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HomeMy WebLinkAboutBLD2002-00014 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 #: BLD02-00014 Received Date 1/8/2002 SITE ADDRESS: 451 KENNEDY RD Issue Date 1/8/2002 PORT HADLOCK, 98339 Expiration Date 1/8/2003 APPLICANT: GREGG C KNOWLES PHONE: (360)385-6088 FRANCESCA K KNOWLES 451 KENNEDY RD PORT HADLOCK WA 98339-9719 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901033002 Section: 3 Township: 29N Range: 01W CONTRACTOR: OWNER PHONE: OWNER, GREGG C KNOWLES PHONE: (360)385-6088 if different: FRANCESCA K KNOWLES 451 KENNEDY RD PORT HADLOCK WA 98339-9719 PROJECT DESCRIPTION NO MLA REQ'D -WOODSTOVE INSTALLATION 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 01/08/2003. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: 1.0 Final ov,I: /( d Zr /U bt u-e-- --,-._. 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 BR vi w Typ e: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00014 Received Date: 1/8/2002 SITE ADDRESS: 451 KENNEDY RD PORT HADLOCK, 98339 OWNER: GREGG C KNOWLES PHONE: (360)385-6088 FRANCESCA K KNOWLES 451 KENNEDY RD PORT HADLOCK WA 98339-9719 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901033002 Section: 3 Township: 29 N Range: 01 W CONTRACTOR: OWNER PHONE: REPRESENTATIVE(S): PROJECT DESCRIPTIO NO MLA REQ'D -WOODSTOVE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 1997 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 Proximity Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 01/08/02 43897 Total: $48.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER 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): • L{ i Jler nQ c\ \' c tLl J C,t ZIP q1S3a3 9 DIGIT PARCEL ID NUMBER cfo'kcA.3Q 'Z Legal Description: Subdivision Name Block Lot(s) Section 3 Township Z North, Range WM APPLICANT C PHONE -6©RR MAILING ADDRESS 5I kKenne6,i \ \ ZIP CI ' 31 PROPERTY OWNER C--1C q `f ,RC e cCt'A \Cl\k^� S PHONE : 0 P. MAILING ADDRESS 4-S" J V,PA FCAil }2 623 ZIP CONTRACTOR _n Yl .N.r. f� PHONE 3 c7-5--6 MAILING ADDRESS 44 e _J i-lr'scAt tom' Y �.0 A ZIP STATE LICENSE# 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 t1cr r �fn�el4� DATE 1 / 8 / FOR OFFICE USE ONLY BASE FEE Q . ODRECEIPT# 1-1 31 CASH/CK# -2-9 9 TOTAL 1.4 g', at, DATE H:\I-IOM E\P LNCNTR\I N FOBLDG\FO RM S\I N STALL.DOC 11/05/01