HomeMy WebLinkAboutBLD2003-00668 BLD03-00668
BUILDING PERMIT APPLIAION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00668 Received Date: 10/22/2003
SITE ADDRESS: 60-2 UPPER BLUFFS DR
PORT TOWNSEND, 98368
OWNER: DANIEL C SCHEALL SR PHONE:
60 2 UPPER BLUFFS DR
PORT TOWNSEND WA 98368
SUBDIVISION: THE BLUFFS BLDG 21 Block: Lot:
PARCEL NUMBER: 965300042 Section: 26 Township: 30 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr 50 GAL ABOVE GROUND PROPANE TANK, GAS PIPING TO RANGE,
BBQ,
AND LOG LIGHTER
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:
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
�13�z2�(>3 Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 ZAN 10/22/03 60303
Total: $47.00
• •
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
PERMIT #: BLD03-00668 Received Date 10/22/2003
SITE ADDRESS: 60 2 UPPER BLUFFS DR Issue Date 10/22/2003
PORT TOWNSEND, 98368
APPLICANT: DANIEL C SCHEALL SR PHONE:
60 2 UPPER BLUFFS DR
PORT TOWNSEND WA 98368
SUBDIVISION: THE BLUFFS BLDG 21 Block: Lot:
PARCEL NUMBER: 965300042 Section: 26 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
OWNER, DANIEL C SCHEALL SR PHONE:
if different: 60 2 UPPER BLUFFS DR
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION: 50 GAL ABOVE GROUND PROPANE TANK, GAS PIPING TO
RANGE, BBQ,
AND LOG LIGHTER
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 10/22/2004.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[‘el/ FinalApproval. AP -ti^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
I:\F_BLD_Permit_Propane.rpt 10/29/19
JEFFERSON COUNTY COMMODY DEVELOPMENT,621 SHERIDAN ST,PORT TO ND WA 98368 PH: (360)379-4450
4
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* XAbove Gro round PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE� �� , INSERT
M PELLET STOVE COOKINGL STOVE
, OTHER(Please Specify) C/IY.f P'4' c `� a..d `; p r bi.6 / 31L1,••• -•
L
Is this appliance (htg stove, hot water tank,furnace,etc.) to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911 #/Road Name):
6 o `ci_ LLpp€ AL 0r
P( l b_ w-yi.. ..i,-,.� f
/ Gig ZIP 5 83 I.8
9 DIGIT PARCEL ID NUMBER q coS — 3 O 0"- O /Z
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range ,7 WM
1/ Y�G2 APPLICANT 6 .t Sct-�e I I PHONE 3 o c CS d 2
MAILING ADDRESS 3 cam_
ZIP
PROPERTY OWNER PHONE
MAILING ADDRESS ,_S
_ ZIP
~
•
CONTRACTOR _ It '•, SUNSHINE PROPANE PHONE
Quality Energy Services Since 1980
10853 Rhody Dr.Hadlock,WA 98339
MAILING ADDRESS
IF/ 'A , (360)385-5797 or 683-4010
www.sunshinepropane.com
_ n ZIP V 1
STATE LICENSE# 5 c.w, tip S/i yz 07 7 GI EXP.DATE / d T
FEDERAL I.D.# q/" / 0 71 8 S 7
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 prop y or structure shall be requested and shall occur during regular business hours.
APPLICANT'S SIGNATURE - ( i4r). .____ DATE /0 / )-L. 03
�i WOR OFFICE USE ONLY / `3 D3
BASE FEE RECEIPT# L (C/
CONSISTENCY REVIEW CASH/CK# 9`,�!/3
TOTAL Pr/ r 0:7 DATE I D /Z.7/ D
*Underground Propane Tank applications require additional information to be submitted. 0 V E R I/
Please contact our office at 360-379-4450 if the back of this application is blank.
g:\permitcenterforms\bldg forms\install-revised 10-23-02.doc
• SITE VISIT REPO.'
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