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HomeMy WebLinkAboutBLD2002-00132 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 #: BLD02-00132 Received Date 3/11/2002 SITE ADDRESS: 311231 HWY 101 Issue Date 3/12/2002 BRINNON, 98320 APPLICANT: BRUCE D ROMIG PHONE: (253)848-9929 520 14TH AVE SE PUYALLUP WA 98377 T 32 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502213016 Section: 21 Township: 25N Range: 02W CONTRACTOR: EVERWARM INC PHONE: 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 08/17/2002 OWNER, BRUCE D ROMIG PHONE: (253)848-9929 if different: 520 14TH AVE SE PUYALLUP WA 98377 PROJECT DESCRIPTION WOOD PIPING 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 03/12/2003 REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: 1 F xaa1 proval: 41/` -, 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_Propa ne.rpt 10/29/19 BIIILDING F:ERIVUT APPLICATIA BRDO2 Oyp1e32 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00132 Received Date: 3/11/2002 SITE ADDRESS: 311231 HWY 101 BRINNON, 98320 OWNER: BRUCE D ROMIG PHONE: (253)848-9929 520 14TH AVE SE PUYALLUP WA 98377 SUBDIVISION: Block: Lot: T 32 PARCEL NUMBER: 502213016 Section: 21 Township: 25 N Range: 02 W CONTRACTOR: EVERWARM INC PHONE: 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 08/17/2002 REPRESENTATIVE(S): PROJECT DESCRIPTIO WOOD PIPING 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: 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 MAM 03/11/02 45836 Total: $48.00 • • JEFFERSON COUNTY COMMUNITY DEVELOPMENT,631 SHERIDAN ST,PORT TOWNSEND W4 98368 PH: (360)379-445Q INSTALLATION PERMIT APPLICATION e-an°D ?? WOODSTOVE PROPANE TANK PELLET STOVE OTHER .?u Is this appliance(htg stove, hot water tank, furnace, etc.) to be installed in a Manufactured/Mobile Home? .— YES 1' NO SITE ADDRESS(911 #1 Road Name); 43.-A, 60a 9S) 32- D ZIP 9 DIGIT PARCEL ID NUMBER \O.2_ c2 / 3 C)f Legal Description: Subdivision Name Block Lot(s) Section Township North, Range W �/�_,� tM �� APPLICANT IQ Y9 fC "�� t--.‘ PHONE c�7c,c s- 2- �i(j MAILING ADDRE / f 0 l .- ZIP 9.49. c2-. • r1W.-Q._112/ PROPERTY OWNER --�� l-l.CrE R 1 \4c "✓1 _ PHONE 53- SLiO ' i92 9 MAILING ADDRESS 62 C� /7 ?, v S . E E . ..2LL.)(.0 \k 1 p Oct ZIP -O -7--7 CONTRACTOR V? j -i PHONE MAILING ADDRESS ---- a c ZIP STATE LICENSE# vTc�k_,._)1 .*, ,. (_ FEDERAL I D # 9 (-- i54 0-7 o EXP.DATE [ � 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 materal falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in thin permit being null and vo,d. 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 at 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 end right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATUR�, �r 2 „. / DATE S 1 63 ! ©Z ' Op L�FOR OFFIC(E�USE ONLY BASE FEE. C F O U E'R # D TQTAL... MAR 1 ? D i,, ,,, � '�.9.2 :WONini2LNCNTR'dNFOBLDO\FORMSIINSTALL,DOC11104/Ot lT J DEPT. OF COf,'MUIN; Y OEW"i) ;'N T©/TO 39dd COG OD _ 3r' TSr76LEO9E: PO . ZOOZ r 9O/E0