HomeMy WebLinkAboutBLD2002-00587 •
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 #: BLD02-00587 Received Date 10/3/2002
SITE ADDRESS: 922 WEST UNCAS RD Issue Date 10/3/2002
PORT TOWNSEND, 98368
APPLICANT: W WA CORP SEVENTH DAY ADV PHONE:
TRUSTEE OF REV TRUST
PORT TOWNSEND WA 983689357
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 902261002 Section: 26 Township: 29N Range: 02W
CONTRACTOR: EVERWARM INC PHONE:
257151 HWY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/17/2004
OWNER, W WA CORP SEVENTH DAY ADV PHONE:
if different: TRUSTEE OF REV TRUST
PORT TOWNSEND WA 983689357
PROJECT DESCRIPTION WOODSTOVE 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 10/03/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalAp�roval: / _L ( /
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
i:\F_BLD_Permit_Propane.rpt 10/29/19
BUILDING PERMIT APPLIl l ION BLD02-00587
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00587 Received Date: 10/3/2002
SITE ADDRESS: 922 WEST UNCAS RD
PORT TOWNSEND, 98368
OWNER: W WA CORP SEVENTH DAY ADV PHONE:
TRUSTEE OF REV TRUST
PORT TOWNSEND WA 983689357
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 902261002 Section: 26 Township: 29 N Range: 02 W
CONTRACTOR: EVERWARM INC PHONE:
257151 HVVY 101
PORT ANGELES WA 98362
Contractor's License EVERWI*088NL Expires 08/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIO WOODSTOVE 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:
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
Seismic Streams
Prop: Prop: Flood Way Floodplain
Total: Total: F&W Landslide
Routing Date: I 6 1.5/
Shoreline Aquifer
�?i Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 PRB 10/03/02 51019
Total: $47.00
•
JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWN SEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
t.�WOODSTOVE 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):
qa We* 110heas Pdk
YON(i- Y1NJ f `se d D t \.. ZIP 1%-NO
9 DIGIT PARCEL ID NUMBER 6I0A CA 1 Wa
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Ranged WM
APPLICANT f e -e c (_ PHONE �1 5" O(So
MAILING ADDRESS 9 A CT of2st (�V Ca S i�__,A •
n
1' t To.o aeva coA---- ZIP t o (4r
PROPERTY OWNER Kil 4Y mA.i\ (IC- PHONE 3 S CM Sz)
MAILING ADDRESS -1t;A i j5l-- (..(n C d S Q cA •
C& f "ics (.."...) ZIP qS 36
CONTRACTOR b/0(io W
Y \ `'Qu,r-v k c ---6 mL_, C�PHONE 4 5 a - - 3 64
MAILING ADDRESS c -1 15 1 ( /0 I (�
P t A 8Q�_ i p A- ZIP 3 a
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 ,14-4PLZ)-
lC-- DATE (C>/ 3 / ��c�.
/ FOR OFFICE USE ONLY (�
BASE FEE RECEIPT# l
CASH/CK# 6`f t C)
TOTAL J-1- DATE 10 / 3 / o2-'
H:HOMEWLNCNTR\INFOBLDG\FORMS\INSTALL.DOC11/05/01