HomeMy WebLinkAboutBLD2000-00048 BUILDING PERMIT APPLICATION
Jefferson County Department of Cqmmunity Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00048 Received Date: 1/19/2000
SITE ADDRESS: 490 SONG DOG HOLLOW RD
QUILCENE, 98376
APPLICANT: BRIAN D BESSEY PHONE:
PO BOX 1
QUILCENE WA 98376-0001
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 701292025 Section: 29 Township: 27 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2000
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK, PIPE & STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: 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: STORMWATER: YES NO AREA
BEDROOMS: BATHROOMS: Wetland Erosion
Exist: Exist: Seismic Streams
Prop: Prop: Flooding Landslide
Total: Total: F&W Plat Conditions
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $46.00 MAM 01/19/00 24008
Total: $46.00
I:\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE K PROPANE TANK PELLET STOVE ( OTHER pp-g-- i "Ui^-e
SITE ADDRESS:
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9 DIGIT PARCEL ID NUMBER 7 0 I ;1(0 0 --6
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT g Rita/W ' 0/144'1- 1 -S,f' PHONE
MAILING ADDRESS PO QO }6 I
AAA_` ZIP WIC
PROPERTY OWNER Ci`-10 "-`f PHONE 10 S'3(4 3 Z
MAILING ADDRESS I ,
ZIP
CONTRACTOR SL.Vl S H I h Q Pe--0 P _ PHONE 3 851_ ,579 7
MAILING ADDRESS (0 t?S 3 QN-0 It O Q
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ZIP i cf 331
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STATE LICENSE #
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FEDERAL I.D. # `1 i- ID cl 7 8 s 7
APPLICANT SIGNATURE �t.GC.r'"c-- ,O- av / ( DATE / / 1 / crk.)
FOR OFFICE USE ONLY
BASE FEE RECEIPT # 24 OO i
IECEOVIE --,ce,SH/CK #S " /-®�' l-,
TOTALtom
, 4ATE 1 /1� / Qtt
JAN 1 9 2000 j
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC4/98
JEFFERSON COUNTY
DEPT. OF COMMUNITY DEVELOPMENT
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 #: BLD00-00048 Received Date 1/19/2000
SITE ADDRESS: 490 SONG DOG HOLLOW RD Issue Date 1/20/2000
QUILCENE, 98376 Expiration Date 1/20/2001
APPLICANT: BRIAN D BESSEY PHONE:
PO BOX 1
QUILCENE WA 98376-0001
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 701292025 Section: 29 Township: 27N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2000
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK, PIPE & STOVE 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 01/20/2001.
REQUIRED INSPECTIONS:
/
[ ] Tank/Line/Appliance: of - ] / O
[ ] FinalApproval: C r-, ... iL- 1 - )�O(
f1
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