HomeMy WebLinkAboutBLD2002-00319 •
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 #: BLD02-00319 Received Date 6/5/2002
SITE ADDRESS: 1771 E MARROWSTONE RD Issue Date 6/6/2002
NORDLAND, 98358
APPLICANT: ROBERT M TIPTON PHONE: (360)385-7528
1771 E MARROWSTONE RD
NORDLAND WA 98358-9636
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921042040 Section: 4 Township: 29N Range: 01 E
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 9/6/2002
OWNER, ROBERT M TIPTON PHONE: (360)385-7528
if different: 1771 E MARROWSTONE RD
NORDLAND WA 98358-9636
PROJECT DESCRIPTION: PROPANE TANK 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 6/6/2003.
REQUIRED INSPECTIONS:
[ ) Tank/Line/Appliance:
[ FinalApproval:��1WIC 0/1/y pj9 -5-24
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
UILDING PERMIT OON B Review
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00319 Received Date: 6/5/2002
SITE ADDRESS: 1771 E MARROWSTONE RD
NORDLAND, 98358
OWNER: ROBERT M TIPTON PHONE: (360)385-7528
1771 E MARROWSTONE RD
NORDLAND WA 98358-9636
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921042040 Section: 4 Township: 29 N Range: 01 E
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 9/6/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTION PROPANE TANK 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: DECK: SETBACK:
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 Bv: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 06/05/02 47827
Total: $47.00
• •
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
V INSTALLATION PERMIT APPLICATION
WOODSTOVE �I' PROPANE TANK PELLET STOVE OTHER
Is this appliance(htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?
YES 1/4NO
SITE ADDRESS(911 #/Road Name):
/77/ 44?7 / 2 Q,t ,L
ji� La�//, �'" La�a''�► ZIP e
9 DIGIT PARCEL ID NUMBER 1Z-i • 04E?_ • 0I1 0
Legal Description:
Subdivision Name Block Lot(s)
Section
� Township North, Range WM
APPLICANT .` 57, /J/("J, C-770. 77,41 PHONE � �
MAILING ADDRESS / ., Ate/ j�r �� '
�'Uc�i 047,(144) .! ZIP ,5'
PROPERTY OWNER � 74/l/V e7PHONE
MAILING ADDRESS / //�� �4�/ �/) �/�-�' 4,,2�I� �/�!
Jc4I,t2�- J�)i 9 (22 ZIP /9,9, -
CONTRACTOR /` PHONE 7EZ----17W
MAILING ADDRESS /? ..��/ �j� -��^''
c ',/2 4G!e, pt4i ZIP 9e 1�
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 4� DATE 6 / // 4/0.._.
FOR OFFICE USE ONLY `-
BASE FEE RECEIPT# L4 R"'52 R
CASH/CK# CAo A
TOTAL DATE 0 / / C7f2_,
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