HomeMy WebLinkAboutBLD2002-00080 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 #: BLD02-00080 Received Date 2/15/2002
SITE ADDRESS: 80 HUCKLEBERRY PL Issue Date 2/15/2002
PORT TOWNSEND, 98368 Expiration Date 2/15/2003
APPLICANT: TYRONE PAG E HILLGER PHONE:
CONNIE LOUISE HILLGER
80 HUCKLEBERRY PL
PORT TOWNSEND WA 983689418 4
SUBDIVISION: CAPE GEORGE VILLAGE DIV 6 Block: Lot:
PARCEL NUMBER: 941400003 Section: 13 Township: 30N Range: 02W
CONTRACTOR:
OWNER, TYRONE PAG E HILLGER PHONE:
if different: CONNIE LOUISE HILLGER
80 HUCKLEBERRY PL
PORT TOWNSEND WA 983689418
PROJECT DESCRIPTION NO MLA RQRD--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 2/15/03.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval: c�n-.nr B it-X,
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_Perm it_Propane.rpt 10/29/99
BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00080 Received Date: 2/15/2002
SITE ADDRESS: 80 HUCKLEBERRY PL
PORT TOWNSEND, 98368
OWNER: TYRONE PAG E HILLGER PHONE:
CONNIE LOUISE HILLGER
80 HUCKLEBERRY PL
PORT TOWNSEND WA 983689418
SUBDIVISION: CAPE GEORGE VILLAGE DIV 6 Block: Lot: 4
PARCEL NUMBER: 941400003 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA RQRD--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: SETBACK:
DECK: 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 Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 PRB 02/15/02 45667
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
U. 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 V NO
SITE ADDRESS(911#/Road Name):
c o UkW°CVmy �PL .
Vf. TOW Vl S e.,Kk / AiA • ZIP 7 0 CO
9 DIGIT PARCEL ID NUMBER Q41 4.00 c 0 3
Legal Description: II //�� ,fI // •
c2etot +- to Mkt Olat t�° in 'VO 1 S D�-t 1*
Subdivision Name V..b+41 e 1 .eo a Vl t l� (V(s io^ � +t,t ureLs` Lot j•G►. l��.
9 6 Block Lot(s)
Section W
/ .Township North, Range M
APPLICANT �+Yt+k.CNSE ( Vie) ?. (-4.1 l\der PHONE G0)37q -gpG Qc
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MAILING ADDRESS 0 �^u,C.kle.�err j PI. �
l p.f.0 n s e,tok . ZIP `�+
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PROPERTY OWNER T+ rote 4 CO rl,nt e. gt dee r PHONE 40) 3 74 -qv?? g
MAILING ADDRESS �O le-be . 1 Tit
lowwSe.AwL, WA ZIP q D 36 f
CONTRACTOR 54-e- Zt'Stal`e ( 6 La L k " ` witor PHONE
MAILING ADDRESS 0'4' 4 v "" game-, tGPYy 49-e.tk-71i f, irtspeel
6W ttlfa io++, oK O ((( ((B G/O 2-- 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 0 Z. / d G, 0 2-
FOR OFFICE USE ONLY �'f
BASE FEE "" ' RECEIPT# ' o 7
CASH/CK# 2-33
TOTAL 18 • 0D DATE 2-LETO
H:\HOME\PLNCNTR\INFOBLDG\FORMS\I NSTALL.DOC 11/05/01