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HomeMy WebLinkAboutBLD2002-00356 • • 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 #: BLD02-00356 Received Date 6/21/2002 SITE ADDRESS: 400 SENTINEL FIRS RD Issue Date 6/21/2002 PORT HADLOCK, 98339 APPLICANT: BRUCE L STARR PHONE: 400 SENTINAL FIRS RD PORT HADLOCK WA 983399736 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921193013 Section: 19 Township: 29N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE LLC PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPL994BH Expires 12/14/2002 OWNER, BRUCE L STARR PHONE: if different: 400 SENTINAL FIRS RD PORT HADLOCK WA 983399736 PROJECT DESCRIPTION PROPANE TANK, GAS LINE, RANGE,WATER HEATER, WALL MOUNT HEATER 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 06/21/2003. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: V/ 7 o`C [ ] FinalApproval: OK 7-?-& 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 UILDING PERMIT APPLICA ON BLD02-00356Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00356 Received Date: 6/21/2002 SITE ADDRESS: 400 SENTINEL FIRS RD PORT HADLOCK, 98339 OWNER: BRUCE L STARR PHONE: 400 SENTINAL FIRS RD PORT HADLOCK WA 983399736 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921193013 Section: 19 Township: 29 N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE LLC PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPL994BH Expires 12/14/2002 REPRESENTATIVE(S): PROJECT DESCRIPTIO PROPANE TANK, GAS LINE, RANGE, WATER HEATER, WALL MOUNT HEATER 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: /U L/`>/� F&W Landslide �j .4( Shoreline Aquifer Forest: Commercial Rural Proximity Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Total: • • JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION Ro, W +Qr H Q T WOODSTOVE X Above Ground PROPANE TANK PELLET STOVE OTHER IAX I r i%At �R,cki-Q.i— 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): 110CD Je: (\i( 1(1' 1 1r5 fici Ar ± k ciIoG( ZIP 9 3 3 9 DIGIT PARCEL ID NUMBER 9 -- I //�j ' © 13 Legal Description: {� Subdivision Name /�i X 3 j I Block Lot(s) Section Township North, Range W M APPLICANT S PHONE _3 7 a-.6 MAILING ADDRESS 40 0 5-en k ! t e I FI R S fed poi i- N (nLOc J`. wi ZIP ?O 33 / PROPERTY OWNER J Gt PHONE MAILING ADDRESS ZIP CONTRACTOR MO U n±C(r\ Pro/004\ a_ PHONE J` MAILING ADDRESS g.615 C E1 i act 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 of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE 6 /a / 03 FOR OFFICE USE ONLY BASE FEE RECEIPT# CASH/CK# TOTAL DATE / / H:\HOME\PLNCNTR\I N FOBLDG\FORM S\I NSTALL.DOC 11/05/01