HomeMy WebLinkAboutBLD2002-00214 •
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 #: BLD02-00214 Received Date 4/16/2002
SITE ADDRESS: 80 BRINNON LN Issue Date 4/16/2002
BRINNON, 98320
APPLICANT: WILLIAM M MARSH PHONE: (360)796-4935
KATHERINE MARSH
PO BOX 47
BRINNON WA 98320-0047 1
SUBDIVISION: PICCINI PLAZA SHORT PLAT Block: Lot:
PARCEL NUMBER: 602353052 Section: 35 Township: 26N Range: 02W
CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735
PO BOX 67
HOODSPORT WA 98548
Contractor's License FERRELPO55LH Expires 8/1/2002
OWNER, WILLIAM M MARSH PHONE: (360)796-4935
if different: KATHERINE MARSH
PO BOX 47
BRINNON WA 98320-0047
PROJECT DESCRIPTION: PROPANE TANK& FIREPLACE INSERT 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 4/16/2003.
REQUIRED INSPECTIONS:
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[ ] FinalApproval: DK e/ 4--R-
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
BLD02-00214
BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00214 Received Date: 4/16/2002
SITE ADDRESS: 80 BRINNON LN
BRINNON, 98320
OWNER: WILLIAM M MARSH PHONE: (360)796-4935
KATHERINE MARSH
PO BOX 47
BRINNON WA 98320-0047
SUBDIVISION: PICCINI PLAZA SHORT PLAT Block: Lot: 1
PARCEL NUMBER: 602353052 Section: 35 Township: 26 N Range: 02 W
CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735
PO BOX 67
HOODSPORT WA 98548
Contractor's License FERRELPO55LH Expires 8/1/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIOP PROPANE TANK & FIREPLACE INSERT 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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 04/16/02 47465
Total: $47.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWN D WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER g,Lhl 1r�
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):
8 R1NMOO LAue
ZIP
9 DIGIT PARCEL ID NUMBER ({2O J L S. -3 6 S
Legal Description: / `�
Subdivision Name l C ( � 1 (PL - cp(,,-j Block Lot(s)
'� c W
Section `"3 5 Township f'J North, Range W M
tk \1 NT 64 1 4- RI C� ' e S f� PHONE (C1O l q(f c o 5 5
MAILING ADDRESS P . 0
( 1i ii o IA JA ZIP
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP
CONTRACTOR C—f27Z A-S PHONE 56) O b 17-5- 3 I i
MAILING ADDRESS , ( n( 0 rI / (0 OD S l" r?j ( t iL) Pc-- C l) 5 T(5/
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 bf entry to the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE ( y E�y�?fY� 1 �c Cam_ DATE / /6 / Q ..
FOR OFFICE USE ONLY
BASE FEE I 1 Uu RECEIPT# -1 ,5
CASH/CK#
TOTAL �1.' C) DATE / ((a/ ()?j
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