HomeMy WebLinkAboutBLD2003-00222 •
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 #: BLD03-00222 Received Date 4/7/2003
SITE ADDRESS: 150 CEDARVIEW DR Issue Date 4/7/2003
PORT TOWNSEND, 98368
APPLICANT: PAUL L OXENBOL PHONE: (360)379-9414
INGE-LISE OXENBOL
150 CEDAR VIEW DR
PORT TOW END WA 98368-9527 180
SUBDIVISION: KALA POINT#9 Block: Lot:
PARCEL NUMBER: 965000320 Section: 27 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
OWNER, PAUL L OXENBOL PHONE: (360)379-9414
if different: INGE-LISE OXENBOL
150 CEDAR VIEW DR
PORT TOWNSEND WA 98368-9527
PROJECT DESCRIPTION: WALL MOUNTED PROPANE HEATER INSIDE SUNROOM
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 4/7/2004.
REQUIRED INSPECTIONS:
[ l Tank/Line/Appliance: it ipPLisue Q,K AsA
[ ] inalAp1.- -al. co-r 5,','
ZS/03
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_Propa ne.rpt 10/29/19
UILDING PERMIT APPLIC ON B RDo w00222
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00222 Received Date: 4/7/2003
SITE ADDRESS: 150 CEDARVIEW DR
PORT TOWNSEND, 98368
OWNER: PAUL L OXENBOL PHONE: (360)379-9414
INGE-LISE OXENBOL
150 CEDAR VIEW DR
PORT TOWNSEND WA 98368-9527
SUBDIVISION: KALA POINT#9 Block: Lot: 180
PARCEL NUMBER: 965000320 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION WALL MOUNTED PROPANE HEATER INSIDE SUNROOM
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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 04/07/03 47863
Total: $47.00
JEFFERSON COUNTY COMMUIDEVELOPMENT,621 SHERIDAN ST,PORT TOWN D WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE
OTHER(Please Specify) +LI_ l"%3LJN Te)j 1-9 r2O Pi r-FQ- 4ed4-1 i2 t h i 50 N(2.o42 frl
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):
/56 C £D,9P//Eis` D2t,/G
Po2i J)LAj/,1.sgiro ZIP RS3k,d
9 DIGIT PARCEL ID NUMBER q bS 00 o 3 2-0
Legal Description:
Subdivision Name 4 L'I Pc'ii r Block Lot(s) '
Section 27- Township `%, North, Range D/ bi WM
APPLICANT 120 U(-- C X t=N/3 C)L- PHONE '3 fc` - 3 _() - 9 --I y-
MAILING ADDRESS /5Q C:a✓/)i-t2v''r tx;' Oa_. _
iDr/a; -IC,L-1 i-i ScN ZIP
PROPERTY OWNER S 4 M 6-PHONE
MAILING ADDRESS
ZIP
CONTRACTOR SUN S[-e f/\ - t'e ,P.Q4,-1c- PHONE " 35 s '" S 7-i 1-
MAILING ADDRESS 'U bs 3 K-h , brzs
Pc,2; t-/4-6t_OC` ZIP `1 y 3 3?
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 applicants property or structure��c> shall be requested and shall occur during regular business hours.
APPLICANTS SIGNATURE fr DK L-i-,- C.Tr-R.---- DATE / /
BASE FEE 'r QtrFOR OFFICE USE ONLY
i RECEIPT# —7 y g l 3
CONSISTENCY REVIEW CASH/CK# T�-L i
TOTAL ` Li 7'
DATE L/--+-/ c
*Underground Propane Tank applications require additional information to be submitted. 0 V E R
Please contact our office at 360-379-4450 if the back of this application is blank.
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