HomeMy WebLinkAboutBLD2000-00800 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 #: BLD00-00800 Received Date 12/12/2000
SITE ADDRESS: 195 ASH LOOP Issue Date 12/12/2000
PORT TOWNSEND, 98368 Expiration Date 12/12/2001
APPLICANT: GEORGE FISHER PHONE: 360-385-3494
195 ASH LOOP
PORT TOWNSEND WA 98368
11
SUBDIVISION: IRVING PARK ADDITION Block: 33 Lot:
PARCEL NUMBER: 963303303 Section: 17 Township: 30N 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,
if different:
PROJECT DESCRIPTION PROPANE TANK AND 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 12/12/2001.
REQUIRED INSPECTIONS:
l Tank/Line/Appliance: _ ; i :,
FinalApproval: ./ /iu t /o!/ / ` //- 0/
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 #: BLD00-00800 Received Date: 12/12/2000
SITE ADDRESS: 195 ASH LOOP
PORT TOWNSEND, 98368
APPLICANT: GEORGE FISHER PHONE: 360-385-3494
195 ASH LOOP
PORT TOWNSEND WA 98368
SUBDIVISION: IRVING PARK ADDITION Block: 33 Lot: 11
PARCEL NUMBER: 963303303 Section: 17 Township: 30 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 AND STOVE
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 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: i /7 CP t` Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/pate
a dteons
p � PP ��a e
Propane Tanks/Stoves $46.00 ZAN 12/12/00 35543
Total: $46.00
is\F_BLD_App_Bld.rpt 10/29/99
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4t50 '
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER P/2.v?AN e, S re,v e.
SITE ADDRESS:911#/ROAD NAME i
p1 S /i5/-f LooP
PeAT '1 oWal s'eN.D CO 14. ZIP q 8 3 1:.$
9 DIGIT PARCEL ID NUMBER { 4 3 3(>3 303
Legal Description:
Subdivision Name ( R V 1 N U' PA ADZ ADD ►'Tt 0 ry Block 33 Lotls) I — 2 + 3
Section 1 —1 Township 3C' North, Range 1 Ned WM
APPLICANT G eo1--C<- M . r 15 f"I C 2 PHONE.360 " 3v 5 — 3 4 cf 4
MAILING ADDRESS i. Ci As Ij Lvo
PORT fou//v5e.vD Wf4• ZIP cr .31✓8
PROPERTY OWNER Gc0 26-C h'1 . Ft 5 He R. PHONE_360 34?5 -3 L((4 Ll
MAILING ADDRESS (q S A S /_j L 00 p
1627 'Tou vs'eN D tt>4 . ZIP 7 36, a
-CONTRACTOR e, 'Jli E. X VA LL.€1 GSlpL y PHONE3(a0 `73 2 — 3-/., ri'
MAILING ADDRESS I1 Al F i sT, � t '?r►A c, 'yri / to .4-
ZIP / F.3 '
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.
APPLICANT SIGNATURE V
Crt-4‘2"-' DATE i/2 / /2 / Z 000
FOR OFFICE USE ONLY
BASE FEE a o
Yj0.- RECEIPT# ,__5 ---Y y,...3
// CASH/CK# C
TOTAL Y( O -O D DATE . / 2/ 12-t,o V
•
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