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Home My WebLink AboutBLD2003-00669 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 #: BLD03-00669 Received Date 10/22/2003 SITE ADDRESS: 1551 LINGER LONGER RD Issue Date 10/22/2003 QUILCENE, 98376 APPLICANT: PORT OF PORT TOWNSEND PHONE: PO BOX 1180 PORT TOWNSEND WA 983680980 T 19 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702251013 Section: 25 Township: 27N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2004 OWNER, PORT OF PORT TOWNSEND PHONE: if different: PO BOX 1180 PORT TOWNSEND WA 983680980 PROJECT DESCRIPTION: BOILER REPLACEMENT WITH NEW GAS LINE AND VENT 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: Lifer 4t't'1I2ti- `i95 I ,ArE(Per) V&Ur ,0 K. It Igile Ale [ ] FinalApproval: -4 6 ff 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 BUILDING PERMIT APPLI( BLD03-00669ION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00669 Received Date: 10/22/2003 SITE ADDRESS: 1551 LINGER LONGER RD QUILCENE, 98376 OWNER: PORT OF PORT TOWNSEND PHONE: PO BOX 1180 PORT TOWNSEND WA 983680980 SUBDIVISION: Block: Lot: T 19 PARCEL NUMBER: 702251013 Section: 25 Township: 27 N Range: 02 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 DESCRIPTIOF BOILER REPLACEMENT WITH NEW GAS LINE AND VENT 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: 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 ZAN 10/22/03 60303 Total: $47.00 JEFFERSON COUNTY COMMA,DEVELOPMENT,621 SHERIDAN ST,PORT TO4ND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION Underground PROPANE TANK* Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE X OTHER(Please Specify) bcv Le,1_. 2 /Q (A�`,, ,Q- (,J/„ I vQ jc.r i _ 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): . /557 IL nU e� i-ancie-' ied 4 uit Lein �jtJ -- ZIP 90?J 7�" 9 DIGIT PARCEL ID NUMBER 700 25/ 0 /3 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT 000- je61-0-0-So PHONE MAILING ADDRESS P 0 i /t0 4oc2 , rrrrl , w�- &5t�1�ZIP 9 PROPERTY OWNER �i`"+.. PHONE MAILING ADDRESS / 10 SUNSHINE PROPANE ZIP CONTRACTOR 14 Quality Energy Services Since 1980 PHONE 10853 Rhody Dr. Hadlock,WA 98339 MAILING ADDRESS I) 'b (360)385-5797 or 683-4010 www.sunshinepropane.com ll� ZIP STATE LICENSE# g u n S ti-10* 0 l�y-� 0 P EXP.DATE /1/bie FEDERAL I.D.# qi- 1 0 7 9 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 property r structure shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE DATE 1 0 / D. 1-/ o3 BASE FEE 4lf 0- OR OFFICE USE ONLY 3 RECEIPT# 0�3D `'1 CONSISTENCY REVIEW � CASH/CK# 99k3 t^ TOTAL "[ /` w DATE /0 /Z Z/ 03 *Underground Propane Tank applications require additional information to be submitted. 0 V E R Please contact our office at 360-379-4450 if the back of this application is blank. g:\permitcenter\forms\bldg forms\install-revised 10-23-02.doc