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HomeMy WebLinkAboutBLD2001-00558 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 #: BLD01-00558 Received Date 10/3/2001 SITE ADDRESS: 10345 RHODY DR Issue Date 10/4/2001 CHIMACUM, 98325 Expiration Date 10/4/2002 APPLICANT: JAMES GREER JR PHONE: (360)385-3086 10343 RHODY DR CHIMACUM WA 98325 T 22 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901101013 Section: 10 Township: 29N Range: 01W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/06/2002 OWNER, CRAIG VAN NESS PHONE: if different: 10347 RHODY DR CHIMACUM WA 98325 PROJECT DESCRIPTION NO MLA REQ'D - PROPANE TANK INSTALLATION & 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 10/04/2002 REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance O kO—g--0 ( [ ] FinalApproval: ;`OK --J ;,,-._C a_y,,.- I L 4`1- cA 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 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00558 Received Date: 10/3/2001 SITE ADDRESS: 10345 RHODY DR CHIMACUM, 98325 OWNER: CRAIG VAN NESS PHONE: 10347 RHODY DR CHIMACUM WA 98325 SUBDIVISION: Block: Lot: T 22 PARCEL NUMBER: 901101013 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/06/2002 REPRESENTATIVE(S): JAMES GREER JR 10343 RHODY DR CHIMACUM WA 98325 PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK INSTALLATION t S-1-0\,/.e 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 Floodplain Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Proximity Plat Conditionb Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 10/03/01 30446 Total: $48.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT, 6_21 SHERIDAN ST,_PORT TOWNISEND WA 9836_8 PH: (360) 379-4450 INSTALLATION PERMIT APPLICATION J/jj4 4 Z11 WOODSTOVE ' PROPANE,TANK PELLET STOVE OTHER S-le,y-e - SITE ADDRESS: 911#/ROAD NAME /o 3 `/3 1 I, ,, R R. C.tr, (nAC.E.,ovt, C INl'q- ZIP C/ S' 32 S 9 DIGIT PARCEL ID NUMBER ,0 / - J 0/ O /3 Legal Description: Subdivision Name " 1 ii-x A... Block Lotls) Section Township North, Range WM APPLICANT Jh .-In w S e- Y-ze Y) / . PHONE Sea 0' MAILING ADDRESS l'o/ 3 V 3 vim. ), ,,A;_ 2001 . (- !mot' ryir,C c.,•✓7 / (4/4 • ZIP 9 7 )- l -' PROPERTY OWNER ( R.11 16. ji yo-r.. N,.S S PHONE MAILING ADDRESS /e 3 ' 7 /'h 0(1 .Z'Jit . c A , :, ✓1 C v,sv-‘ f t/V C.•t • ZIP 9K 3 2 _S. CONTRACTOR e-O ii/P A 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. 7 APPLICANT SIGNATURE � DATE /L% / 03/ ©/ `/ FOR OFFICE U E ONLY BASE FEE / ?'- RECEIPT#49- ys---,-„, (� CASH/CK # `L)TOTAL DATE /O/ ,, 3/ ' 'H:\HOMEIPLNCNTR\FORMS1INSTALL.DOC10/99