HomeMy WebLinkAboutBLD2000-00797 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 #: BLD00-00797 Received Date 12/11/2000
SITE ADDRESS: 731 MOUNTAIN VIEW RD Issue Date 12/12/2000
QUILCENE, 98376 Expiration Date 12/12/2001
APPLICANT: JANICE R DINESEN PHONE: (360)765-3925
731 MOUNTAIN VIEW RD
QUILCENE WA 98376-9526
Ti
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 701292017 Section: 29 Township: 27N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2001
OWNER,
if different:
PROJECT DESCRIPTION PROPANE TANK, GAS PIPE & HEAT 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 12/12/2001.
REQUIRED INSPECTIONS:
�a1Sfc7Line/Appiianc er)/e'- %/�� /G ,
[� t=iriaT/�pprova�'^+ �c // j f r
_C-1""
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 #: BLD00-00797 Received Date: 12/11/2000
SITE ADDRESS: 731 MOUNTAIN VIEW RD
QUILCENE, 98376
APPLICANT: JANICE R DINESEN PHONE: (360)765-3925
731 MOUNTAIN VIEW RD
QUILCENE WA 98376-9526
SUBDIVISION: Block: Lot: T 1
PARCEL NUMBER: 701292017 Section: 29 Township: 27 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP`077QP Expires 11/17/2001
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: PROPANE TANK, GAS PIPE & HEAT STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: 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
Type Amount Paid By: Date: �rReceipt Plat dons
Receipt:
Propane Tanks/Stoves $48.00 MAM 12/11/00 35537
Total: $48.00
is\F_BLD_App_Bld.rpt 10/29/99
1�1y12 4EJEFFERSON COUNTY PERMIT CENTER. 621 SHERIDAN ST< PORT'TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE r/ PROPANE TANK PELLET !/ / _STOVE OTHER 2. f'-4-
SITE ADDRESS:
911# OAD NAME 73 ' ! '/Ou�- h
h1ai I�iJ t
R
Qcc.rCc 1.3c,�
9 DIGIT PARCEL ID NUMBER 7 ° 1 2 q O/ /
Legal Description:
Subdivision Name
Block Lots)
Section Township North, Range WM
APPLICANT j�( r 1'd 1I n L C���
PHONE 76.1 _3 9-2-3—
MAILING ADDRESS SD
ZIP
PROPERTY OWNER r I( �
• ,/' PHONE
MAILING ADDRESS
ZIP
CONTRACTOR Sl...y) S H In@ Pao p _
PHONE 3 8�' 579 7
MAILING ADDRESS (0 $5 3 R1-1-o 0 0 2 .
Porr N- �c cic c ?c. .
STATE LICENSE # ���S�,p O��Q P
EXP. DATE_______I Or 1
FEDERAL I.D. # 91_ 10 q 7 8 S7
APPLICANT SIGNATURE
l DATE 1)_ / / _ _
FOR OFFICE USE ONLY
BASE FEE �?
RECEIPT #
CASH/CK # 73�a-
TOTAL __ UD > �,Ol
- DATE /G/ /I/
H:\HOME\PLNCN TR\FORMSUNSTALL.0004/98