HomeMy WebLinkAboutBLD2000-00323 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 #: BLD00-00323 Received Date 5/25/2000
SITE ADDRESS: 2390 ANDERSON LAKE RD Issue Date 5/25/2000
CHIMACUM, 98325 Expiration Date 5/25/2001
APPLICANT: SHAWN D RUSSELL PHONE: (360)732-4226
PO BOX 293
CHIMACUM WA 98325
1
SUBDIVISION: RUSSELL SHORT PLAT Block: Lot:
PARCEL NUMBER: 901104020 Section: 10 Township: 29N 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 GAS HEAT STOVE & PIPE 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 05/25/2001.
REQUIRED INSPECTIONS:
[1 an Line/Appliance: 5. •
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[� 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 #: BLD00-00323 Received Date: 5/25/2000
SITE ADDRESS: 2390 ANDERSON LAKE RD
CHIMACUM, 98325
APPLICANT: SHAWN D RUSSELL PHONE: (360)732-4226
PO BOX 293
CHIMACUM WA 98325
SUBDIVISION: RUSSELL SHORT PLAT Block: Lot: 1
PARCEL NUMBER: 901104020 Section: 10 Township: 29 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: GAS HEAT STOVE & PIPE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 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
F&W Landslide
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Pr xlt - Plat Conditions
Type Amount Paid By: Date: Rmleceipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 05/25/00 31554
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
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JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER ,U (T'.4
SITE ADDRESS: j RUB
911#/ROAD NAME 6/0Catn /Y11— f/ ,e4 ilk
Ut lyit ,t j es_ ZIP gt3 25
9 DIGIT PARCEL ID NUMBER 9 o( I o - Dal C)
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT kit 4(A7 ' l L$5e_CdQ PHONE 73 Z '42')
MAILING ADDRESS 7 Pc oc,x c163
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PROPERTY OWNER k v" JJ PHONE
MAILING ADDRESS
ZIP
CONTRACTOR Sll✓l S H Ili Q. P 20 P A•44-Q_ PHONE 3 8, - 5717
MAILING ADDRESS (D g 5 3 Qt+ID O 02 .
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ZIP 5 3`(
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STATE LICENSE #
SL.c LI,S fF A4i4.. 07]Q P EXP. DATE l I /OC?_
FEDERAL I.D. # 9 l- I o g 7 8 SS7
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APPLICANT SIGNATURE �C.GI.r"0,- ,D(f)-, ' ay- / ( DATE 1/ / /7 / HIV
FOR OFFICE USE ONLY
BASE FEE (� (� RECEIPT # 3)55
D 1E C E �/]1 V E IsH/CK # 9-1 5 g
4TOTAL 6 .00 TE 5/25-/ OD
MAY 2 5 WOO
JEFFERSONA COUNTY
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DEPT. OF COMMUNITY DEVELOPMENT