HomeMy WebLinkAboutBLD2002-00002 •
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 #: BLD02-00002 Received Date 1/2/2002
SITE ADDRESS: 121 BAY RIDGE RD Issue Date 1/2/2002
PORT TOWNSEND, 98368 Expiration Date 1/2/2003
APPLICANT: DAVID C FOSTER PHONE: 3- _ 9�5�
TRUDY B FOSTER
121 BAY RIDGE DR
PORT TOWNSEND WA 983689681
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002131025 Section: 13 Township: 30N Range: 02W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPL994BH Expires 12/14/2002
OWNER, DAVID C FOSTER PHONE:
if different: TRUDY B FOSTER
121 BAY RIDGE DR
PORT TOWNSEND WA 983689681
PROJECT DESCRIPTION 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 01/02/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval:�d4�K /a,s=67
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
BUILDING PERMIT APPLICATION Review Type:
Review Type:
Jefferson County Department of'Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD02-00002 Received Date: 1/2/2002
SITE ADDRESS: 121 BAY RIDGE RD
PORT TOWNSEND, 98368
OWNER: DAVID C FOSTER PHONE:
TRUDY B FOSTER
121 BAY RIDGE DR
PORT TOWNSEND WA 983689681
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002131025 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPL994BH Expires 12/08/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO PROPANE TANK
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
210 -I_ Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditiont.
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 ZAN 01/02/02 43877
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
/ INSTALLATION PERMIT APPLICATION
WOODSTOVE V 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(911#/Road Name):
Qi f3q`-\ (Z).14o6- f op
2 i 0c,JLI SCti ZIP q D 1P�
9 DIGIT PARCEL ID NUMBER D O 2- / 31 c ZS
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT .} R ,l -1--20\b roJ Gc\ - PHONE -71—?'C SL('
MAILING ADDRESS I Q I 13A fa bc.0c
ZIP
PROPERTY OWNER 1 j'7"') 1T 1 �I Q J 1 (---D S!( t-'(2-- PHONE S1cl ,`-'l
MAILING ADDRESS S (Y\ C
ZIP
CONTRACTOR I"`Ov0J!A- i +� Pf-coPfln�C—' PHONE 2 g J - (0 v..3
MAILING ADDRESS fr)2T e-\--.1"ID LOC.lc_ c,)(o 5 Crf,mACv/,---‘
ZIP
STATE LICENSE# OO (OTT i. 9�-4 4 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. JC--0•
I further agree to provide access and right .f en ry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any
required later inspections. Access and righ . en to the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE I���:��
+ ) DATE i / � / °:-.)----
FOR OFFICE USE ONLY
BASE FEE 1j // RECEIPT# ` M g17-2
//// CASH/CK# / ` �OP
TOTAL l['�/ ('V DATE '42-1/ 2 / 0 Z
•
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