The URL can be used to link to this page

Home My WebLink AboutBLD2003-00484 • 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#: BLD03-00484 Received Date 8/5/2003 SITE ADDRESS: 291 FAWN MEADOW RD Issue Date 8/8/2003 CHIMACUM, 98325 APPLICANT: CAROLYN E MARQUETTE PHONE: (360)675-1185 RICHARD LINDELL 1960 COPSE LONNIN PL OAK HARBOR WA 98277-8890 8 SUBDIVISION: FAWN MEADOW Block: Lot: PARCEL NUMBER: 901225008 Section: 22 Township: 29N Range: 01W CONTRACTOR: FERRELLGAS PHONE: (360)582-0231 646 SO 3RD AVE SEQUIM WA 98382 Contractor's License FERRELP055LH Expires 08/01/2004 OWNER, CAROLYN E MARQUETTE PHONE: (360)675-1185 if different: RICHARD LINDELL 1960 COPSE LONNIN PL OAK HARBOR WA 98277-8890 PROJECT DESCRIPTION: ABOVE GROUND PROPANE TANK AND MOVING LINE 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 08/08/2004. REQUIRED INSPECTIONS: [17 Tank/Line/Appliance: �AI 4 Cxyt. coz_ j?7/ [VI" FinalApproval: 7K .4cir- qz/o3L At _ 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 10/29/19c • BUILDING PERMIT APPLIkTION B RD02-006668 eview Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD03-00484 Received Date: 8/5/2003 SITE ADDRESS: 291 FAWN MEADOW RD CHIMACUM, 98325 OWNER: CAROLYN E MARQUETTE PHONE: (360)675-1185 RICHARD LINDELL 1960 COPSE LONNIN PL OAK HARBOR WA 98277-8890 SUBDIVISION: FAWN MEADOW Block: Lot: 8 PARCEL NUMBER: 901225008 Section: 22 Township: 29 N Range: 01 W CONTRACTOR: FERRELLGAS PHONE: (360)582-0231 646 SO 3RD AVE SEQUIM WA 98382 Contractor's License FERRELP055LH Expires 08/01/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI ABOVE GROUND PROPANE TANK AND MOVING LINE 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 $0.00 ZAN 08/05/03 Total: $0.00 JEFFERSON COUNTY COMITY DEVELOPMENT,621 SHERIDAN ST,PORT T•SEND 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) 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): ] �/ (.w v v Kt l C%t()c-; 9? L, 6� 1Y1. 1Z4,Ci rY'1 •C4 v- A ZIP Li •�r� 9 DIGIT PARCEL ID NUMBER 1" �.) t )`_. Legal Description: Subdivision Name Block Lot(s) Section Township North, /Range WM APPLICANT hp_rp\b•-, 0,1 u---1)1-2 PHONE\J( ) l MAILING ADDRESS '� •'� • 1 T 'j Y-7 �►'11Yti\G. C' tvti� ZIP ,�LSi PROPERTY OWNER '�,rr\ PHONE MAILING ADDRESS ZIP CONTRACTOR f f f 11 ( Cti� PHONE MAILING ADDRESS E''' \h• ZIP 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 pr ertyyorrsstructure shall be_requested and shall occur during regular business hours. /APPLICANTS SIGNATURE '"'3 2 T( 's/!J/ J: DATE Z / L / gi-` BASE FEE 141oUR OFFICE USE ONLY RECEIPT# J a-1 CONSISTENCY REVIEW CASH/CK#TOTAL Let r DATE C/ S / 0 3 *Underground Propane Tank applications require additional information to be submitted. OVER Please contact our office at 360-379-4450 if the back of this application is blank. =Mk H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC