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Home My WebLink AboutBLD2003-00588 UILDING PERMIT APPLICA•ON BLD03-00588 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00588 Received Date: 9/22/2003 SITE ADDRESS: 201 PLUTE RD NORDLAND, 98358 OWNER: STEVEN BLEY PHONE: DEBORA S BLEY 2847 SW 302ND PL FEDERAL WAY WA 980232344 SUBDIVISION: Block: Lot: PARCEL NUMBER: 021282014 Section: 28 Township: 30 N Range: 01 E CONTRACTOR: KINETIC SONSTRUCTION INC PHONE: 2847 SW 302ND PLACE FEDERAL WAY WA 98023 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr Woodstove 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 CJZ 09/22/03 60035 Total: $47.00 • 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 #: BLD03-00588 Received Date 9/22/2003 SITE ADDRESS: 201 PLUTE RD Issue Date 9/22/2003 NORDLAND, 98358 APPLICANT: STEVEN BLEY PHONE: DEBORA S BLEY 2847 SW 302ND PL FEDERAL WAY WA 980232344 SUBDIVISION: Block: Lot: PARCEL NUMBER: 021282014 Section: 28 Township: 30N Range: 01 E CONTRACTOR: KINETIC SONSTRUCTION INC PHONE: 2847 SW 302ND PLACE FEDERAL WAY WA 98023 OWNER, STEVEN BLEY PHONE: if different: DEBORA S BLEY 2847 SW 302ND PL FEDERAL WAY WA 980232344 PROJECT DESCRIPTION: Woodstove 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 09/22/2004. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: Zde2 Alit/[= �j� //O /, [ ] FinalApproval: -Per- mi na l 1//30/01 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 JEFFERSON COUNTY COMMUDEVELOPMENT,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) 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): 90 ) t—0 TE Q.0 ').1n Vim t_.•1f-1 0 v3 i I ZIP 9,5?,..-36,g 9 DIGIT PARCEL ID NUMBER V�) Dg--ot 4 Legal Description: Subdivision Name Block Lot(s) Section 0—� Township 30 North, Range \ (6bt j-- WM APPLICANT j \(.EN‘ c<J l�J�4 PHONE c>D L2 1514 -- 1.ip-t MAILING ADDRESS D--`6 `t7 ?C.,3 302 V i Ct�(_,t1 ;.--- c'"_O .JAL- 13..01/4,-1 1."� ZIP 97s / D- PROPERTY OWNER •..DC-;. V\.SZ— PHONE MAILING ADDRESS ZIP CONTRACTOR c..301/4.v'v4 .. PHONE MAILING ADDRESS ZIP STATE LICENSE# ,) IV 4:t C-1 ‘ L ,S\ EXP.DATE ')1 ' - (S ' O 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 r- -. • or in consequence of the granting of this permit. I further agree to provide a - s and ght o effe-on County and it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of e • to the ,pplicant'•pr•-perty or structure shall be requested and shall occur during regular business hours. ¢ APPLICANTS SIGNATURE �4' �f-7 I� I� LLD( Fj DATE / 4 I / it f )4t.-t. *i rl C J..k. r2�) Lea.., q---7,QJJR OF E USE ONLY (ono�� BASE FEE RECEIPT# CONSISTENCY REVIEW / ' le CK# (F 3 I 1 TOTAL Lj 7• DATE 1 / In / 3etC1 *Underground Propane Tank applications require additional information to be submitted. 0 V E R OP- Please contact our office at 360-379-4450 if the back of this application is blank. g:\permitcentehforms\bldg forms\install-revised 10-23-02.doc