HomeMy WebLinkAboutBLD2000-00362 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 #: BLD00-00362 Received Date 6/7/2000
SITE ADDRESS: CEDAR Issue Date 6/7/2000
PORT HADLOCK, 98339 Expiration Date 6/7/2001
APPLICANT: JULIE ROGERS PHONE: (360)385-4029
190 CEDAR AVE
PORT HADLOCK WA 98339
21,22
SUBDIVISION: HAYDEN'S SUP TO SOUTH PT Block: 1 Lot:
PARCEL NUMBER: 958800106 Section: 02 Township: 29N Range: 01W
CONTRACTOR: R & S SALES AND SERVICE PHONE: (360)385-5564
PO BOX 708
CHIMACUM WA 98325
Contractor's License RSSALS*022PB Expires 10/01/2000
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK&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 06/07/2001.
REQUIRED INSPECTIONS:
[ IL/Tank/Line/Appliance:
7
[ V FinalApproval: 6 170\7421
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 #: BLD00-00362 Received Date: 6/7/2000
SITE ADDRESS: CEDAR
PORT HADLOCK, 98339
APPLICANT: JULIE ROGERS PHONE:
190 CEDAR AVE
PORT HADLOCK WA 98339
(360)385-4029
SUBDIVISION: HAYDEN'S SUP TO SOUTH PT Block: 1 Lot: 21,22
PARCEL NUMBER: 958800106 Section: 02 Township: 29 N Range: 01 W
CONTRACTOR: R & S SALES AND SERVICE PHONE: (360)385-5564
PO BOX 708
CHIMACUM WA 98325
Contractor's License RSSALS*022PB Expires 10/01/2000
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK & STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE: PRO
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: 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
—PrQximity - I-'lat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 LMB 06/07/00 31617
Total: $48.00
I:\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE X PROPANE TANK PELLET STOVE OTHER --cec_ � j19 CG,f'ylf ‘4-rs -64 v'e-
SITE ADDRESS:
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2 e / r 17
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7,
9 DIGIT PARCEL ID NUMBER O r�eo/G 6
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT /e ,. .c S,9-/eS /-40-t/ Ser !C ''_ PHONE .Jj9'-S'5/a 57
MAILING ADDRESS IPA ,$o1 k , 4
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PROPERTY OWNER JLt/%' dy(? f - PHONE 3�S - LP Z 1
MAILING ADDRESS /ye j jC'e liff � )
d /4ws�y� 4(/�' ki)l/i4 ZIP FcG.S8,?,
CONTRACTOR /C .V-C. --C;51-/4-( ,7.-100/ -C 1/i e'r PHONE ,?O/-//2 Z.
MAILING ADDRESS fpol, id 2( 7 ,gi t
C/ 1 JfrZ 4, C a jyt_ h /G4 !ZIP Cr2v2
STATE LICENSE# CC 14b4116. if -5-S f�/,5 72 2 Pi3 EXP. DATE ru/00e)
FEDERAL I.D. # 'O/ W S' c / eel' cCO
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 Z7-7 /Z--- / DATE ce I C
FOR`OFFICE USE ONLY
BASE FEE
EE RECEIPT#: Ii tf t a').
CASHi�K,�
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TOTAL DATE .'.;."/(.
H:\H O ME\PLN CNTR\FORMS\INSTALL.DO C 10/99