HomeMy WebLinkAboutBLD2000-00317 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 #: BLD00-00317 Received Date 5/22/2000
SITE ADDRESS: 2363 OLD GARDINER RD Issue Date 5/22/2000
SEQUIM, 98382 Expiration Date 5/22/2001
APPLICANT: DEANNE HILL PHONE: (360)797-7290
2363 OLD GARDINER RD
SEQUIM WA 983828704
2
SUBDIVISION: GATCHET SHORT PLAT#2 Block: Lot:
PARCEL NUMBER: 002352029 Section: 35 Township: 30N Range: 02W
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License CENEXHS022NQ Expires 06/01/2000
OWNER, DEANNE HILL PHONE: (360)797-7290
if different: 2363 OLD GARDINER RD
SEQUIM WA 983828704
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 05/22/2001.
REQUIRED INSPECTIONS:
["J Line/Appliance: "57 a-L9-(7 n( L<: �
['j Fi nalApproval: .77(11-)A ACCetic (') 1 �c
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 #: BLD00-00317 Received Date: 5/22/2000
SITE ADDRESS: 2363 OLD GARDINER RD
SEQUIM, 98382
APPLICANT: DEANNE HILL PHONE: (360)797-7290
2363 OLD GARDINER RD
SEQUIM WA 983828704
SUBDIVISION: GATCHET SHORT PLAT#2 Block: Lot: 2
PARCEL NUMBER: 002352029 Section: 35 Township: 30 N Range: 02 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
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 Flood Plane
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
—Proximity - Neat Conditions
Type Amount Paid By: Date: Receipt: Approved/pate
Propane Tanks/Stoves $48.00 MAM 05/22/00 30890
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS:
9 1#ROAD NAME b.3 aid l5 01/4 Al.et4 VCR+
�e�u.'.�►�+ !N 4 ZIP 5!83/ 8
9 DIGIT PARCEL ID NUMBER 002-- + 35-1- • ()-2 1
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT l Gia/A•/C f I/ PHONE 36c' 7 97
MAILING ADDRESS
ZIP
PROPERTY OWNER PHONE
MAILING ADDRESS ' SdilewSe
ZIP
CONTRACTOR CeA )4 21 rip„s.7^"' PHONE3-0 7J . 40/4"--45—
MAILING ADDRESS P O, L?o,C QV
wit}• ZIP s12P3 .
eE)< O,� Crb STATE LICENSE# � 4/.5 a (� EXP. DATE '^ t co a
FEDERAL I.D. # �1
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 attorneys 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
un
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 --.,< / ate, c'i O
FOR OFFICE USE ONLY
BASE FEE � cam- - °�RECEIPT#�,
3Ot161
.
CASH/CK#
TOTAL DATE ? 1
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