HomeMy WebLinkAboutBLD2002-00556 •
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 #: BLD02-00556 Received Date 9/20/2002
SITE ADDRESS: 20 CORBRIDGE PL Issue Date 9/20/2002
PORT TOWNSEND, 98368
APPLICANT: NORMAN C JOHNSON PHONE:
IRENE C JOHNSON
1023 CALHOUN
PORT TOWNSEND WA 98368 151
SUBDIVISION: KALA POINT#3 Block: Lot:
PARCEL NUMBER: 965000009 Section: 27 Township: 30N Range: 01W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTI00088CC Expires 05/01/2004
OWNER, NORMAN C JOHNSON PHONE:
if different: IRENE C JOHNSON
1023 CALHOUN
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION ABOVE GROUND PROPANE TANK AND 2 FIREPLACES AND GAS
LINLS
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 09/20/2003.
REQUIRED INSPECTIONS:
y
[ l Tank/Line/Appliance: 1 � 4iø &c Ok �'Q/��OZ
[ 1 FinalApproval: f / c l i l) r0 B/dZ
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
41)BUILDING PERMIT APPLIC•ON BLD02-00556
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD02-00556 Received Date: 9/20/2002
SITE ADDRESS: 20 CORBRIDGE PL
PORT TOWNSEND, 98368
OWNER: NORMAN C JOHNSON PHONE:
IRENE C JOHNSON
1023 CALHOUN
PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#3 Block: Lot: 151
PARCEL NUMBER: 965000009 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIO ABOVE GROUND PROPANE TANK AND 2 FIREPLACES AND GAS
LINES
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
Seismic Streams
Prop: Prop: Flood Way Floodplain
Total: Total: F&W Landslide
Routing Date: shoreline Aquifer
��2o/o2, , , Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 ZAN 09/20/02 50987
Total: $47.00
JEFFERSON COUNTY COMMUN DEVELOPMENT,621 SHERIDAN ST,PORT TOWN ND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE Above Ground PROPANE TANK PELLET STOVE OTHER X rep)G-C-es
I
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):
-0 G6 3 r ; dly-e_ G1"
c-4.--''..:e .---k--- -42-°-----
it,:te.igt ZIP
9 DIGIT PARCEL ID NUMBER roc o o a D c1
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT PHONE
MAILING ADDRESS
ZIP
PROPERTY OWNER jtA°rvv a v... ..ro L N,5 vv.. PHONE ,S y Jo S )
MAILING ADDRESS v CO r h r, CAP Gt: Q /
fc/ ,`y I ZIP /0-3U t
CONTRACTOR PC/97/ 6, L Ctivs-j G.v l �a J PHONE 3 5-1r/`
MAILING ADDRESS �-3 jet° / f r�
f ,- - Tip h, �.,.s�---rl ZIP 9 PO
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.
APPLICANT SIGNATURE — DATE q / I D V\
FOR OFFICE USE ONLY
/� __J O _L�
BASE FEE 1' / '' RECEIPT# _
/�7 CASH/CK# J
/
TOTAL "F / ( DATE q /.C)/,02,._
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