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Home My WebLink AboutBLD2003-00598 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#: BLD03-00598 Received Date 9/24/2003 SITE ADDRESS: 70 EXPLORER LN Issue Date 9/24/2003 PORT LUDLOW, 98365 APPLICANT: WILLIAM A HARJU PHONE: PEGGY A HARJU 70 EXPLORER LN PORT LUDLOW WA 98365 151 SUBDIVISION: PORT LUDLOW NO. 2 AREA 3 Block: Lot: PARCEL NUMBER: 990603151 Section: 9 Township: 28N Range: 01 E CONTRACTOR: DOWN RIGHT COZY PHONE: (253)691-7518 27877 RESOURCE RIDGE AVE NE KINGSTON WA 98346 Contractor's License DOWNRC*985JT Expires 04/30/2004 OWNER, WILLIAM A HARJU PHONE: if different: PEGGY A HARJU 70 EXPLORER LN PORT LUDLOW WA 98365 PROJECT DESCRIPTION: Fireplace Insert 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 09/24/2004. REQUIRED INSPECTIONS: 6.. Tank/Line/Appliance: ODD huffs-C'r e /o//G3 [y}� FinalApproval: .eye -Oar e/ , ,//3 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 10/29/19E UILDING PERMIT APPLICAIbN BLD03-00598 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00598 Received Date: 9/24/2003 SITE ADDRESS: 70 EXPLORER LN PORT LUDLOW, 98365 OWNER: WILLIAM A HARJU PHONE: PEGGY A HARJU 70 EXPLORER LN PORT LUDLOW WA 98365 SUBDIVISION: PORT LUDLOW NO. 2 AREA 3 Block: Lot: 151 PARCEL NUMBER: 990603151 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: DOWN RIGHT COZY PHONE: (253)691-7518 27877 RESOURCE RIDGE AVE NE KINGSTON WA 98346 Contractor's License DOWNRC*985JT Expires 04/30/2003 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' Fireplace Insert 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 CJZ 09/24/03 60048 Total: $47.00 JEFFERSON COUNTY COMMUNI•EVELOPMENT,621 SHERIDAN ST,PORT TOWN.)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): 7Q k/o/e7(r)" 2 ,f/e Airt Z Gl vL- a ZIP POK2 S 9 DIGIT PARCEL ID NUMBER 190 603 /6/ Legal Description: Subdivision Name Block Lot(s) / J Section Township North, Range / WM APPLICANT Le-/MI- /Q. //g t/G( PHONE 9Z/` Q6 7 61 MAILING ADDRESS 7ff(/ IS,,<'A//}�)� L.9M i-7 2 /Y ZIP 9 6?:g‘--S� PROPERTY OWNER 5 9/ PHONE MAILING ADDRESS ZIP CONTRACTOR 7),01/7,Q/G,//7" (04/ PHONE 3.a 997--�c�s MAILING ADDRESS ZIP STATE LICENSE# OCIV/I/ 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 resu of or in consequence of the granting of this permit. I further agree to provide access and right of a try to efferson Count nd it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the ph a is prgp rty r ructure shall be requested and shall occur during regular business hours. APPLICANT'S SIGNATURE f „(L /�. �i � DATE ,9 67i41 / cJ BASE FEE FOR OFFICE USE ONLY RECEIPT# 260018 CONSISTENCY REVIEW �I CASH/CK# TOTAL DATE GI /a4/oO63 *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. g:\permitcenter\forms\bldg forms\install-revised 10-23-02.doc