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HomeMy WebLinkAboutBLD2002-00520 • • 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#: BLD02-00520 Received Date 9/6/2002 SITE ADDRESS: 41 DUNGENESS PL Issue Date 9/6/2002 PORT TOWNSEND, 98368 APPLICANT: DUANE R NAIL PHONE: MARTA P NAIL 41 DUNGENESS PL PORT TOWNSEND WA 983689413 6 SUBDIVISION: CAPE GEORGE COLONY DIV 7 Block: 14 Lot: PARCEL NUMBER: 939601406 Section: 13 Township: 30N Range: 02W CONTRACTOR: FERRELLGAS PHONE: (360)582-0231 646 SO 3RD AVE SEQUIM WA 98382 Contractor's License FERRELP055LH Expires 08/01/2003 OWNER, DUANE R NAIL PHONE: if different: MARTA P NAIL 41 DUNGENESS PL PORT TOWNSEND WA 983689413 PROJECT DESCRIPTION PROPANE STOVE 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 09/06/2003. REQUIRED INSPECTIONS: [ ] Tan a/Appliance: © K /D—/-o Z cxT ..r.r io -ot [ j FinalApproval: Ord >D o 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 00 BUILDING PERMIT APPLICAMN BR vi w TypeO Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00520 Received Date: 9/6/2002 SITE ADDRESS: 41 DUNGENESS PL PORT TOWNSEND, 98368 OWNER: DUANE R NAIL PHONE: MARTA P NAIL 41 DUNGENESS PL PORT TOWNSEND WA 983689413 SUBDIVISION: CAPE GEORGE COLONY DIV 7 Block: 14 Lot: 6 PARCEL NUMBER: 939601406 Section: 13 Township: 30 N Range: 02 W CONTRACTOR: FERRELLGAS PHONE: (360)582-0231 646 SO 3RD AVE SEQUIM WA 98382 Contractor's License FERRELP055LH Expires 08/01/2002 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO PROPANE STOVE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: 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 F&W Landslide Routing Date: ��^^ Shoreline Aquifer V�'D Forest: Commercial Rural Proximity Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 PRB 09/06/02 49626 Total: $47.00 • ' JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER ,/'D Dt2 Vt e 57 VC C2 STO ye) <c{/u` i 7`o r e.)(/4 71 7ix i,t K Is this appliance (htg stove, hot water tank,furnace, etc.)to be installed in a Manufacc red/Mobile Home? YES i—NO SITE ADDRESS(911 #/Road Name): `74/ ,,2 n?mess 1/4GG, f r T W!mot !e vt 1 �V M . ZIP �� 6.g k 9 DIGIT PARCEL ID NUMBER Legal Description: ,,//i� / Subdivision Name (.&pe 6&)rt e co 10" ,/ ii 7 Block / Lot(s) Section Township North, Range WM APPLICANT (f ill Ma vz-tc:t a/ci / 1 PHONE 3 7 - (p l MAILING ADDRESS / Li t')e,CVt el C illG[.0 -e // r6 d'7- j r� C.l,) /i S {�_L�-t�( V`-)Q ZIP e 3 AS-- PROPERTY OWNER :bug ✓t'e_ 4- M a r-fa /VQ / / PHONE 3 71 4,O 6S- MAILING ADDRESS 1 �J(,{!/(C P vt e S S Q �l , (�f�� or1 %oW �Se GC �Q ZIP lCJ &? CONTRACTOR /e,/-r^e//g Q S PHONE /ea `1'22.. g)..? 7/ MAILING ADDRESS 1(p `S , 3 r' 4 d L 6 e U l',4-, r ZIP g3 8- L STATE LICENSE# /� ('O I r6[6 3 5-f EXP.DATE T7/ Z i 1 0 3 FEDERAL I.D.# F E. Re_ L. Po 6 '-1+ 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 rig _of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access an ight Of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE - h7101/4.--- ------- /i, ^c '1 DATE d FOR OFFICE USE ONLY BASE FEE RECEIPT# I ,-7 CASH/CK# +4-TOTAL - -o DATE / / H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC 11/05/01