HomeMy WebLinkAboutBLD2002-00217 i •
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 #: BLD02-00217 Received Date 4/17/2002
SITE ADDRESS: 610 MC MINN RD Issue Date 4/17/2002W PORT TONSEND, 98368
APPLICANT: JOSEPH C WALDEN PHONE:
EVELIN WALDEN
610 MCMINN RD
PORT TOWNSEND WA 983689004
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002014001 Section: 12 Township: 30N Range: 02W
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 9/6/02
OWNER, JOSEPH C WALDEN PHONE:
if different: EVELIN WALDEN
610 MCMINN RD
PORT TOWNSEND WA 983689004
PROJECT DESCRIPTION PROPANE TANK, STOVE, RANGE AND BOILER
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 4/17/03.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: ICE L/".) cK C_ 9-#23-c-e_
[ j FinalApproval: N/( ///y
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
i:1F_BLD Permit_Propane.rpt 10/29/99
• BUILDING PERMIT APPLIC•ION BRDO2NOOp2e11
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00217 Received Date: 4/17/2002
SITE ADDRESS: 610 MC MINN RD
PORT TOWNSEND, 98368
OWNER: JOSEPH C WALDEN PHONE:
EVELIN WALDEN
610 MCMINN RD
PORT TOWNSEND WA 983689004
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 002014001 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 9/6/02
REPRESENTATIVE(S):
PROJECT DESCRIPTIO PROPANE TANK, STOVE, RANGE AND BOILER
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 $47.00 PRB 04/17/02 47501
Total: $47.00
1111
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOW END 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 NO
SITE ADDRESS(911 #/Road Name):
7b /P/ C ///J/� /��,
/,J4J l�` ,4-6
poeq-- � VAJ5e , v /1 . ZIP 98 3 C�6
9 DIGIT PARCEL ID NUMBER / v O Z C�/L/ (. 0
Legal Description:
Subdivision Name Block Lot(s)
Section W
//� Township North, Range M
APPLICANT C<1'0v 141--e-ti6-70 PHONE 3 8 -0/0 q
MAILING ADDRESS (..o/O 44 C ,71,1/V,u , "
ia• 7' ZIP 9(336,S
PROPERTY OWNER Sib PHONE
MAILING ADDRESS
ZIP
CONTRACTOR C_ N 457-7\ PHONE
MAILING V
ADDRESS
/� //�� ZIP
STATE LICENSE# Ceti 14 5 2 2_liK 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 ----\*Cy/1 v"� DATE -/ / 1> / f.. Z-
`7 FOR OFFICE USE ONLY /�
BASE FEE [ ' RECEIPT# "( z cf
CAS ASOI t 27 kz.
TOTAL 4-7 12 DATE h--/ L7 /62--
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