HomeMy WebLinkAboutBLD2001-00081 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 (800)831-2678
PERMIT #: BLD01-00081 Received Date 2/7/2001
SITE ADDRESS: 150 CEDARVIEW DR Issue Date 2/7/2001
PORT TOWNSEND, 98368 Expiration Date 2/7/2002
APPLICANT: PAUL OXENBOL PHONE:
CEDARVIEW DR
PORT TOWNSEND WA 98368
180
SUBDIVISION: KALA POINT#9 Block: Lot:
PARCEL NUMBER: 965000320 Section: 27 Township: 30N Range: 01W
CONTRACTOR: NORTHWEST FIREPLACE PHONE: (360)373-4631
4207 WHEATON WAY
SUITE A
BREMERTON WA 98310
Contractor's License NORTHFG044K0 Expires 05/07/2001
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK AND FIREPLACE
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 02/07/2002.
REQUIRED INSPECTIONS:
[ Tank/Line/Applian /10/
[ ] FinalApproval: b rs _//l
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
Inspector's Phone Hours 8:00 a.m. - 9:00 a.m.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Perm it_Propane.rpt 10/29/19
I ,
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00081 Received Date: 2/7/2001
SITE ADDRESS: 150 CEDARVIEW DR
PORT TOWNSEND, 98368 Q
APPLICANT: PAUL OXENBOL PHONE: 37 /-941I L(
CEDARVIEW DR
PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#9 Block: Lot: 180
PARCEL NUMBER: 965000320 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: NORTHWEST FIREPLACE PHONE: (360)373-4631
4207 WHEATON WAY
SUITE A
BREMERTON WA 98310
Contractor's License NORTHFG044K0 Expires 05/07/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK AND FIREPLACE
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: 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
27 F&W Landslide
Routing Date: /? Shoreline Aquifer
�/ Forest: Commercial Rural
—1-'r Ot a��donsType Amo�rt Paid By: Date: Receipt: Appro ate
Propane Tanks/Stoves $48.00 ZAN 02/07/01 38255
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-445b
INSTALLATION PERMIT APPLICATION
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WOODSTOVE X, PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS:
911#/ROAD NAME SO - R\JIt
(PcAz; To 1.x1 S t„, ` ZIP `? 3
9 DIGIT PARCEL ID NUMBER
Legal Description: _
Subdivision Name �� ���r ` (�'�'( / Block Lot(s)
Section Township North, Range WM
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APPLICANT I)L) l C KC. PHONE
MAILING ADDRESS ( Co e `�`��`/r e t'S l� f
IBC r? T O tO
ZIP
PROPERTY OWNER ' tr`9( PHONE
MAILING ADDRESS
ZIP
CONTRACTOR •
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MAILING ADDRESS 4 2 o (kJ A--01-.) W✓C(y
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STATE LICENSE# Ns(D S2 t E-E F O Lk-t-)- KG- 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.
APPLICANT SIGNATURE �tl t `- rl `` DATE' / r I -
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