HomeMy WebLinkAboutBLD2001-00544 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 #: BLD01-00544 Received Date 9/27/2001
SITE ADDRESS: 11 ANDERSON ST Issue Date 9/27/2001
PORT HADLOCK, 98339 Expiration Date 9/27/2002
APPLICANT: JEFFREY GRAVES PHONE:
11 ANDERSON ST
PORT HADLOCK WA 98339-9632
44-48
SUBDIVISION: IRONDALE Block: 87 Lot:
PARCEL NUMBER: 961808704 Section: 34 Township: 30N Range: 01W
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License RSSALS*022PB Expires 10/01/2001
OWNER, BANK OF NY PHONE:
if different: 4837 WATT AVE #200
SACRAMENTO CA 95660
PROJECT DESCRIPTION Propane tank and heating 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 09/27/2002.
REQUIRED INSPECTIONS:
[ ] Tank/ ne/Appliance:c(7K _ l i I _c-,t
[ FinalApproval: 49/‹. 1 -'a.- 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.
HOT LINE AVAILABLE 24 HOURS A DAY
i:1F_BLD_Permit Propane.rpt 10/29/19
0-0
BUILDING PERMIT APPLICATION SReP8w ype 9
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00544 Received Date: 9/27/2001
SITE ADDRESS: 11 ANDERSON ST
PORT HADLOCK, 98339
OWNER: JEFFREY GRAVES PHONE:
11 ANDERSON ST
PORT HADLOCK WA 98339-9632
SUBDIVISION: IRONDALE Block: 87 Lot: 44-48
PARCEL NUMBER: 961808704 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585
PO BOX 518
AUBURN WA 98071-0518
Contractor's License RSSALS*022PB Expires 10/01/2001
REPRESENTATIVE(S):
PROJECT DESCRIPTIO Propane tank and heating 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:
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 Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 PRB 09/27/01 30454
Total: $48.00
JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST. PORT TOWN_SEND WA 98368 PH; (3601 379-4450
INSTALLATION PERMIT APPLICATION 624494(
WOODSTOVE X)PROPANE TANK PELLET STOVE OTHER 64.4
SITE ADDRESS:
911#/ROAD NAME l/ 4`(4/r/S'Qr')
I-L4kb ( k) ZIP 9e339
9 DIGIT PARCEL ID NUMBER 7t /30e 7 Q
Legal Description:
Subdivision Name Block Lotls)
Section Township North, Range WM
APPLICANT � ¢S Sid A--1 Pi- UlL PHONE 3'2 9 Sy 25'
MAILING ADDRESS A Q 76,g .
G h I w,a_C uA,\ W W ZIP l (n02Sr-
PROPERTY OWNER ZC f" f esS AN/e S PHONE 37?-e5'o
MAILING ADDRESS 6/ ESQ f
Atz_4-
44K4 f0 C- WV\ ZIP 9'833 7
CONTRACTOR WY'S pi- $evtiic` PHONE 371 sy2 9
MAILING ADDRESS )°,Q, Acsc , c�
c 4 I N'10.�U-M^- 1J A ZIP ?ea
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 DATE g / O' /
07.
FOR OFFICE U E ONLY
BASE FEE � RECEIPT#
CASH/CK# 4150
TOTAL E C LS E �l2-112I
7j)_ :.._.. a � � Cry
H:\HOMEIPLNCNTR\FORMS\INSTALL.DOC10/99
� 27 1
DEPT. OF COMMUNITY DEVELOPMENT