HomeMy WebLinkAboutBLD2001-00532 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 #: BLD01-00532 Received Date 9/20/2001
SITE ADDRESS: 2603 CENTER RD Issue Date 9/20/2001
CHIMACUM, 98325 Expiration Date 9/20/2002
APPLICANT: GEORGE NIEMINEN PHONE:
2603 CENTER RD
CHIMACUM WA 983259760
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901263003 Section: 26 Township: 29N Range: 01W
CONTRACTOR: HERITAGE FIREPLACE SHOP PHONE:
19410 VIKING AVAE
POULSBO WA 98370
OWNER, GEORGE NIEMINEN PHONE:
if different: 2603 CENTER RD
CHIMACUM WA 983259760
PROJECT DESCRIPTION PROPANE 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 09/20/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[,r Fi nalApproval:
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
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BUILDING PERMIT APPLICATION BRDOw00pe2
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00532 Received Date: 9/20/2001
SITE ADDRESS: 2603 CENTER RD
CHIMACUM, 98325
OWNER: GEORGE NIEMINEN PHONE:
2603 CENTER RD
CHIMACUM WA 983259760
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901263003 Section: 26 Township: 29 N Range: 01 W
CONTRACTOR: HERITAGE FIREPLACE SHOP PHONE:
19410 VIKING AVAE
POULSBO WA 98370
REPRESENTATIVE(S):
PROJECT DESCRIPTIO PROPANE 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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 PRB 09/20/01 30242
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT. 621 SHERIDAN ST. PORT TOWNSEND WA 98368 PHI_ (3601 37_9-4450
INSTALLATION PERMIT APPLICATION
020 pig-I/Ve-
WOODSTOVE PROPANE TANK 17STOVE OTHER
SITE ADDRESS: 6,0 QQ /D (ffn�M C vn2 W N ?a 3 2 I
911#/ROAD NAME 3 ��T�F-
�yy� ZIP
630 9 DIGIT PARCEL ID NUMBER 0 t L._.b 3
Legal Description:
Subdivision Name Block Lot(s)
Section ZEp Township 21 rr North, Range l WM
APPLICANT 6- -0/e E' /1%e/I7/,vJ.v PHONE 5 d a 7 3 Z
MAILING ADDRESS -5A 0 E A-1 A i+a dLc
ZIP
PROPERTY OWNER 54/ne. PHONE
MAILING ADDRESS
ZIP
CONTRACTOR /-t GQ/ T1I( rigfinlAGE SNP PHONE 3.0 77q J e 46
MAILING ADDRESS f� /D ///4KfAJ( /4i/s
p,1L5fSO vV 6 ZIP '/137°
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 anv
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 /�4'/j """
DATE �f / Z-o l 42,
FOR OFFICE USE ONLY
BASE FEE RECEIPT# 62
CASH/CK#
17 1
TOTAL 40-e/ DATE /0/ of
H:\HOMEPLNCNTR\FORMS\INSTALL.000 10/99