Loading...
HomeMy WebLinkAboutBLD2002-00436 • • . . 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 PERMIT #: BLD02-00436 Received Date 8/5/2002 SITE ADDRESS: 890 BERRY HILL LN Issue Date 8/5/2002 CHIMACUM, 98325 APPLICANT: LARRY E WILSON PHONE: (360)732-0131 SANDRA K WILSON 980 BERRY HILL LN PORT TOWNSEND WA 98368 g SUBDIVISION: Block: Lot: PARCEL NUMBER: 901333014 Section: 33 Township: 29N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 9/6/2002 OWNER, LARRY E WILSON PHONE: (360)732-0131 if different: SANDRA K WILSON 980 BERRY HILL LN PORT TOWNSEND WA 98368 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: /c. 9-.26- o Z [ ] FinalApproval: ©1c)t.-c..7.--, 6 - 0 Z 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 BLD02-00436 fltUILDING PERMIT APPLICA.N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00436 Received Date: 8/5/2002 SITE ADDRESS: 890 BERRY HILL LN CHIMACUM, 98325 OWNER: LARRY E WILSON PHONE: (360)732-0131 SANDRA K WILSON 980 BERRY HILL LN PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: 9 PARCEL NUMBER: 901333014 Section: 33 Township: 29 N Range: 01 W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 9/6/2002 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: 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 08/05/02 49371 Total: $47.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN at-,PORT TOWARD WA 98368 PH: (360)379-4450 u INSTALLATION PERMIT APPLICATION WOODSTOVE " `Above Ground PROPANE TANK PELLET STOVE OTHER Is this appliance(htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home? YES NO SITE ADDRESS(91 /Road Name): D / /2/Z 1ilii V�% !/ 9 O,V S / u2'4 ZIP 9706c? 9 DIGIT PARCEL ID NUMBER o/- 333 0/4 Legal Description: III Subdivision Name Block Lot(s) ,� Section � � Township North, Range7 WM APPLICANT <`-�`:O4,4 Zj- / C)/� /PHONE 2 ` e/i/ MAILING ADDRESS 9 e O /Y'/zj2 / //) 7b/2T" /C u*9 S'E' b , oat? ZIP 787,Z8- . PROPERTY OWNER A)i)24 V/Z UA.1 PHONE MAILING ADDRESS V O R , i IL.C. LIAti 7Da>2- o 5r� ;e ,mil .r) ,� 7,� / S / , zIP 5 �J rs' CONTRACTOR Ao(/ ie PHONE 7S 2 — ill 5. MAILING ADDRESS 7. /ad"( C:W? Cik.01/9 k() ZIP g32- 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 J County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and ri of entry the app' ant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE g/ J / 0 z —I r V" 'f l /7/Q FOR OFFICE USE ONLY BASE FEE / RECEIPT# g3 / CASH/CK# C �J S TOTAL It 7 0 DATE ?-/J /y 2 H:\TOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC11/05/01