HomeMy WebLinkAboutBLD2002-00387 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 #: BLD02-00387 Received Date 7/5/2002
SITE ADDRESS: 2054 VAN TROJAN RD Issue Date 7/9/2002
CHIMACUM, 98325
APPLICANT: THOMAS JAY PHONE: (360)732-4238
PO BOX 295
CHIMACUM WA 98325
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901211008 Section: 21 Township: 29N 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, THOMAS JAY PHONE: (360)732-4238
if different: PO BOX 295
CHIMACUM WA 98325
PROJECT DESCRIPTION: PROPANE TANK& GAS PIPE 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 7/9/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval: �` 1 �� ;.. �, "a .�� ,
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
BLD02-00387
UILDING PERMIT APPLICON Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00387 Received Date: 7/5/2002
SITE ADDRESS: 2054 VAN TROJAN RD
CHIMACUM, 98325
OWNER: THOMAS JAY PHONE: (360)732-4238
PO BOX 295
CHIMACUM WA 98325
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901211008 Section: 21 Township: 29 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 & GAS PIPE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY:
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 $47.00 MAM 07/05/02 49134
Total: $47.00
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JEFFERSON COUNTY PERMIT CEP*, 621 SHERIDAN ST, PORT TOWNSEND W368 PH: (360) 379-4450
INSTALLATION PERMIT APPLICATION ,
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Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT t �u11v A,-�� PHONE 7 ) �= ��-3
MAILING ADDRESS T o C�� �-
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PROPERTY OWNER
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MAILING ADDRESS
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CONTRACTOR Suvl 5 H I n Pa-0F o 9 AL_ PHONE a 8,�' $717
MAILING ADDRESS (O !7 S 3 R I+D !r j d Q ,
Poer (+4j, uoQC. UN, . ZIP 5cf33c
STATE LICENSE # SL.I VI S ff P 07 7 Q p EXP. DATE I I f Off,
FEDERAL I.D. # 9!- I o a 7 8 S 7
APPLICANT SIGNATURE CC-G!�'c` ,Q� Crl. ( DATE / /
FOR OFFICE USE ONLY D LS
BASE FEE C F U l5 RECEIPT # 49 131-1
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CASH/CK # �
TOTAL _ JUL " 5 2002 DATE ---/ 5 /Cj�
DWI. OF COMMUNITY DEVELOPMENT
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