Loading...
HomeMy WebLinkAboutBLD2002-00628 • 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 #: BLD02-00628 Received Date 10/22/2002 SITE ADDRESS: 341 MC MINN RD Issue Date 10/22/2002 PORT TOWNSEND, 98368 APPLICANT: GEORGE L HAYES TRUSTEE PHONE: LINDA D B HAYES TRUSTEE PO BOX 1804 PORT TOWNSEND WA 983680210 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001072002 Section: 7 Township: 30N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, GEORGE L HAYES TRUSTEE PHONE: "' J �„ if different: LINDA D B HAYES TRUSTEE �i � � urr r-_ PO BOX 1804 ' PORT TOWNSEND WA 983680210 -ram PROJECT DESCRIPTION GAS HOT WATER TANK, RANGE, D RAND GAS DRAIN 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 10/22/2003. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: [ ] FinalApproval:j,L y'_(t_c.. 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_Perm it_Propane.rpt 10/29/19 BUILDING PERMIT APPLICA Review N 00628 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00628 Received Date: 10/22/2002 SITE ADDRESS: 341 MC MINN RD PORT TOWNSEND, 98368 OWNER: GEORGE L HAYES TRUSTEE PHONE: LINDA D B HAYES TRUSTEE PO BOX 1804 PORT TOWNSEND WA 983680210 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001072002 Section: 7 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO GAS HOT WATER TANK, RANGE, DRYER AND GAS DRAIN 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 F&W Landslide Routing Date: ii22 Shoreline Aquifer ( 1ra-. Forest: Commercial Rural Proximity Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 ZAN 10/22/02 51207 Total: $48.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHEAIDAN ST. PORT TOWNS.WA 9836$ PH: 1360) 379-4450 CINSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER V3 W r l V` SITE ADDRESS: 911#/ROAD NAME ' cL S e a C1/1 1-1 ' , `C ; vi N ZIP j b r 9 DIGIT PARCEL ID NUMBER Q© I 0 7 0 0 Legal Description: _ Subdivision Name ("©\FERh//Yicrv'! L .' T I Block Lot(s) Section 7 Township 30 North, Range / e4J0_ ' WM APPLICANT .> G1 RGE" 4, `/ i4 yES 3 PHONE 7l.-3<0-/ MAILING ADDRESS PO AO /9OLI PoLI "lb t.15pM. ZIP /Bj g PROPERTY OWNER c Vvx e- PHONE MAILING ADDRESS ZIP Q=0 ?._- CONTRACTOR PHONE 1 MAILING ADDRESS ',` OCT1 a 3 j ZOOZ ZIP ��lY STATE LICENSE # EXP. D T� p1.OF(;`�`tPJ ELOPP�ti EMT 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. 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 1 / Z Z �I FOR OFFICE USE ONLY SiBASE FEE V / v RECEIPT# 1 �• f 4' CASH/CK# c— TOTAL --�t DATE t H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99