HomeMy WebLinkAboutBLD2002-00412 •
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 #: BLD02-00412 Received Date 7/18/2002
SITE ADDRESS: 191 WEATHER-N-HEIGHTS LN Issue Date 7/18/2002
BRINNON, 98320
APPLICANT: SCHAEFFER TRUSTEE PAUL P PHONE:
ALVA G SCHAEFFER TRUSTEE
191 WEATHER N HTS
BRINNON WA 98320-9716 3
SUBDIVISION: BARNETT&TURLIS SHORT PLAT Block: Lot:
PARCEL NUMBER: 502282021 Section: 28 Township: 25N Range: 02W
CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735
PO BOX 67
HOODSPORT WA 98548
Contractor's License FERRELPO55LH Expires 8/1/2002
OWNER, SCHAEFFER TRUSTEE PAUL P PHONE:
if different: ALVA G SCHAEFFER TRUSTEE
191 WEATHER N HTS
BRINNON WA 98320-9716
PROJECT DESCRIPTION: PROPANE TANK &STOVE 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 7/18/2003.
REQUIRED INSPECTIONS:
[ ] (tank/Line/Appliance: c?-6 -d
[ ] FinalApproval: /9� fr /n 7/5/03,
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
BUILDING PERMIT APPLIC ON B RDOe YOOppe2
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00412 Received Date: 7/18/2002
SITE ADDRESS: 191 WEATHER-N-HEIGHTS LN
BRINNON, 98320
OWNER: SCHAEFFER TRUSTEE PAUL P PHONE:
ALVA G SCHAEFFER TRUSTEE
191 WEATHER N HTS
BRINNON WA 98320-9716
SUBDIVISION: BARNETT&TURLIS SHORT PLAT Block: Lot: 3
PARCEL NUMBER: 502282021 Section: 28 Township: 25 N Range: 02 W
CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735
PO BOX 67
HOODSPORT WA 98548
Contractor's License FERRELPO55LH Expires 8/1/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTION PROPANE TANK & STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY:
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
Routing Date: F&W_ Landslide
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 07/18/02 49242
Total: $47.00
•
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWWND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVEXPROPANE TANK
PELLET STOVE OTHER v J p e
Is this appliancce (htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911 #/Road Name):
Be‘'t1 rz O AI (.:LT x,
,P� ZIP 47 l'..2..4 •
9 DIGIT PARCEL ID NUMBER 10 2- ` 2 - 0�
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
o`
t
APPLICANT '! v j . e. .f-"r;e" tr, PHONE , 'tra - '5,1 t A:
MAILING ADDRESS Z. A+are e `, xr ra Lf e^,,
ZIP
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP
CONTRACTOR Fe V' v. `e 1 PHONE
MAILING ADDRESS
h" ,. --6 11-1 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 f ,,, t , '`'.,),,rt,41 I er,_, DATE 7 / f v' I :'r:‘'
-7 FOR OFFICE USE ONLY ' `
BASE FEE 4 '7 . O RECEIPT# "7ci -2 L
CASH/CK# ?i;‘,"J
TOTAL LI q ' r" DATE / I S/ b2....„.
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