HomeMy WebLinkAboutBLD2000-00749 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 #: BLD00-00749 Received Date 11/20/2000
SITE ADDRESS: 1360 CHIMACUM RD Issue Date 11/21/2000
CHIMACUM, 98325 Expiration Date 11/21/2001
APPLICANT: NIQUETTE LIVING TRUST PHONE:2'33 s5 - 3-2--O
JAMES W NIQUETTE
8411 104TH ST NW
GIG HARBOR WA 983326848 T 45
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901142031 Section: 14 Township: 29N Range: 01W
CONTRACTOR: TANK: CENEX SUPPLY& MARKETING S-ravE : 2t S PHONE: (360)732-4585
PO BOX 518 SALE.3
AUBURN WA 98071-0518 Rssft�.s x-oz't.rr> ►o/oi /01
Contractor's License RSSALS*022PB Expires 10/01/2001
OWNER, NIQUETTE LIVING TRUST PHONE:
if different: JAMES W NIQUETTE
8411 104TH ST NW
GIG HARBOR WA 983326848
PROJECT DESCRIPTION PROPANE TANK& FREE STANDING 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 11/21/2001.
REQUIRED INSPECTIONS:
[ ] ' Tank/Line)/Appliance: ;(•) -s /A-17" f/ 7'o
[ Fi nalApproval: DX ./iar 4,/,4 //—/9 O/
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 #: BLD00-00749 Received Date: 11/20/2000
SITE ADDRESS: 1360 CHIMACUM RD
CHIMACUM, 98325
APPLICANT: NIQUETTE LIVING TRUST PHONE: 263 g5 t 3Z40
JAMES W NIQUETTE
8411 104TH ST NW
GIG HARBOR WA 983326848
SUBDIVISION: Block: Lot: T 45
PARCEL NUMBER: 901142031 Section: 14 Township: 29 N Range: 01 W
CONTRACTOR: CENEX SUPPLY & MARKETING — Tp/NI K PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License RSSALS*022PB Expires 10/01/2001
ARCH ITECT/
ENGINEER : S Sales - STONE_
PROJECT DESCRIPTION: PROPANE TANK & FREE STANDING 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 Ruraloo
Type Amount Paid By: Date: �rRecei�pt: Approved/Datey - ons
Total:
is\F_BLD_App Bld.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 ee°. .J41-1 C,j ,SQV 11 .
0
SITE ADDRESS:
911#/ROAD NAME /..:5 c me?4 11 yyi ‘seilMhbric11.
/2 YJ !f
C� 'A . ZIP /�I,��
9 DIGIT PARCEL ID NUMBER /D� /�fZ 23/
/
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT ,F',f S -s &/' �, 1/Ie--- e PHONE 20///z \,..
MAILING ADDRESS /40, ,&Ox' 7,g
C1i'me?LaG-1-t IAA< ZIP f,'•-.?-2
PROPERTY OWNER ,7✓JyJ /I// ! ' 3 PHONE .75 —.57S-/—3 y'O�
MAILING ADDRESS J/
ZIP
CONTRACTOR A91 -C c As n-f1Ci ..s-I/%C P PHONE "j Jr--- ,S /;,•2g
MAILING ADDRESS '0, ,3O,>c 7,0e
e..7,4 i rvLG[. e-(mac lei, 4,114:1 !ZIP ,3 S ---� �
STATE LICENSE # �C A•A&.. �5s,4-/SR * Dr?2fl.& EXP. DATE /07 j�COQ/
FEDERAL I.D. # 6 27 90 5' 3Ol 0®/ D00/
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 �7 ^ J"" - DATE /Of / if / 4,0
FOR OFFICE USE ONLY
..._
BASE FEE l G� RECEIPT#
CASH/CK #
TOTAL` DATE • / AO/00
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