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HomeMy WebLinkAboutBLD2000-00638 S , 4 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD00-00638 Received Date: 10/2/2000 SITE ADDRESS: 9182 RHODY DR CHIMACUM, 98325 APPLICANT: JAMES T LEE PHONE: (360)732-4447 DENISE LEE PO BOX 13 CHIMACUM WA 98325 SUBDIVISION: Block: Lot: T 22 1 PARCEL NUMBER: 901142017 Section: 14 Township: 29 N Range: 01 W CONTRACTOR: CENEX SUPPLY&MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/01/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: 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 Flood Plane outing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: �rRel eip Approve��ateons Propane Tanks/Stoves $48.00 MAM 10/02/00 34506 Total: $48.00 i:\F_BLD_App_Bld.rpt 10/29/99 , JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: 1360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE NI, PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: J 911#/ROAD NAME Cl I t1)C3, t. , '3f' ZIP 9 DIGIT PARCEL ID NUMBER got - I L " o i Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT ,y` 1. , +1' t PHONE 4-1 91917 MAILING ADDRESS t { ZIP {ter PROPERTY OWNER w't 1 PHONE MAILING ADDRESS i/v1 ZIP CONTRACTOR C 1e1 PHONE MAILING ADDRESS 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 nd 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 nd right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE / / L./4 1 � FOR OFFICE USE ONLY BASE FEE RECEIPT # � TOTAL.-_ . BATE =; Lai / H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99 t 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 (800)831-2678 PERMIT#: BLD00-00638 Received Date 10/2/2000. SITE ADDRESS: 9182 RHODY DR Issue Date 10/3/2000 CHIMACUM, 98325 Expiration Date 10/3/2001 APPLICANT: JAMES T LEE PHONE: (360)732-4447 DENISE LEE PO BOX 13 CHIMACUM WA 98325 • T 22 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901142017 Section: 14 Township: 29N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/01/2001 OWNER, if different: PROJECT DESCRIPTION PROPANE TANK 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 10/03/2001. REQUIRED INSPECTIONS: [ ] jLine/Appliance: [ FinalApproval: © G 11-7-OD BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. SPECIAL CONDITIONS MAY APPLY -SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY