Loading...
HomeMy WebLinkAboutBLD2000-00703 { 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 #: BLD00-00703 Received Date 10/24/2000 SITE ADDRESS: 1145 DEER CREEK RD Issue Date 10/25/2000 QUILCENE, 98376 Expiration Date 10/25/2001 APPLICANT: ALAN HAWS PHONE: (425)557-1963 JANA HAWS 23506 SE 8TH ST SAMMAMISH WA 98074 1 SUBDIVISION: DRYDEN SHORT PLAT Block: Lot: PARCEL NUMBER: 601032023 Section: 3 Township: 26N Range: 01W CONTRACTOR: FERRELLGAS (NorthwesttVChimney) PHONE: 1-888-933-7735 PO BOX 67 HOODSPORT WA 98548 Contractor's License NORTHCS101CB Expires 01/24/2001 OWNER, ALAN HAWS PHONE: (425)557-1963 if different: JANA HAWS 23506 SE 8TH ST SAMMAMISH WA 98074 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 10/25/2001. REQUIRED INSPECTIONS: [ U Tank/Line/AppTian 7'9/%!k�� JNr �¢- �=X. 7" c_ /C r [ ,] inalApprova /cI /f 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 #: BLD00-00703 Received Date: 10/24/2000 SITE ADDRESS: 1145 DEER CREEK RD QUILCENE, 98376 APPLICANT: ALAN HAWS PHONE: (425)557-1963 JANA HAWS 23506 SE 8TH ST SAMMAMISH WA 98074 SUBDIVISION: DRYDEN SHORT PLAT Block: Lot: 1 PARCEL NUMBER: 601032023 Section: 3 Township: 26 N Range: 01 W CONTRACTOR: FERRELLGAS PHONE: 1-888-933-7735 PO BOX 67 HOODSPORT WA 98548 Contractor's License NORTHCS101CB Expires 01/24/2001 ARCHITECT/ Northwest Chimney ENGINEER : 510 Dekalb STE D Port Orchard, WA 98366 NORTHCS101CB 1 /24/2001 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 1'r xlmlty - Nlat Conditions Type Amount Paid By: Date: Receipt: Approvewvate Propane Tanks/Stoves $48.00 MAM 10/24/00 34619 Total: $48.00 is\F_BLD_App_Bid.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLA.TION PERMIT APPLICATION WOODSTOVE ,, PROPANE TANK PELLET STOVE OTHER ?CO r Me 340V-c SITE ADDRESS: / /- p 911#/ROAD NAME �r^�/ 4,5 O�� c �e(t.- k /) I_ q p C..i�(J.' /c e„ t (,v ) ZIP !O 3 7c 9 DIGIT PARCEL ID NUMBER l�j('�/ 0 31 23 Legal Description: Subdivision Name Block Lotls) Section Township North, Range WM APPLICANT GG✓• //6(J S PHONE 744 MAILING ADDRESS 2, 3 S 0 6 :S-; ? p/� J Cr {t't hela r»•t r*,J L f ZIP (?f©I cf PROPERTY OWNER 7�"' [G:n jTG(i✓J S PHONE 17,-),C- S S 7' /9 C3 MAILING ADDRESS 235 0 6 S .. J� 7L4 c sp rn .+'t f(oft. t /n/J1' 9 s Y:7I4 --- ZIP 9 0 7 CONTRACTOR A/t9(4& �J'.& C4.01 n � PHONE 36 V 1(�� 5)24. MAILING ADDRESS 5/0 rr 4�-t / l LJ Sf-e (©� t ore 4 (nJ 4 ZIP 9,34 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 t the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE („A—.) DATE /O / y / Cam' FOR OFFICE USE ONLY BASE FEE RECEIPT# � CASH/CK# Cf Si TOTAL DATE 1 v/Z3/dV H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99 gw oa •1-03