Loading...
HomeMy WebLinkAboutBLD2001-00001 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 #: BLD01-00001 Received Date 1/2/2001 SITE ADDRESS: 171 WHITNEY RD Issue Date 1/2/2001 QUILCENE, 98376 Expiration Date 1/2/2002 APPLICANT: ARLENE I HANSEN PHONE: (360)765-4967 C/O MARY KAY HUDSON 171 WHITNEY RD QUILCENE WA 98376 2 SUBDIVISION: BRYANT SHORT PLAT#2 Block: Lot: PARCEL NUMBER: 601273016 Section: 27 Township: 26N 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 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 01/02/2002. REQUIRED INSPECTIONS: VTank/Lin ppliance: 641 6�, m, .-' l et/ FinalAppr 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. HOT LINE AVAILABLE 24 HOURS A DAY BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00001 Received Date: 1/2/2001 SITE ADDRESS: 171 WHITNEY RD QUILCENE, 98376 APPLICANT: ARLENE I HANSEN PHONE: (360)765-4967 C/O MARY KAY HUDSON 171 WHITNEY RD QUILCENE WA 98376 SUBDIVISION: BRYANT SHORT PLAT#2 Block: Lot: 2 PARCEL NUMBER: 601273016 Section: 27 Township: 26 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 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK INSTALLATION 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: Shoreline Aquifer Forest: Commercial Rural —Proximity - Flat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $46.00 MAM 01/02/01 37197 Total: $46.00 is\F_BLD_App_Bld.rpt 10/29/19 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER SITE DDRESS: 911#/ROAD OAD NAME / ? / i'.1f G'I 1 dei) ,( 1t c. • / ,ram 9- ZIP 9 DIGIT PARCEL ID NUMBER b/ 5/ Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM r't/-, k,4.APPLICANT PHONE _5 © ? ,_ '79 ; 7 MAILING ADDRESS / 7 / rL)G- -,( T-F"l._.e ., s4) ZIP / e .-737 y PROPERTY OWNER /4>" ��-t� -�. /4 PHONE:. 6,0 7�-9. 96 7 MAILING ADDRESS J' CTV'i ZIP CONTRACTOR C€Y' k PHONE MAILING ADDRESS ZIP 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. )11a APPLICANT SIGNATURE DATE / / (/. / v/ 71 FOR OFFICE USE ONLY BASE FEE 1 f e RECEIPT# 3 ) Li // CASH/CK# ? ,C j TOTAL 41L7 "-- DATE l / 2./ I H:\HOME\PLNCNTR\FORMS\lNSTALL.DOC 10/99