HomeMy WebLinkAboutBLD2002-00456 • •
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 #: BLD02-00456 Received Date 8/14/2002
SITE ADDRESS: 301 DENNIS BLVD Issue Date 8/14/2002
PORT TOWNSEND, 98368
APPLICANT: MARILYN N HULSLANDER PHONE: (360)379-9479
301 DENNIS BLVD
PORT TOWNSEND WA 98368-9481
58
SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot:
PARCEL NUMBER: 940500057 Section: 13 Township: 30N Range: 02W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 5/1/2004
OWNER, MARILYN N HULSLANDER PHONE: (360)379-9479
if different: 301 DENNIS BLVD
PORT TOWNSEND WA 98368-9481
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 8/14/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
] (FInaIA royal: (i i!t/? /r
BUILDING INSPECTION HOT-LINE 379-0455.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
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likUILDING PERMIT APPLICATION B Review
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00456 Received Date: 8/14/2002
SITE ADDRESS: 301 DENNIS BLVD
PORT TOWNSEND, 98368
OWNER: MARILYN N HULSLANDER PHONE: (360)379-9479
301 DENNIS BLVD
PORT TOWNSEND WA 98368-9481
SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: 58
PARCEL NUMBER: 940500057 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTI00088CC Expires 5/1/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP 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 08/14/02 49434
Total: $47.00
• •
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE X 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?
A YES NO
SITE ADDRESS(911#/Road Name):
VO y- + I o\A) d1se },-)cl W'7`l ZIP ! U .36
9 DIGIT PARCEL ID NUMBER q -/C) 5 tJ ll 5 i
Legal Description: ,
Subdivision Name ��L- �4 o t2- c�C 'v ) LL,A�� �/ Block Lots)
Section 13 Township 30 10 North, Range c) YV WM
APPLICANT �� r ( C( Y� C� �" PHONE 360 / 9 — c��/ F
MAILING ADDRESS 301r��V1 n L S E 1 jc!
?O r f' 1 C I,V ' 5 e vld J )A ZIP 9'S36 c-)
PROPERTY OWNER CV I I�1 ),1 ��l �. 1 S l c�ul[�e r PHONE * 6' 0/J 7 f-- 9779
9
MAILING ADDRESS 'C t 0 e 1'1 )'l I S E 1 U d
Pb 1-1- To' IL) n s e v)cd C&t/s1 ZIP 9d'<` d'
CONTRACTOR P6 IT i I Q,r 4. C.C+I,-.1 ..r-Nij PHONE 3 c�. ao ?� :1'
MAILING ADDRESS 3 .SL I A l 0
0,.i T-4c',0 Al ci.:= r ICi k 0/�,5 fl ZIP 9 8 J g
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 say, Indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses which
may in any way accn i 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 ///`G/,LGG�l'' i��"� '--7'G� -'L DATE / // / L e;L-,
FOR OFFICE USE ONLY BASE FEE RECEIPT# LH i--I
- 4
`1 CASH/CK# 61 1
'
TOTAL ) '� DATE U /I4/ Q
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