HomeMy WebLinkAboutBLD2000-00614 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 #: BLD00-00614 Received Date 9/22/2000
SITE ADDRESS: -2c 1. 4S3 LILLIAN ST Issue Date 9/22/2000
CHIMACUM, 98325 Expiration Date 9/22/2001
APPLICANT: JACK L HIRSCHEL PHONE:
MAXINE HIRCHEL
202 LILLIAN ST
PORT HADLOCK WA 98339 T 1,2
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901101007 Section: 10 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& PIPING 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 09/22/2001.
REQUIRED INSPECTIONS:
[ Tank/Lln /Appliance: _-3() t.S') O 1< <V , -c$
11/
FinalAppro I: 1 L/ / B,G Aidi
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 PERMI jAPPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00614 Received Date: 9/22/2000
SITE ADDRESS: 2/1.63 LILLIAN ST
CHIMACUM, 98325
APPLICANT: JACK L HIRSCHEL PHONE:
MAXINE HIRCHEL
202 LILLIAN ST
PORT HADLOCK WA 98339
SUBDIVISION: Block: Lot: T 1,2
PARCEL NUMBER: 901101007 Section: 10 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 & PIPING 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: 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
Type Amount Paid By: Date: —Proximity
Approved/Date dons
p �
Propane Tanks/Stoves $48.00 MAM 09/22/00 34361
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERID.A4ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER t I^
SITE ADDRESS: C
911#/ROAD NAME 11 p. LL_ / )L�,1/� 3+•
l
Poi 1 �1anit t 1pct. ZIP 11: 1
9 DIGIT PARCEL ID NUMBER Go I I a J 30 ri
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT inn a •Ll_ l `0 I r Y 1--Q'__` PHONE Y IO
MAILING ADDRESS c2 _0 A �
Vc;1-V ` CI1.bC_1C ZIP
PROPERTY OWNER JQ Vyl--Q PHONE
MAILING ADDRESS
ZIP
CONTRACTOR 1\ T J S -t(J S -'11 Lit CA) PHONE � CD 11 �?
MAILING ADDRESS PO e-)O k 7108
Y 1I VY C iAir) ZIP 01 Bs . J
STATE LICENSE # C n I J 1, )E S3 ) C 34-02V&P. DATE l 0 "- I - C)CD
FEDERAL I.D. # O ' G a 5 3J1� 1 �J
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.
(-fora pp u cQn4-)
APPLICANT SIGNATURE t-L ( 1 f)n DATE n{ / d /
FOR OFFICE USE ONLY
BASE FEE RECEIPT#
CASH/CK#
TOTAL DATE / /
H:\HO ME\PLNCNTR\FORMS\INSTALL.DOC 10/99