HomeMy WebLinkAboutBLD2002-00487 • •
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 #: BLD02-00487 Received Date 8/21/2002
SITE ADDRESS: 201 E MOORE ST Issue Date 8/22/2002
PORT HADLOCK, 98339
APPLICANT: RANDY HAUF PHONE:
201 E MOORE ST
PORT HADLOCK WA 98339
37-41
SUBDIVISION: IRONDALE Block: 16 Lot:
PARCEL NUMBER: 961801607 Section: 35 Township: 30N 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, WAYNE E HOWELL TRUSTEE PHONE:
if different: BARBARA J HOWELL TRUSTEE
326 COOK AVENUE EXT
PORT TOWNSEND WA 98368-9627
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 8/22/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval: ‘94- /42
oK G/0 /Z/v j p1
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
•
BLD02-00487
BUILDING PERMIT APPLICAON Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00487 Received Date: 8/21/2002
SITE ADDRESS: 201 E MOORE ST
PORT HADLOCK, 98339
OWNER: WAYNE E HOWELL TRUSTEE PHONE:
BARBARA J HOWELL TRUSTEE
326 COOK AVENUE EXT
PORT TOWNSEND WA 98368-9627
SUBDIVISION: IRONDALE Block: 16 Lot: 37-41
PARCEL NUMBER: 961801607 Section: 35 Township: 30 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 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:
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 08/21/02 49518
Total: $47.00
JEFFERSON COUNTY COMMUNI DEVELOPMENT,621 SHERIDAN ST,PORT TOWN D WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE X Above Ground PROPANE TANK PELLET STOVE OTHER
Is this appliance (htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?
YES - NO
SITE ADDRESS(911#/Road Name):
�-6:/ S-Asr /14). /z Ste'
zi,,R42
/9173' ZIP ,$)
- 13 i '
9 DIGIT PARCEL ID NUMBER 9 / - 5c1/- C v
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT ��A--0 liA' //L7zz PHONE
MAILING ADDRESS a-6 /�� . ) 7 S / v%C30/2- SL-7-
l 4 s z--o /e ZIP S73 3 2
PROPERTY OWNER ��� �0 �� ono 'E Lf PHONE °-��' S- 3, S
MAILING ADDRESS 7 2 `c� Z/012 S,4y),.11Z /O/l/ �., 1
73z./s/1/S�/U� / [.l/`! ZIP Y<C7'Slo c5)
CONTRACTOR 6C/tk�, PHONE ./$ -- l 5
MAILING ADDRESS / (2-Y 1/43v 9675
C /r /9c-m /09 ' 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 of entry to • applicant's property or structure shall be requested and shall occur during regular business hours.
0"er4#
APPLICANT SIGNATURE DATE
ad FOR OFFICE USE ONL�I [� Q /
zi
BASE FEE �� RECEIPT# l / S(i
CASH/CK# C JJ `J
TOTAL 1777, DATE /21 / Da-
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