDOe 00ppe12
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00612 Received Date: 9/28/2004
SITE ADDRESS: 7715 FLAGLER RD
NORDLAND, 98358
OWNER: VINCENT P ZODIACO PHONE:
JOYCE L ZODIACO
PO BOX 77
NORDLAND WA 98358
SUBDIVISION: Block: Lot: T 9
PARCEL NUMBER: 021294017 Section: 29 Township: 30 N Range: 01 E
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NO MLA REQUIRED -
REPLACING 500 GALLON ABOVE GROUND PROPANE TANK
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: 2003 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 CJZ 09/28/04 67725
Total: $48.00
JEFFERSON COUNTY COMMUN EVELOPMENT,621 SHERIDAN ST,PORT TOWN WA 98368 PH; (360)379-4450
1STALLATION 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 PLLET STOVE COOKING STOVE
OTHER(Please Specify) 5-00
Is this appliance(htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home?
YES X NO
SITE ADDRESS(911#/Road Name):
/ k,412--vi ck, CXJ/T - ZIP 9-3)
9 DIGIT PARCEL ID NUMBER OZ/ Z'/40/7
Legal Description:
Subdivision Name Block Lot(s)
Q'
Section J Township . 0 Al North, Range C)/ WM
APPLICANT v/A)C 4.i1 Z t 4i ' PHONE —3L'z) -Ser-N ` 3.4l
MAILING ADDRESS Py E)• BL/ - x -77 ) .S LI;(y
lULN-Al.›-t-'�L,,Q j'tea/4 ZIP q
PROPERTY OWNER V/NLC'4s r # \/&C ? 2C 1 c U PHONE
MAILING ADDRESS
ZIP
CONTRACTOR i✓ 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 attorneys 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 Jefferson Coun and it's employees,representatives or agents for the purpose of application review and any required
later inspections. Access and right of entry the a Ii pe '',Anil-lure all be requested and shall occur during regular business hours.
APPLICANTS SIGNATURE w i DATE 9 / 2 / 24-3C'51
FOR OFFICE USE ONLY ""j
BASE FEE $4.� `C��,,, __ _ ,} RECEIPT# .(91 f a r
CONSISTENCY REVIEW .--F ir CASH/CK# J (a b
TOTAL DATE - I f�l� /Ol'
* __.�_.
Propane Tank applications require additional information to be submitted. `,^ I) 1- I `)
Please contact our office at 360-379-4450 if the back of this application is blank. OV E 4 + 4 ,
! t.
.. i
i
. T. ( L. _ . .
(--MY. T&g,y $iy2'
J00 ,
-b
ea,, ,,, , ,vi •0w env
.p ;P A C r, 0
c 0 -0 .Ill � , f ti
i T Y. 1
,,-.
13 co) -,,c? 40
-t. g.71 --, ...a. ,yr'A.+, ,,3
9F % .Ala.0111SP:� i'4C::: ,
Tsie �' f.
1 \ -4.1
' I
\ i 1 I RI
4
'S lu...I .m.'4 -N-
i .\.Z : ' t--
P ._ , ,
-,i -r7.:- i
N T I
> m
i 1
vs t
D W `/
co
QQ' In
D 1
i rn
v C
_
T t
o
r
II ( ) x_
z TEN
o
I
o urt Zap
�3
III 4
m
V b f V 4
i il.,
> , �W
7 N
tc V
\III -...-...
2�
y
ti
—_ m ^,
? ; 0
�, s o TITLE: WASTEWATER SYSTEM AS—BUILT
m N. m m JOHN SCOTT FLEMING ENGINEERING, INC.
o ' m PARCEL # 021 -294-017 JS '
o o �� CLIENT: VINCE & JOYCE ZODIACO
o 0 4289 MUIRWOOD CIRCLE P.O. BOX 44
PORT ANGELES, WA 98362
RENO, NV 89509 (360) 452-8500, FAX: (360) 452-3383