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HomeMy WebLinkAboutBLD2000-00187 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 #: BLD00-00187 Received Date 3/27/2000 SITE ADDRESS: 1275 SR20 Issue Date 3/27/2000 PORT TOWNSEND, 98368 Expiration Date 3/27/2001 APPLICANT: JOHN M VINCENT PHONE: 1275 HWY 20 PORT TOWNSEND WA 98368 5 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901193003 Section: 19 Township: 29N 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, if different: PROJECT DESCRIPTION PROPANE TANK& HEATING 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 03/27/2001. REQUIRED INSPECTIONS: [ `] Tank/ n ppliance [ ] FinalApproval: � � 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 #: BLD00-00187 Received Date: 3/27/2000 SITE ADDRESS: 1275 SR20 PORT TOWNSEND, 98368 APPLICANT: JOHN M VINCENT PHONE: 1275 HWY 20 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: 5 PARCEL NUMBER: 901193003 Section: 19 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 06/01/2000 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK & HEATING STOVE 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 Routing Date: Shoreline Aquifer Forest: Commercial Rural Proximity Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 03/27/00 25527 Total: $48.00 I:\F_BLD_App_Bld.rpt 10/29/99 t JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE / PROPANE TANK PELLET STOVE OTHER V\ P (`1, c+:.•�U - •... SITE ADDRESS: ,911#/ROAD NAME ._ 7S iL,t4)r O3© /9 ZIP 9*sg•-. 6 g 9 DIGIT PARCEL ID NUMBER ?o / ---/ / 3 _ 00 3 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT J 4Lk t.✓�r N[ ,Lfi PHONE Z60 �£�'�' �����✓ MAILING ADDRESS )�2.�� lj�w y p2CJ ,Po iz (1'`-'/9 ZIP -/ g PROPERTY OWNER PHONE MAILING ADDRESS "'— Y l ZIP CONTRACTOR � ��el 7- <;-:;�n7-et5 PHONE � O 7-k,;R��g�j MAILING ADDRESS Q 0'1747( Le "1-1 ZIP /c s. STATE LICENSE# Leh)��X /7 S O) �J C� EXP. DATE CJb L� /" 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 ' / 7 / e7L) .C � FOR OFFICE USE ONLY BASE FEE 7 RECEIPT# CASH/CK# TOTAL DATE J /i 0C) H:\HOME\PLNCNTR\FORMS\IN STALL.DO C 10/99