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HomeMy WebLinkAboutBLD2002-00305 • 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 #: BLD02-00305 Received Date 5/29/2002 SITE ADDRESS: 281 NOLTON RD Issue Date 5/29/2002 NORDLAND, 98358 APPLICANT: ROSANNE E KRAMNICZ PHONE: 281 NOLTON RD NORDLAND WA 983589539 SUBDIVISION: NOLTON'S EAST PT Block: Lot: PARCEL NUMBER: 975901103 Section: 29 Township: 30N Range: 01 E CONTRACTOR: BEN'S HEATING SERVICE INC PHONE: 360-385-3600 1436 FIR ST PORT TOWNSEND WA 98368 Contractor's License BENSHSI033BS Expires 06/17/2002 OWNER, ROSANNE E KRAMNICZ PHONE: if different: 281 NOLTON RD NORDLAND WA 983589539 PROJECT DESCRIPTION PROPANE TANK AND FURNACE 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 05/29/2003. REQUIRED INSPECTIONS: [�] Tank/Line/Appliance: �.c _5 f,5''3 70[ ] FinalApproval: �. � ) i 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:\F_BLD_Permit_Propane.rpt 10/29/19 • BUILDING PERMIT APPLIMTION Type05: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00305 Received Date: 5/29/2002 SITE ADDRESS: 281 NOLTON RD NORDLAND, 98358 OWNER: ROSANNE E KRAMNICZ PHONE: 281 NOLTON RD NORDLAND WA 983589539 SUBDIVISION: NOLTON'S EAST PT Block: Lot: PARCEL NUMBER: 975901103 Section: 29 Township: 30 N Range: 01 E CONTRACTOR: BEN'S HEATING SERVICE INC PHONE: 360-385-3600 1436 FIR ST PORT TOWNSEND WA 98368 Contractor's License BENSHSI033BS Expires 06/17/2002 REPRESENTATIVE(S): PROJECT DESCRIPTIO PROPANE TANK AND FURNACE 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: (21 io 2_- r Shoreline Aquifer Forest: Commercial Rural Proximity Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 PRB 05/29/02 47727 Total: $47.00 JEFFERSON COUNTY COMITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE )-PROPANE TANK PELLET STOVE OTHER /66,7-4i. �"A 4094 7t- Is this appliance (htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile HomeZ _ YES — NO SITE ADDRESS(911#/Road Name): / 6 Xd P/,4 d ilimOz-pi Cr� 17 f/ ,. ZIP / s(��� 9 DIGIT PARCEL ID NUMBER / -2 5- ' Q Legal Description: > Subdivision Name O� 7:01-' 5 6115 f ei_' Block / / Lot(s) /a2 C r31/Y Section �1 Township North, Range / 1 T1% 1 WM APPLICANT ����� G ✓l )7 ? 8$ —36 D Y��'G.S' L7<%k� -'L: �L�l C f-P G �` PHONE c� MAILING ADDRESS r lI - , / 2. e�f �% �d2 / 5 P., 4i ZIP 9 •F � O PROPERTY OWNER ease 4-h 4-i' / Z 4,J C Z PHONE S -Gv 7� MAILING ADDRESS t / e// M"9 6/ / o zc / , ZIP 9< ,7 � CONTRACTOR E i S /4 41 1 L (5i ave t' fh G? PHONE 3 3 6,0 MAILING ADDRESS / LI S (O `ilkeel `O,v7, !�/rl e-eGG/ ivi ZIP %:NG�'f t1 STATE LICENSE# ,?e4c//5/a.?zs EXP.DATE 4°�1Z,1ZCe0 Z FEDERAL I.D.# 60/ '75-/ y" 00 By signing the application form, the applicant/owner attests that the information pr erein is true and correct to tR t their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect q trli. lication packet may result in r it being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all lia i i ie ,j dgme co tisos> sona ney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of th !a g of er With I further agree to provide access and right of entry to Jefferson County and it's empl yees, r presentatives or agents f purpos of application review and any required later inspections. Access and right of entry to the applicant's property or struc ure sh ..be requested and shall oc' ur duringre ular business hours. �f�� DEPT.OF CO'.' ,_� \,r.LOPMEN1 APPLICANT SIGNATURE del DATE / ? /G f/°2 ,,,,�,\\ FOR OFFICE USE ONLY /� BASE FEE • 47• W RECEIPT# 77Z' !' CASH/CK# 12 � TOTAL 47 e00 DATE / 2y/ ©Z- H:\HOME\PLNCNTR\I NFOBLDG\FORMS\I NSTALL.DOC 11/05/01