HomeMy WebLinkAboutBLD2002-00215 • •
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 #: BLD02-00215 Received Date 4/16/2002
SITE ADDRESS: 150 HALL MOUNTAIN RD Issue Date 4/17/2002
QUILCENE, 98376
APPLICANT: DAVID J RUGH PHONE:
17416 95TH AVE NE
BOTHELL WA 98011-3613
T 23+
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 801324003 Section: 32 Township: 28N 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, DAVID J RUGH PHONE:
if different: 17416 95TH AVE NE
BOTHELL WA 98011-3613
PROJECT DESCRIPTION: PROPANE TANK PIPING &STOVE INSTALLATION
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 4/17/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/' .: .
[yr FinalApproval: O/e t —/`-e`O
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
OBUILDING PERMIT APPLICION B RD p Review
ye:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00215 Received Date: 4/16/2002
SITE ADDRESS: 150 HALL MOUNTAIN RD
QUILCENE, 98376
OWNER: DAVID J RUGH PHONE:
17416 95TH AVE NE
BOTHELL WA 98011-3613
SUBDIVISION: Block: Lot: T 23+
PARCEL NUMBER: 801324003 Section: 32 Township: 28 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 DESCRIPTION PROPANE TANK PIPING & STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997
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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 04/16/02 47467
Total: $48.00
JEFFERSON COUNTY PERMIT CEN•, 621 SHERIDAN ST, PORT TOWNSEND W368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE ROPANE TANK PELLET STOVE (� OTHER CS S` uQ 1 Q�,e.
SITE ADDRESS: ff
911#/ROAD NAME t
62 _ _ ,Aui(-, ZIP q8,37
9 DIGIT PARCEL ID NUMBER O I 3 .1---L7L O 0 3
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT be
PHONE
MAILING ADDRESS 17 �"Uo q'S _
tin ZIP , c)((
PROPERTY OWNER PHONE
MAILING ADDRESS
ZIP
CONTRACTOR S(-4-v1 s M I n e. P2o p _ PHONE 3 8 - 571 7
MAILING ADDRESS (O Q S 3 RI+0 it 0 2 .
Poe-i- µ14,j L.c ZIP S cf 3
STATE LICENSE # SCA115 if A14. p7 7 QP EXP. DATE I I /O
FEDERAL I.D. # 9 l- 10 g 7 8 S 7
APPLICANT SIGNATURE `t.C,l e'-c`- 40, ( DATE #- / !S- / Oa.
FOR OFFICE USE ONLY
BASE FF.E • RECEIPT #
lECFEDWE
CASH/CK #
TOTAL -'—
DATE _/ /
APR 1 6 2002, ,,_,)
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DEPT. OF COMMUNITY DEVELOPMENT