HomeMy WebLinkAboutBLD2001-00683 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 #: BLD01-00683 Received Date 12/13/2001
SITE ADDRESS: 180 LONE STAR RD Issue Date 12/14/2001
QUILCENE, 98376 Expiration Date 12/14/2002
APPLICANT: RICHARD D HANON PHONE: (360)765-3255
180 LONE STAR RD
QUILCENE WA 98376-9701
T2
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 701052004 Section: 5 Township: 27N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, RICHARD D HANON PHONE: (360)765-3255
if different: 180 LONE STAR RD
QUILCENE WA 98376-9701
PROJECT DESCRIPTION NO MLA REQ'D TAN K-4 %/OATES_
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 12/14/2002.
REQUIRED INSPECTIONS:
[ ] Tank/Line • ppliance: 7EPL4LERAVTICIAW Ok 0 2-
A 14e EUrr M-6W t- eit //19/DZ
[ ] FinalApproval:
OK 1.1
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BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Propane.rpt 10/29/19
3
BUILDING PERMIT APPLICATION BR evi
w Typ e:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00683 Received Date: 12/13/2001
SITE ADDRESS: 180 LONE STAR RD
QUILCENE, 98376
OWNER: RICHARD D HANON PHONE: (360)765-3255
180 LONE STAR RD
QUILCENE WA 98376-9701
SUBDIVISION: Block: Lot: T 2
PARCEL NUMBER: 701052004 Section: 5 Township: 27 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D TANJK_F vop ,. N TEI
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
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 MAM 12/13/01 43726
Total: $48.00
JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORTS TOWNSEND WA 98368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER 6i4 1. c-,- Q,4/
SITE ADDRESS: �,.
911#/ROAD NAME I(�O b LX v'-2_5 1 7-y
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9 DIGIT PARCEL ID NUMBER 7 0 I 0S a— oCy
Legal Description: �,�,,
Subdivision Name �•).. ' Block
Lot(s)
Section Township North, Range WM
APPLICANT k t aGL,a 4 rnyth____ Gt O. b im Z 7 PHONE 3
MAILING ADDRESS S
ZIP
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PROPERTY OWNER
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MAILING ADDRESS
ZIP
CONTRACTOR SLLvI 5 H 1 n e P2o p Ate,_
PHONE 3 S,c- 57y 7
MAILING ADDRESS (0 47 5 3 RH-a a[, 02 .
Pori- 1+1 Lo cdc 4)-G ' ZIP 5 33
STATE LICENSE # SLAVISH-pic 077QP EXP. DATE l I f CI
FEDERAL I.D. # 9 l- t o ct 7 Q S7
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APPLICANT SIGNATURE Lr �-c._ � 01e,
DATE / /
FOR OFFICE USE ONLY
BASE FEE RECEIPT # 143��
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CASH/CK # j0Z_
TOTAL
DATE I'Z/ /3/O I
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