HomeMy WebLinkAboutBlD2002-00493 4110 •
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 #: BLD02-00493 Received Date 8/23/2002
SITE ADDRESS: 477 N JACOB MILLER RD Issue Date 8/27/2002
PORT TOWNSEND, 98368
APPLICANT: PAUL D SAASTAD PHONE: (360)379-1804
CAROLYN J SAASTAD
477 N JACOB MILLER ROAD
PORT TOWNSEND WA 98368 1
SUBDIVISION: RHOADES/CARROLL SHORT PLAT Block: Lot:
PARCEL NUMBER: 001051021 Section: 5 Township: 30N Ranpe: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, PAUL D SAASTAD PHONE: (360)379-1804
if different: CAROLYN J SAASTAD
477 N JACOB MILLER ROAD
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION: PROPANE TANK, HEATER& PIPING
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 8/27/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval: .L6-py
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
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BUILDING PERMIT APPLICION BLD02-0049 3Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00493 Received Date: 8/23/2002
SITE ADDRESS: 477 N JACOB MILLER RD
PORT TOWNSEND, 98368
OWNER: PAUL D SAASTAD PHONE: (360)379-1804
CAROLYN J SAASTAD
477 N JACOB MILLER ROAD
PORT TOWNSEND WA 98368
SUBDIVISION: RHOADES/CARROLL SHORT PLAT Block: Lot: 1
PARCEL NUMBER: 001051021 Section: 5 Township: 30 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP PROPANE TANK, HEATER & PIPING
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 08/23/02 49559
Total: $47.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWN S'mVD WA 98368 PH: (360)379-4450
INSTAL TION PERMIT APPLICATION w
WOODSTOVE /bove Ground PANE TANK PELLET STOVE OTHERP6' Q ,
Is this appliance(htg s e, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911#/Road Name):
47 -7 ' . c.) e 117 ///.av
w ("ZIP ` F) 6V
9 DIGIT PARCEL ID NUMBER O CD / Q S / b 2--/
Legal Description:
Subdivision Name Block Lot(s)
f�Section Township North, Range '7 C, / D WM
APPLICANT / �y-� fa_ f a`PHONE J ( / c� o t
MAILING ADDRESS J Q7
ZIP
PROPERTY OWNER ar PHONE /r
MAILING ADDRESS
ZIP
CONTRACTOR et.,47, PHONE 617J ! ? 7
MAILING ADDRESS /0 O ^ 3 Fr 1,Y �
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STATE LICENSE# cr �I/fp U 7 a p EXP.DATE // 2-
FEDERAL I.D.# q i " /D -7 8237
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 SIGNATUREC.:;e7....-- g v-o" ') DATECf" / -.22-r b
FOR OFFICE USE ONLY
BASE FEE R
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A sH/CK# I q O t 9
TOTAL ms 2 3 ATE /23 /02
H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.D0C11/05/01
DEPT. OF COMMUNITY DEVELOPMENT