HomeMy WebLinkAboutBLD2001-00270 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 #: BLD01-00270 Received Date 5/11/2001
SITE ADDRESS: 51 OLD CHURCH RD Issue Date 5/11/2001
QUILCENE, 98376 Expiration Date 5/11/2002
APPLICANT: SCOTT ABBOTT PHONE: 360-765-4447
ANNE RICKER
1160 E QUILCENE RD
QUILCENE WA 98376 17
SUBDIVISION: WORTHINGTON'S Block: 2 Lot:
PARCEL NUMBER: 999800212 Section: 24 Township: 27N Range: 02W
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 AND COOK 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 05/11/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Li /Appliance: 7 f7NIC/ L±X T rofc
[ 11'' FinalApproval: L
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
i:\F_BLD_Permit_Propanespt 10/29/19
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00270 Received Date: 5/11/2001
SITE ADDRESS: 51 OLD CHURCH RD
QUILCENE, 98376
APPLICANT: SCOTT ABBOTT PHONE: 360-765-4447
ANNE RICKER
1160 E QUILCENE RD
QUILCENE WA 98376
SUBDIVISION: WORTHINGTON'S Block: 2 Lot: 17
PARCEL NUMBER: 999800212 Section: 24 Township: 27 N Range: 02 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 INSTALLATION AND COOK STOVE
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION MAIN:
CODE EDITION: 1997 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 Floodplain
F&W
Routing Date: -4Shoreline Landslide
Aquifer
�'�� r _.__ Forest: Commercial gRural
—Proximity - Plat C; d tions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 ZAN 05/11/01 40059
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (360) 379-4450 ,
INSTALLATION PERMIT APPLICATION
WOODSTOVE - PROPANE TANK PELLET STOVE OTHER L d'OGS 4 "l-
SITE ADDRESS: /
911#/ROAD NAME 3 aid e 4 v iC� 1 P V
62utt,ene_ &'A. - ZIP 58-3
9 DIGIT PARCEL ID NUMBER ", 0e a /
Legal Description:
Subdivision Name (t1 c f 1 ,ra '(E rf < Block Lot(s)/ /fc ig-(,s o,
Section Township North, Range WM
APPLICANT 4..1 >h.e derC-Ae PHONE 7G S - 1/-%2/ 7
MAILING ADDRESS /7) CJ /3 ,r.
6z /revtc W � ZIP pf J'
PROPERTY OWNER 711,4 [ r (° PHONE / G S-- `/C/f
MAILING ADDRESS or-6 B,C o2 & 5
6✓ t ice.ri l , 4,1 ZIP 7 t? c` 7.6
CONTRACTOR CnE Y r -) PHONE 3406
MAILING ADDRESS ' lE — 2 Q
`-71 / ' ` ZIP
STATE LICENSE# . Q EXP. DATE Ci ' / .O (
FEDERAL I.D. # 4// 0 2 5 t OQ1 SI
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.
i1
APPLICANT SIGNATURE DATE - l i j / ;ii 6.+1
FOR OFFICE USE ONLY
BASE FEE "" RECEIPT# q
CASH/CK# '
TOTAL - 00 DATE _D l/( 1 ,`
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