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HomeMy WebLinkAboutBLD2000-00665 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 #: BLD00-00665 Received Date 10/11/2000 SITE ADDRESS: 151 WILLOW ST Issue Date 10/11/2000 QUILCENE, 98376 Expiration Date 10/11/2001 APPLICANT: SASHA WEISS PHONE: (360)765-4288 151 WILLOW ST QUILCENE WA 98376 127 SUBDIVISION: Block: Lot: PARCEL NUMBER: 601334133 Section: 33 Township: 26N 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, SASHA WEISS PHONE: (360)765-4288 if different: 151 WILLOW ST QUILCENE WA 98376 PROJECT DESCRIPTION PROPANE TANK 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 10/11/2001. REQUIRED INSPECTIONS: [ an 4 ppliance: Ali /O I$/ th)c [ FinalApproval: D,& io/lcf`e f Ir� N�G►L 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 #: BLD00-00665 Received Date: 10/11/2000 SITE ADDRESS: 151 WILLOW ST QUILCENE, 98376 APPLICANT: SASHA WEISS PHONE: (360)765-4288 151 WILLOW ST QUILCENE WA 98376 SUBDIVISION: Block: Lot: 127 PARCEL NUMBER: 601334133 Section: 33 Township: 26 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 VALUATION MAIN: CODE EDITION: ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 1-'roximlty - Neat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 10/11/00 34657 Total: $48.00 is\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 7 PROPANE TANK s PELLET STOVE OTHER SITE ADDRESS: /c7 )f () 911#/ROAD NAME /J��/ © p'p �M'I/L�Z�C/L� ko ZIP 2O ft -71� 9 DIGIT PARCEL ID NUMBER 1p o` ' ; Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT $yi4 ` ! PHONE 7 �02 iFsis MAILING ADDRESS / / 01,0 c _37- 41_, aZ'-3/�_ L4- s41 Z I P 43 76 PROPERTY OWNER 09S-4IIJ I S S PHONE MAILING ADDRESS /5/ }/ L LOld 5 r- ^7 C r�/2��2 lilJ +� ZIP ,V 5-./ CONTRACTOR 79 [� PHONE MAILING ADDRESS 734 - /A F4 ZIP 9e3c9s 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. _•e 14 Jy DATE / / // / APPLICANT SIGNATUR FOR OFFICE USE ONLY BASE FEE RECEIPT# 39(.5 q. CASH/CK# f-"`0 TOTAL DATE ID it / H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99