HomeMy WebLinkAboutBLD2000-00183 •
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 #: BLD00-00183 Received Date 3/23/2000
SITE ADDRESS: 5761 CAPE GEORGE RD Issue Date 3/24/2000
PORT TOWNSEND, 98368 Expiration Date 3/24/2001
APPLICANT: NORA CALDWELL PHONE: (360)379-4748
5761 CAPE GEORGE RD
PORT TOWNSEND WA 98368
6
SUBDIVISION: DISCOVERY RIDGE DIV II Block: Lot:
PARCEL NUMBER: 001195006 Section: 19 Township: 30N Range: 01W
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 06/01/2000
OWNER, NORA CALDWELL PHONE: (360)379-4748
if different: 5761 CAPE GEORGE RD
PORT TOWNSEND WA 98368
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 03/24/2001.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval: 7 /C )A-" 4;
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
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00183 Received Date: 3/23/2000
SITE ADDRESS: 5761 CAPE GEORGE RD
PORT TOWNSEND, 98368
APPLICANT: NORA CALDWELL PHONE: (360)379-4748
5761 CAPE GEORGE RD
PORT TOWNSEND WA 98368
SUBDIVISION: DISCOVERY RIDGE DIV II Block: Lot: 6
PARCEL NUMBER: 001195006 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: CENEX SUPPLY & MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 06/01/2000
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: STORMWATER: YES NO AREA
BEDROOMS: BATHROOMS: Wetland Erosion
Exist: Exist: Seismic Streams
Prop: Prop: Flooding Landslide
Total: Total: F&W Plat Conditions
Shoreline Aquifer
Routing Date: Forest: Commercial Rural
Proximity
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 03/23/00 25524
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMU TY DEVELOPMENT, 621 3ifiE=1 , PORT TOWNSEND WA 98368 PH: 1360) 379-4450
STALLATION PERMIT APPLICATION
WOODSTOV 7( PROPANE TANK ELLET STOVE OTHER
SITE ADDRESS: //// c �.
911#/ROAD NAME C� / to , C1 . -U
Q`r l t/V-7 (-ZIP 1()
9 DIGIT PARCEL ID NUMBER C (31 t q, c 00 L0
Legal Description:
Subdivision Name Block Lot(s)
Section Township North ange W I�
APPLICANT K.)6\(ct. ( Q /"eL\ PHONE
MAILING ADDRESS `)101 CCA' , �� T r 9
p'11 uk) ZIP ( Cl (__
-3
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP
CONTRACTOR (y E' t e 4. 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 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 entry to the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE DATE / - / C)Cs)
FOR OFFICE USE ONLY
BASE FEE o o
�L (1 j RECEIPT.# -
CASHACK# e
H:\HO ME\PLNCNTR\FORMS\INSTALL.DOC 10/99