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HomeMy WebLinkAboutBLD2000-00748 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 #: BLD00-00748 Received Date 11/20/2000 SITE ADDRESS: 961 CENTER VALLEY RD Issue Date 11/21/2000 CHIMACUM, 98325 Expiration Date 11/21/2001 APPLICANT: JAMES NIQUETTE PHONE: 8411 104TH ST NW GIG HARBOR WA 98332-6848 T3 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901232011 Section: 23 Township: 29N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING TANK PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License RSSALS*022PB Expires 10/01/2001 OWNER, 12 + L5 Sdki — 3TDVE if different: 9_55A-LS 012_Pj (pIoI //oat PROJECT DESCRIPTION PROPANE TANK& STOVE 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 11/21/2001. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: t^ C \1 'Zz FinalApproval: I - 1 ) -Z.2 -0 a 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 #: BLD00-00748 Received Date: 11/20/2000 SITE ADDRESS: 961 CENTER VALLEY RD CHIMACUM, 98325 APPLICANT: JAMES NIQUETTE PHONE: 8411 104TH ST NW GIG HARBOR WA 98332-6848 SUBDIVISION: Block: Lot: T 3 PARCEL NUMBER: 901232011 Section: 23 Township: 29 N Range: 01 W CONTRACTOR: CENEX SUPPLY& MARKETING TAt•3 PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License RSSALS*022PB Expires 10/01/2000 ARCHITECT/ I2 # S Sa les S1-DVE ENGINEER : PROJECT DESCRIPTION: PROPANE TANK & STOVE 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: 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: �rReceilpt: Approved/Date ons Propane Tanks/Stoves $48.00 MAM 11/20/00 34584 Total: $48.00 is\F_BLD App_Bld.rpt 10/29/99 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 i INSTALLA.TION PERMIT APPLICATION O WOODSTOVE X PROPANE TANK PELLET STOVE ) OTHER Az,,1,714.e../iitf‘ J t s/'I` S1 ADDRESS: J C � ,6 ��// 911 76/#/ROAD NAME / ��j/mot.t-a An, W14 ZIP 7 f f 2- S'--- 9 DIGIT PARCEL ID NUMBER 90/ a.Z,3„7 D// s''(..- Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT AST <12-AS ,qi O _(-e c1///G € PHONE _' Q`~"//Z Z.- MAILING ADDRESS Pin Dx 7DE'' h f 11GZ 414,\ ZIP 9'g3.7 r- PROPERTY OWNER --U %!�/-1. /,� ' PHONE , ,Cr 3 O j SAD (� MAILING ADDRESS p�t I I I b y-+[S"!L` kl W 6i1 HaVbb(, WA ci i5332 W64$P CONTRACTOR /elS ..�.1z/S fjZAJ .---/'J, /ic e PHONE 377 SV/,? 7 MAILING ADDRESS le,;' , fi©}C 70 k /� Gila GGf i kik ZIP fe c,5.2Ss STATE LICENSE # /T Z) /C SS,4/S 022 P>r3 EXP. DATE /%//20o f FEDERAL I.D. # O7 9®3 rf QCi/ Zi 7d/ 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 � `//Z7 DATE %/ / /7 / 1 FOR OFFICE USE ONLY qUBASE FEE RECEIPT# .. - 8 CASH/CK# TOTAL D c-9---U DATE - 0 La'00 H:\HOME\PLNCNTR\FORMS\INSTALL.DOC 10/99