HomeMy WebLinkAboutBLD2003-00508 0
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 #: BLD03-00508 Received Date 8/12/2003
SITE ADDRESS: 10-2 BLUFFS DR Issue Date 8/12/2003
PORT TOWNSEND, 98368
APPLICANT: ELVIN N TYAU PHONE:
JANET M TYAU
10 BLUFFS DR#2
PORT TOWNSEND WA 98368
SUBDIVISION: THE BLUFFS BLDG 1 Block: Lot:
PARCEL NUMBER: 965300002 Section: 26 Township: 30N Range: 01W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI983O6 Expires 9/26/2004
OWNER, ELVIN N TYAU PHONE:
if different: JANET M TYAU
10 BLUFFS DR#2
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION: Propane tank and fireplace insert 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 8/12/2004.
REQUIRED INSPECTIONS:
N Tank/Line/Appliance:9.<C )' 5---"O7
[.y FinalApproval: �2 `-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
I:\F_BLD_Permit_Propane.rpt 10/29/19
•
BUILDING PERMIT APPLIION BLD03-00508Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00508 Received Date: 8/12/2003
SITE ADDRESS: 10-2 BLUFFS DR
PORT TOWNSEND, 98368
OWNER: ELVIN N TYAU PHONE:
JANET M TYAU
10 BLUFFS DR#2
PORT TOWNSEND WA 98368
SUBDIVISION: THE BLUFFS BLDG 1 Block: Lot:
PARCEL NUMBER: 965300002 Section: 26 Township: 30 N Range: 01 W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTP198306 Expires 9/26/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI Propane tank and fireplace insert 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:
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 PRB 08/12/03 58314
Total: $47.00
JEFFERSON COUNTY COMMI DEVELOPMENT,621 SHERIDAN ST,PORT TO•ND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* I Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE I FIREPLACE INSERT PELLET STOVE COOKING STOVE
OTHER(Please Specify)
Is this appliance (htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?,
YES f®' NO
SITE ADC" 1911#/Road Name):
POD / �Us/L'�" , k✓�} _ ^ ZIP 9S36S
p
9 DIGIT PARCEL ID NUMBER /b cs— 3 00 — Gl�pr-
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT /)')ONn icily/ Pob Qn Z" ��^� PHONE 3 p$S
MAILING ADDRESS 2AS Chung C 14 rn 1rC0 p
Pori ?�4d)ock i w'"¢ ZIP 9S33 7 ,r�
PROPERTY OWNER IQ),2't T 2y PHONE 37/ ` 960%
MAILING ADDRESS JO — a B j L 6S .Dr'
?or ToG--"s J ZIP / o36f
CONTRACTOR MO&H7q/r Pre to qn r PHONE 3ISS - G SS 3
MAILING ADDRESS Z 6 S en 1,0, 460),.. 20 p- O
?vrI+ oi�?dIook, Wi+ ZIP 6337 /
STATE LICENSE# /N Ow/ r Jl 9%306 EXP.DATE 9 �6 `OV
FEDERAL I.D.# (jC»- —077- '0)-
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 the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT'S SIGNATURE J� . DATE
A-7 FOR OFFICE USE ONLY
BASE FEE ( .UD RECEIPT# �y 783t�
CONSISTENCY REVIEW CASH/CK# +o/ff
//''
TOTAL 7.00 DATE / IZ/O 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. MI*
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