HomeMy WebLinkAboutBLD2002-00431 I
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 #: BLD02-00431
SITE ADDRESS: 11298 COYLE RD Received Date 8/5/2002
QUILCENE, 98376 Issue Date 8/5/2002
APPLICANT: MICHAEL E ANDERSON
11298 COYLE RD +PHONE: (42 2
QUILCENE WA 98376 /10 /
SUBDIVISION: ,
Block: Lot:
PARCEL NUMBER: 601211002 Section: 21 Township: 26N Range: 01W
CONTRACTOR: PETTIT OIL CO
PO BOX 1031 PHONE: (36.0 'fuss-
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 5/1/2004
OWNER, MICHAEL E ANDERSON
if different: 11298 COYLE RD PHONE: (425)471-0842
QUILCENE WA 98376
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 8/5/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval:
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 APPLICA!ON BLRDOe 00431
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00431 Received Date: 8/2/2002
SITE ADDRESS: 11298 COYLE RD
QUILCENE, 98376
OWNER: MICHAEL E ANDERSON PHONE: (425)471-0842
11298 COYLE RD
QUILCENE WA 98376
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 601211002 Section: 21 Township: 26 N Range: 01 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 5/1/2004
REPRESENTATIVE: PHONE:
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 By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 08/02/02 49365
Total: $47.00
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JEFFEFRSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE X PROPANE TANK PELLET STOVE OTHER [�
SITE ADDRESS:
9 1#ROAD NAME I 1 z q C 1 v p, ��U ct
9 DIGIT PARCEL ID NUMBER &C) 7-- I < 00 Z
Legal Description:
Subdivision Name Block Lotls)
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Section 7- 1 Tow
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APPLICANT IVI ic,t4,4 t, PHONE 412 c' Lill L.2
MAILING ADDRESS I 1 Z/ ` . �t tie.
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Q .t,1 I ,,,,a I iAf ZIP g37b
PROPERTY OWNER I19t( Q. I Sc p.J PHONE StlsvtE„.
MAILING ADDRESS SPVVI f__
SPI)lr- ZIP S 1
CONTRACTOR [eta / ®i I it.� PHONE (`;/-P+�S! 3 S -277 2.MAILING ADDRESS 2-35 ,1 r�✓ CG / 799
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.
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APPLICANT SIGNATURE _ DATE 7/ 39/ Oa
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