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HomeMy WebLinkAboutBLD2002-00502 • 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 #: BLD02-00502 Received Date 8/29/2002 SITE ADDRESS: 3537 OAK BAY RD Issue Date 8/29/2002 PORT HADLOCK, 98339 APPLICANT: C D PEEVEY TRUST PHONE: (360)437-0485 CD PEEVEY TRUSTEE 3535 OAK BAY RD PORT HADLOCK WA 98339-9729 T 112 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921191011 Section: 19 Township: 29N Range: 01 E CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420 PO BOX 1031 PORT TOWNSEND WA 98368 Contractor's License PETTIOCO88CC Expires 5/1/2004 OWNER, C D PEEVEY TRUST PHONE: (360)437-0485 if different: CD PEEVEY TRUSTEE 3535 OAK BAY RD PORT HADLOCK WA 98339-9729 PROJECT DESCRIPTION: PROPANE TANK& INSERT 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 8/29/2003. REQUIRED INSPECTIONS: [ Tank/Line/Appliance: L-) GoAft0 /0—/ -B ti [re FinalApprov . (,✓/CA5". J t (O-1-r�2 U 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 J S BUILDING PERMI APPLIC -ION BLRD02-005502 ew Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00502 Received Date: 8/29/2002 SITE ADDRESS: 3537 OAK BAY RD PORT HADLOCK, 98339 OWNER: C D PEEVEY TRUST PHONE: (360)437-0485 CD PEEVEY TRUSTEE 3535 OAK BAY RD PORT HADLOCK WA 98339-9729 SUBDIVISION: Block: Lot: T 112 PARCEL NUMBER: 921191011 Section: 19 Township: 29 N Range: 01 E 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 & INSERT 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 08/29/02 49580 Total: $47.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOPS 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLIC (ION WOODSTOVE 6 PROPANE TANK PELLET STOVE OTHER h ,Iri Is this appliance (htg stove, hot water tank,furnace,etc.)to be install in a Ma factured/Mobile Home? ,. YES NO SITE ADDRESS(911#/Road Name): jjK 1/ 4-4 c 1, C C j.L7 ZIP (33 t 9 DIGIT PARCEL ID NUMBER t2 2 0 / Q !r Legal Description: Subdivision Name Block Lot(s) D'Acq Section Ni IY:y. / 4 Township 1 W , r� North, Range ; M 4,„ APPLICANT PHONE 9370 Ai' MAILING ADDRESS,35 33* p K ia-7/ e:. f is 1,4 ZIP :33ri PROPERTY OWNER PHONE MAILING ADDRESS A 22)'?,,_�.-. ZIP CONTRACTOR 0_bJ7 ( 7► Pe-1'4;4— PHONE MAILING ADDRESS 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 right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. 1 APPLICANT SIGNATURE ) % ' DATE ,a / ` / "t1- •- (p,. BASE FEE � EIPT# 4 9S D 0 1[Mii H/CK# ©CO�ZTOTAL iTb E U /2 L/ O Z ._ H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC11/05/01 DEPT. OF COMMUNITYDEVELOPMENT