HomeMy WebLinkAboutBLD2002-00402 •
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 #: BLD02-00402 Received Date 7/16/2002
SITE ADDRESS: 328 CRAIG RD Issue Date 7/16/2002
SEQUIM, 98382
APPLICANT: STEVEN B FRY PHONE:
SHERYL A FRY
PO BOX 3129
SEQUIM WA 983825008
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 902042021 Section: 4 Township: 29N Range: 02W
CONTRACTOR: VINCE BETTGER PHONE:
NEW HAVEN RD
PORT ANGELES WA 98362
OWNER, STEVEN B FRY PHONE:
if different: SHERYL A FRY
PO BOX 3129
SEQUIM WA 983825008
PROJECT DESCRIPTION INSTALLATION OF CONVECTION OVEN
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 07/16/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/ ppliance. (r) j 7-Z 4,....,
[ `j" FinalApproval: O(-‹ jc._
7 a(0-o --
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
91JILDING PERMIT APPLICAT N Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD02-00402 Received Date: 7/16/2002
SITE ADDRESS: 328 CRAIG RD
SEQUIM, 98382
OWNER: STEVEN B FRY PHONE:
SHERYL A FRY
PO BOX 3129
SEQUIM WA 983825008
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 902042021 Section: 4 Township: 29 N Range: 02 W
CONTRACTOR: VINCE BETTGER PHONE:
NEW HAVEN RD
PORT ANGELES WA 98362
REPRESENTATIVE(S):
PROJECT DESCRIPTIO INSTALLATION OF CONVECTION OVEN
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
/// F&W Landslide
Routing Date:
/,4 jpe Shoreline Aquifer
l v Forest: Commercial Rural
Proximity plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 PRB 07/16/02 49255
Total: $47.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOVVNSEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE Above Ground PROPANE TANK PELLET STOVE OTHER deinVP.i'aa-C CellVec i;o 1
Is this appliance (htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home?
YES X NO
SITE ADDRESS(911#/Road Name):
3zg Craig f -
nutty\ / wA ZIP g83SZ-
9 DIGIT PARCEL ID NUMBER 9O 2- 0 YZ O zl
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT shunt P( PHONE 340-G r -P-7s�
MAILING ADDRESS 3Z$ Gral is • JPO1 /3/47
SeQuty\ , LAA R43r2, zip 9r ic2._.
PROPERTY OWNER STWe 4—Sk Pe-( ,c.� PHONE 36O-G 83 '.I-75-
,r�
MAILING ADDRESS '3r4 GraL • / P-0. 66y gal
6oQutkX, tool- q$387i ZIP ?83S7'Z
CONTRACTOR VI nG 1✓ 1,--& -e Y PHONE 360/4.
MAILING ADDRESS icitU aL_tl
Poi-CGwgJes, wii- T8.36z- ZIP 78367-
STATE LICENSE# 13err4 vA-za 6 a' EXP.DATE .5A S7O3
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 fucture shall be requested and shall occur during regular business hours.
APPLICANT SIGNATUREL.- DATE 7 / /6 / 0a-
47 FOR OFFICE USE ONLY ^�
BASE FEE O'_ RECEIPT# L��
CASH/CK# Ll a6z(
TOTAL 47 per, DATE i_/ I L(27----
H:W OM E\P LNCNTR1I N FOBLDG\FORMS\I N STALL.DOC 11/05/01