HomeMy WebLinkAboutBLD2002-00024 a
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 #: BLD02-00024 Received Date 1/14/2002
SITE ADDRESS: 150 CEDARVIEW DR Issue Date 1/14/2002
PORT TOWNSEND, 98368 Expiration Date 1/14/2003
APPLICANT: PAUL L OXENBOL PHONE: (360)379-9414
INGE-LISE OXENBOL
150 CEDAR VIEW DR
PORT TOWNSEND WA 98368-9527 180
SUBDIVISION: KALA POINT#9 Block: Lot:
PARCEL NUMBER: 965000320 Section: 27 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, PAUL L OXENBOL PHONE: (360)379-9414
if different: INGE-LISE OXENBOL
150 CEDAR VIEW DR
PORT TOWNSEND WA 98368-9527
PROJECT DESCRIPTION NO MLA REQ'D -PROPANE HEATER INSIDE SHOP
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 01/14/2003.
REQUIRED INSPECTIONS:
[1 Tank/Lin Applianc . ee":7<jr.---
V- FinalApproval: vC/C /a�-D-z—
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
02-00
BUILDING PERMIT APPLICATION BR view Ty024
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00024 Received Date: 1/14/2002
SITE ADDRESS: 150 CEDARVIEW DR
PORT TOWNSEND, 98368
OWNER: PAUL L OXENBOL PHONE: (360)379-9414
INGE-LISE OXENBOL
150 CEDAR VIEW DR
PORT TOWNSEND WA 98368-9527
SUBDIVISION: KALA POINT#9 Block: Lot: 180
PARCEL NUMBER: 965000320 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE HEATER INSIDE SHOP
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
F&W Landslide
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditionc
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 01/14/02 45514
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 Pe'.'t:,P, F ra.S (-(i4 C Q
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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9 DIGIT PARCEL ID NUMBER ' . C '6b 0 • �- •0
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT PC`t_1 i.- C> Y- Ef t•-)17,c:;c_ PHONE .5 .1 ci C1 4-t
MAILING ADDRESS I-CO C�- 1>ACZ J(6 LA.) r2-. ,
P -t`.i (O 1'vrj L 7 ZIP t J A 9 g-.51c-.
PROPERTY OWNER 5 4 N ET PHONE
MAILING ADDRESS
ZIP
CONTRACTOR .>t.^i:; .1-4 f N(5- Pi2c,PA L ' PHONE
MAILING ADDRESS
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 DATE / /
�` v� FOR OFFICE USE ONLY / 't
BASE FEE D ` RECEIPT#
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CASH/CK# S
TOTAL Li- p r�. DATE L /(LI /(:)- ---
H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC 11/05/01