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Home My WebLink AboutBLD2002-00624 • • 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 #: BLD02-00624 Received Date 10/18/2002 SITE ADDRESS: 261 MARGARET ST Issue Date 10/21/2002 PORT LUDLOW, 98365 APPLICANT: DUANE R ANDERSON PHONE: (360)437-1391 SHARI J ANDERSON 261 MARGARET STREET PORT LUDLOW WA 98365 T 107 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821333003 Section: 33 Township: 28N Range: 01 E CONTRACTOR: NORTHWEST FIREPLACE PHONE: (360)373-4631 2700 VINCENT WAY BREMERTON WA 98312 Contractor's License NORTHFG044K0 Expires 5/7/2004 Mountain Propane PHONE: ( 36 0 ) 38 5-6883 265 Chimacum RD Port Hadlock, WA 98339 MOUNTPI983O6 9/26/2004 PROJECT DESCRIPTION: PROPANE TANK& HEAT 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 10/21/2003. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance //-,Yr-o'� [ ] FinalApproval: f/.--/c9 'z-),-e-___ 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_Pe rm it_Propane.rpt 10/29/19 UILDING PERMIT APPLICAON B RD02 00w 62 4 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00624 Received Date: 10/18/2002 SITE ADDRESS: 261 MARGARET ST PORT LUDLOW, 98365 OWNER: DUANE R ANDERSON PHONE: (360)437-1391 SHARI J ANDERSON 261 MARGARET STREET PORT LUDLOW WA 98365 SUBDIVISION: Block: Lot: T 107 PARCEL NUMBER: 821333003 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: NORTHWEST FIREPLACE PHONE: (360)373-4631 2700 VINCENT WAY BREMERTON WA 98312 Contractor's License NORTHFG044K0 Expires 5/7/2004 Mountain Propane 265 Chimacum RD PHONE: ( 360 ) 385-6883 Port Hadlock, WA 98339 MOUNTPI983O6 9/26/2004 PROJECT DESCRIPTION PROPANE TANK & HEAT STOVE 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 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 10/18/02 51190 Total: $47.00 JEFFERSON COUNTY COMMUNI DEVELOPMENT, 621 SHERIDAN ST, PORT TOWN Olt WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION A-80V-E- 612-0L) 3\° /L.( WOODSTOVE n PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: ( �4-4 rty L c� 74- � �AQ �f t 911#/ROAD NAME �� j 1�2Q / G�"'� 6(49 a n t- d- (1 w G✓/4-- y LV ZIP �O 9 DIGIT PARCEL ID NUMBER 0 Z l "" 3 3 3 - o a 7 Legal Description: p Subdivision Name Block /d 7 Lotlsl ll -?— Section 3 3 Township Zd North, Range / f WM AP!'"!CANT 2v,9-/Vr '4i i lL eA$C// , PHONE 36'0- Y3 7-/3 9/ MAILING ADDRESS 76 ( n4 -, , l ---�(L ai--- Pon / i(/Q- &Pt. wi)--- ZIP 90 3 6J PROPERTY OWNER 54'/i"-- PHONE MAILING ADDRESS ZIP ��d�Y� r VYltx,�-(1,�/i fe1 ',, / /jam� / / / CONTRACTOR ,v U/` � v`�0�� / R LI1--/TK--- PHONE 3 v 6 3 73 �v 3 MAILING ADDRESS '2_0 7 btl 0 ti h � c 71 4 $um-, ti/ -ko,t Gv'9- 71$/0 ZIP STATE LICENSE# C..,6 (1 'J' ) EXP. DATE FEDERAL I.D. # r/ ,rr By signing the application form, the applicant/owner attests that the information provided herein is true d orrec t 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 o the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE / / FOR OFFICE USE ONLY i (� BASE FEE `^ �c `I�7 ` CJ� RECEIPT# `� 1 l 0 �-, CASH/CK# 3330 TOTAL �'- ;mot) Ld:,, 4' ,._. _. y_ DATE Y___._.� L _/1'6'. H:\HOME\PLNCNTR\FORMS\INSTALL.DOC10/99 I OCT 1 8 2002 1,_2i Jen6 ' ie 1, t e L ` (+� DEPT. OFJCOMMUNITY DEVELOPMENT 1