Loading...
HomeMy WebLinkAboutBLD2002-00656 • 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 #: BLD02-00656 Received Date 11/5/2002 SITE ADDRESS: 81 MOUNTAIN TRAIL CT Issue Date 11/6/2002 BRINNON, 98320 APPLICANT: ERIC J SMITH PHONE: (360)796-3042 BARBARA SMITH 11 MT TRAIL CT BRINNON WA 98320-9649 15 SUBDIVISION: OLYMPIC CANAL ADDITION 5 Block: 14 Lot: PARCEL NUMBER: 981301415 Section: 21 Township: 25N Range: 02W CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735 PO BOX 67 HOODSPORT WA 98548 Contractor's License FERRELPO55LH Expires 8/1/2004 OWNER, ERIC J SMITH PHONE: (360)796-3042 if different: BARBARA SMITH 11 MT TRAIL CT BRINNON WA 98320-9649 PROJECT DESCRIPTION: PROPANE TANK 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 11/6/2003. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: A 00 litfe"s ONLY /D/G 08, [ ] FinalApproval: -C ,06 45 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 IICUILDING PERMIT APPLICAON BLD02-00656 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00656 Received Date: 11/5/2002 SITE ADDRESS: 81 MOUNTAIN TRAIL CT BRINNON, 98320 OWNER: ERIC J SMITH PHONE: (360)796-3042 BARBARA SMITH 11 MT TRAIL CT BRINNON WA 98320-9649 SUBDIVISION: OLYMPIC CANAL ADDITION 5 Block: 14 Lot: 15 PARCEL NUMBER: 981301415 Section: 21 Township: 25 N Range: 02 W CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735 PO BOX 67 HOODSPORT WA 98548 Contractor's License FERRELPO55LH Expires 8/1/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION PROPANE TANK 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 MAM 11/05/02 51299 Total: $47.00 '1111111IL. 0 , JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNS END WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION 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 Horn y :. YES NO SITE ADDRESS(911#/Road Name): ( YlT : T iL ITT' CI�:I•10q l ZIP L� � 9 DIGIT PARCEL ID NUMBER q I`ce:i `�I Legal Description: (� J' -� • Subdivision Name ��mp(('_. Cvi41'L -L PCDD IT)b� S Block j`t' Lot(s) rn Section n� Township�-, i North, Range WM APPLICANT L�K--�t C--.E r�IC_R 3 'n z ` - PHONE 31oa - 7q6 36 - MAILING ADDRESS l I W I K..R - i L O T ,,be-t. NiO ( a ZIP )�-3 PROPERTY OWNER PHONE . © _ /_.�'t MAILING ADDRESS ZIP CONTRACTOR 7E �� ,G Pr5 PHONE•�v P7� ` MAILING ADDRESS t 0 • IBC} 4 6 `7 �[�_Q f-ton .PC WA ZIP q g�z/ STATE LICENSE# 100 I — 56 517LC 2 EXP.DATE ' // i 0 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. r bituk APPLICANT SIGNATURE DATE /Q /cP / Q FOR OFFICE USE ONLY �(j BASE FEE 41-•r�o D l5 l� �r., D _U E R EIPT# 5'12,99 NOVCA /CK# 4'1'1 bC TOTAL `Vv 1>4 - 5 2002 I I E I I / 5 / cZ i H:\HOME1PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC11/05/01 0., „ IY DEPT. OF COMMUNITY DEVELOPMENT