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HomeMy WebLinkAboutBLD2001-00117 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 #: BLD01-00117 Received Date 2/27/2001 SITE ADDRESS: 211 SETON RD Issue Date 2/27/2001 PORT TOWNSEND, 98368 Expiration Date 2/27/2002 APPLICANT: CA Al2- ES MOO PHONE: 9/ SUBDIVISION: KEARNEY'S PLAT Block: Lot: PARCEL NUMBER: 904800009 Section: 21 Township: 30N Range: 01W CONTRACTOR: OWNER, PHONE: if different: PROJECT DESCRIPTION Propane Tank 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 02/27/2002. REQUIRED INSPECTIONS: [ �F�and ine/Appliance:779/k/K O IC .3/224©t !..Lr-- [ proya c / 3/2.,2V tC:.- 2(q. 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 is\F_BLD_Permit_Propane.rpt 10/29/19 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00117 Received Date: 2/27/2001 SITE ADDRESS: 211 SETON RD PORT TOWNSEND, 98368 APPLICANT: GOA <S >u pu PHONE: SUBDIVISION: KEARNEY'S PLAT Block: Lot: 9/ PARCEL NUMBER: 904800009 Section: 21 Township: 30 N Range: 01 W CONTRACTOR: PHONE: PHONE: ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: Propane Tank TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 1997 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 Floodplain F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural —Proximity - Iiat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 PRB 02/27/01 38132 Total: $48.00 r' 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 ADDRESS: 2`( S� 911#/ROAD NAME C fV.. �' ( /QOtra�/�✓�CN�� ZIP 9 DIGIT PARCEL ID NUMBER 676 C/t- '' C�07 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range / WM APPLICANT r Cr�J- �4 (, f'.' yf�9K � PHONE 38 �e l98 MAILING ADDRESS ,° ItJr (S(AI S' L 64 {� r J!�/NJaC/v� ZIP 93‘0 PROPERTY OWNER `l/M / fj/lt-S / igaeri PHONE 39 7173 MAILING ADDRESS Z t 1 S' 7 i / /t/ (l/fif/V�v ✓�U ZIP 98�o-X/ CONTRACTOR PHONE MAILING ADDRESS , Q r ZIP STATE LICENSE# �=^�/` �— 1 o c7 �L-Ft 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. Z� d APPLICANT SIGNATURE t DATE / / FOR OFFICE'USE ONLY BASE FEE RECEIPT# 3 CASH/CK# i TOTAL DATE gi-7/ 0 l H.\HOME\PLNCNTR\FORMS\IN STALL.DOC 10/99