HomeMy WebLinkAboutBLD2001-00668 , . i
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 #: BLD01-00668 Received Date 11/29/2001
SITE ADDRESS: 11 RHODODENDRON ST Issue Date 11/29/2001
PORT TOWNSEND, 98368 Expiration Date 11/29/2002
APPLICANT: S C GRANGER PHONE: (360)379-3185
11 RHODODENDRON ST
PORT TOWNSEND WA 98368
9
SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 7 Lot:
PARCEL NUMBER: 938400709 Section: 12 Township: 30N Range: 02W
CONTRACTOR: DISCOVERY BAY CONST CO INC PHONE: 385-4372
PO BOX 1410
PORT TOWNSEND WA 98368
Contractor's License DISCOBCO90B9 Expires 08/20/2003
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK, PROPANE FURNACE, PROPANE FIREPLACE
INSERT
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 11/29/2002.
REQUIRED INSPECTIONS:
[ ] ank/Line Appliance: ThNK Ni- L /NL-- cO`c 0 z/ / 1
['] FinalApprovaIY V< <-.,/„1.-(2-.)— of
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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
BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00668 Received Date: 11/29/2001
SITE ADDRESS: 11tn%csrxse ror\
PORT TOWNSEND, 98368
OWNER: S C GRANGER PHONE: (360)379-3185
11 RHODODENDRON ST
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 7 Lot: 9
PARCEL NUMBER: 938400709 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: DISCOVERY BAY CONST CO INC PHONE: 385-4372
PO BOX 1410
PORT TOWNSEND WA 98368
Contractor's License DISCOBCO90B9 Expires 08/12/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO PROPANE TANK, PROPANE FURNACE, PROPANE FIREPLACE
INSERT
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
Ff9/ô/
S&W Landslide
1
Routing Date: / /(4976/
)\ Shoreline Aquifer
Forest: Commercial Rural
Proximity ' a •■d. .•■
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 ZAN 11/29/01 42527
Total: $48.00
,JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHFRIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
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WOODSTOVE /N PROPANE TANK PELLET STOVE OTHER Etiv✓� •\'-� �(/ - \h
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): •
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C. C7('.vTArt ZIP q 3( 0
9 DIGIT PARCEL ID NUMBER L? Q' `^- -1°
Legal Description:
Subdivision Name Block Lot(s)
Section W
y� Township North, Range M
APPLICANT SGW �cL (s _ ( 9;10 G rLyJ) PHONE 2 3 4/37 z
MAILING ADDRESS \' .)e 1''{ 10 Port 16 LA) h St✓r L
ZIP
PROPERTY OWNER P'ck L , 1�` PHONE ` \
MAILING ADDRESS t\ �e C� �(\ P6 �} 'T t-w S
r11
ZIP 9 s.3-41
CONTRACTOR U\S C b -� q1„ C r.f\,S4' PHONE 3 %c / '� 7
MAILING ADDRESS U " 1� (i7
ik)A ZIP S g
STATE LICENSE# D\SCO 8C)9'Q g -I EXP.DATE <Sl y
0 3
FEDERAL I.D.# b- t a,7 6 7
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 FAS DATE 11 / ! / O
i4j
L �� FOR OFFICE USE ONLY
BASE FEE '1 O, RECEIPT# S-. •
CASH/CK# /5- 7 3 3
TOTAL 1 (>1'77O DATE 11 /04/ 01/
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