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HomeMy WebLinkAboutBLD2000-00649 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 #: BLD00-00649 Received Date 10/4/2000 SITE ADDRESS: 91 RANDOLPH ST Issue Date 10/4/2000 PORT HADLOCK, 98339 Expiration Date 10/4/2001 APPLICANT: RENEE M TALLEY PHONE: (360)385-0988 PO BOX 698 PORT HADLOCK WA 983390698 5&6 SUBDIVISION: PORT HADLOCK Block: 2 Lot: PARCEL NUMBER: 989400205 Section: 1 Township: 29N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/01/2001 OWNER, RENEE M TALLEY PHONE: (360)385-0988 if different: PO BOX 698 PORT HADLOCK WA 983390698 PROJECT DESCRIPTION PROPANE TANK INSTALLATION 1— f'/ © F',9/`/!q a5 7-6 iJ T 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 10/04/2001. REQUIRED INSPECTIONS: [%] ne/Appliance:] / (/< 7— C_ //V O/C /b (f)O oi_d_..7 [1( FinalApproval: 0 K C. /©'�.--0 / 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 r BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00649 Received Date: 10/4/2000 SITE ADDRESS: 91 RANDOLPH ST PORT HADLOCK, 98339 APPLICANT: RENEE M TALLEY PHONE: (360)385-0988 PO BOX 698 PORT HADLOCK WA 983390698 SUBDIVISION: PORT HADLOCK Block: 2 Lot: 5&6 PARCEL NUMBER: 989400205 Section: 1 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 09/01/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK 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: �rReceilpt Plat a ateons Receipt: PP Conditions Propane Tanks/Stoves $48.00 MAM 10/04/00 34522 Total: $48.00 is\F_BLD_App_Bld.rpt 10/29/99 r JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (3601 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE X PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: 2/iN^�)! P� 7 911#/ROAD NAME / /,C/v , - �/y� J gQ' #2 b Lz[ Lt.)i t ZIP ✓ G ?..5 9 DIGIT PARCEL ID NUMBER Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT PHONE MAILING ADDRESS ZIP PROPERTY OWNER &th / /(E ;1 1.1 PHONE Ja S -0988 MAILING ADDRESS 9/ 2/9/4 POL 11-7lA`-D ce. w ZIP YF,)3, CONTRACTOR (4/1 PHONE — ��-3 MAILING ADDRESS �Q Qom/ C.> �� J Q Q? t / ♦/�ct4 U. i/ ZIP 9�J J-.)S STATE LICENSE# EXP. DATE 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 SIGNATUR DATE 0-1/./..4// • FOR OFFICE USE ONLY BASE FEE RECEIPT# j CASH/CK# TOTAL DATE tri b H:\HOME\PLNCNTR\FORMS\I NSTALL.DOC 10/99