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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 (800)831-2678
PERMIT #: BLD01-00664 Received Date 11/28/2001
SITE ADDRESS: 7715 FLAGLER RD Issue Date 11/28/2001
NORDLAND, 98358 Expiration Date 11/28/2002
APPLICANT: VINCENT ZODIACO PHONE: (775)825-3643
JOYCE ZODIACO
4289 MUIRWOOD CIR
RENO NV 89509
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 021294017 Section: 29 Township: 30N Range: 01 E
CONTRACTOR: SEAHOME SERVICES, INC PHONE: (360)765-3749
7425 THORNDYKE RD
QUILCENE WA 98376
Contractor's License SEAHOSI077KS Expires 11/17/2003
OWNER, VINCENT ZODIACO PHONE: (775)825-3643
if different: JOYCE ZODIACO
4289 MUIRWOOD CIR
RENO NV 89509
PROJECT DESCRIPTION NO MLA REQ'D - PROPANE TANK& FURNACE
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 11/28/2002
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: L-10,. ) 7-i2,w Ar o.< /.Z_ate _,) ,
4' FinalApproval: (7) /, -.,L I ' 0(
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
is\F_BLD_Permit_Propane.rpt 10/29/19
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BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00664 Received Date: 11/28/2001
SITE ADDRESS: 7715 FLAGLER RD
NORDLAND, 98358
OWNER: VINCENT ZODIACO PHONE: (775)825-3643
JOYCE ZODIACO
4289 MUIRWOOD CIR
RENO NV 89509
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 021294017 Section: 29 Township: 30 N Range: 01 E
CONTRACTOR: SEAHOME SERVICES, INC PHONE: (360)765-3749
7425 THORNDYKE RD
QUILCENE WA 98376
Contractor's License SEAHOSI077KS Expires 11/17/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK & FURNACE
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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 11/28/01 43752
Total: $48.00
JEFFEfRSON COON I Y COMMUNITY DEVELOPMENT.621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: 1360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE riV-PROPANE TANK PELLET STOVE ''OTHER \....? FJr,i -c.F__
SITE ADDRESS:
911#ROAD NAME ) ) 1 5 FL"teA- 2 A,tk/% 1 wfc
ZIP f 5ZSK
9 DIGIT PARCEL ID NUMBER Q A / (9 !y 0/7
Legal Description:
Subdivision Name Block Lots)
Section 9 Township Al ,f North, Range ' . � WM
_ 4 APPLICANT � � 4' V(�/�' C .4�PHONE / �7q
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MAILING ADDRESS / -<; i (&AY t !e'"
r i�ca,,,e_ 1 ,ti t ZIP 476, 76
PROPERTY OWNER V//��,,in C ® (s R ,Q /42 j C PHONE d 5~ V S W
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MAILING ADDRESS .2 I t l�11�.1,N add C I R Q{A
Q ta0 M . ZIP V [� Vg
CONTRACTOR T(dorne, Cry I•C.`- -1r7L PHONE 3t O`7 3765 1 /
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MAILING ADDRESS `AS T/L Wo✓O,.. 1 2d
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STATE LICENSE# ,cril v$1 0-2-7/ .5 EXP.DATE /%/�7/a3
FEDCnAL I.D.# //''-- /C573 /Z
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 rig of entry to the appl' ant's property or structure shall be requested and shall occur during regular business hours.
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DEPT. OF COMMUNITY DEVELOPMENT