HomeMy WebLinkAboutBLD2004-00663 ItILDING PERMIT APPLICATTN BLD04-00663
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00663 Received Date: 10/19/2004
SITE ADDRESS: 381 SUNSET BLVD
PORT TOWNSEND, 98368
OWNER: DORIS E FULLER PHONE: (360) 385-2949
381 SUNSET BLVD
PORT TOWNSEND WA 98368-9443
SUBDIVISION: CAPE GEORGE COLONY DIV 2 Block: 4 Lot: 31
PARCEL NUMBER: 938100431 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: EVERWARM INC PHONE: (360) 452-3366
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/17/2006
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr 120 GAL A/G PROPANE TANK AND FIREPLACE INSERT - NO MLA
REQ'D
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:
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 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 10/19/04 67924
Total: $48.00
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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 #: BLD04-00663 Received Date 10/19/2004
SITE ADDRESS: 381 SUNSET BLVD Issue Date 10/20/2004
PORT TOWNSEND, 98368
APPLICANT: DORIS E FULLER PHONE: (360) 385-2949
381 SUNSET BLVD
PORT TOWNSEND WA 98368-9443 31
SUBDIVISION: CAPE GEORGE COLONY DIV 2 Block: 4 Lot:
PARCEL NUMBER: 938100431 Section: 13 Township: 30N Range: 02W
CONTRACTOR: EVERWARM INC PHONE: (360)452-3366
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/17/2006
OWNER, DORIS E FULLER PHONE: (360) 385-2949
if different:
381 SUNSET BLVD
PORT TOWNSEND WA 98368-9443
PROJECT DESCRIPTION: 120 GAL A/G PROPANE TANK AND FIREPLACE INSERT - NO MLA
REQ'D
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 10/20/2005.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: /kly't/Afe /,1-/ Oyi
FinalApproval: t%P�j [2,-2*—bZ.
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£
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,62 : ••N ST, PORT TOWNSE D W , 98568 PH: (36Q)379.44¢Q
INSTALLATION PERMIT APPLICATION
WOODSTOVE x PROPANE TANK PELLET STOVE OTHER
Is this appliance(htg stove, hot water tank, furnace, etc.) to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(D11 */Road Name):
(7_S ZIP 9 9•3
9 DIGIT PARCEL ID NUMBER 3 R' - /Q o - , 3 I
•
Legal Description:
Subdivision Name i Block // a Lot(s)
Section Township North, Range WM
APPLICANT c-� lj .C..„/ S F-G[ /���L PHONE 3 40 - -
MAILING ADDRESS• 3 7 / �/� �<<i' ry / )
1-C) 0274 / G GO /-7 n(- W R ZIP 9 9
PROPERTY OWNER G �P �C / PHONE
MAILING ADDRESS - ` / /-1. /— /,‘
ZIP -3
CONTRACTOR EL) e h Le.,a/21't? �fLG'l/�Z� HbniOPHONE ""A6,D - - 3 3 4. la
MAILING ADDRESS 6- ? ( / w
14r7 9 �� r� P ZIP 8 3 l=
STATE LICENSE# t V Efe W J 0 g Znf L_, EXP.DATE SS ( L1 0`,*3_
FEDERAL I D # -I I - I s± 4 O '7 oc
By signing the applwatlon form, the applicant/owner waits 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 thle permit being null and vo,d.
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 end 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.
APPLICANT SIGNATURE c� _ DATE /O 1 /9 I O
471
FOR OFFICE USE ONLY F!�
BASE FEE r `=tom' COg. RECEIPT#
rzrn5oi. 244.00
Mr) CASH/OK*
TOTAL DATE1., „(
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