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HomeMy WebLinkAboutBLD2000-00655 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 #: BLD00-00655 Received Date 10/6/2000 SITE ADDRESS: 10347 RHODY DR Issue Date 10/6/2000 CHIMACUM, 98325 Expiration Date 10/6/2001 APPLICANT: CRAIG VAN NESS PHONE: (360)385-5443 MARIA M VAN NESS 10347 RHODY DR CHIMACUM WA 983258710 T 53 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901101042 Section: 10 Township: 29N Range: 01W CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/01/2001 OWNER, CRAIG VAN NESS PHONE: (360)385-5443 if different: MARIA M VAN NESS 10347 RHODY DR CHIMACUM WA 983258710 PROJECT DESCRIPTION PROPANE TANK&STOVE 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 10/06/2001. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: '-3nhS.Z-; i% -4 g7-1-re,) [.] FinalApproval: ©KU C- 10-1L-op 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 #: BLD00-00655 Received Date: 10/6/2000 SITE ADDRESS: 10347 RHODY DR CHIMACUM, 98325 APPLICANT: CRAIG VAN NESS PHONE: (360)385-5443 MARIA M VAN NESS 10347 RHODY DR CHIMACUM WA 983258710 SUBDIVISION: Block: Lot: T 53 PARCEL NUMBER: 901101042 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/01/2001 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK & STOVE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 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 F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural —Proximity - Plat C; d dons Type Amount Paid By: Date: Receipt: Approved) ate Propane Tanks/Stoves $48.00 MAM 10/06/00 34531 Total: $48.00 is\F_BLD_App_Bld.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: 1360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER rioA r 1, 3—Dv e SITE ADDRESS: 911#/ROAD NAME .�'%' V7 /2///� Si /7//'),7 C.t� y�L L c✓G9. ZIP 9f 3 2 9 DIGIT PARCEL ID NUMBER 476// " /‘1-/ — L?6/?- Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT 1G�/i 'I`- C)7L�/� y/� "Pv, /ClesS. PHONE L_ el ev"f% MAILING ADDRESS ./d 3 C-/--7 ,e/1 -4 • ,- &/2/7( 6? el l// • ZIP ? i PROPERTY OWNER flc , r�S PHONE /�d-Z.�� C ��.��d-)-� a MAILING ADDRESS �{ r� L l U�_ ZIP CONTRACTOR ! .2-Q, PHONE c � MAILING ADDRESS 5 � ZIP 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 SIGNATURE /' t,e.—/ DATE/G' / Z./ / 27D FOR OFFICE USE ONLY BASE FEE RECEIPT# t CASH/CK'# 9 S TOTAL + -fjc /�, DATE Cj ` t) H:\H OME\PLNCNTR\FORMS\IN STALL.DOC 10/99