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Home My WebLink AboutBLD2004-00112 • • 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 #: BLD04-00112 Received Date 2/24/2004 SITE ADDRESS: 5663 CAPE GEORGE RD Issue Date 2/24/2004 PORT TOWNSEND, 98368 APPLICANT: ROBERT L WHITNEY JR PHONE: DIANA WHITNEY 5663 CAPE GEORGE RD PORT TOWNSEND WA 983689042 3 SUBDIVISION: DISCOVERY RIDGE DIV II Block: Lot: PARCEL NUMBER: 001195003 Section: 19 Township: 30N Range: 01W CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/12/2005 OWNER, ROBERT L WHITNEY JR PHONE: if different: DIANA WHITNEY 5663 CAPE GEORGE RD PORT TOWNSEND WA 983689042 PROJECT DESCRIPTION: 250 GALLON ABOVE GROUND PROPANE TANK AND HEAT STOVE 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 02/24/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance:CAA 7-74A14C--.:Z.s1DY7/vr G/ivLs o ic...4/1/3,5/ [ FinalApproval: #67 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 0UILDING PERMIT APPLICA ION BLD04-00112 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD04-00112 Received Date: 2/24/2004 SITE ADDRESS: 5663 CAPE GEORGE RD PORT TOWNSEND, 98368 OWNER: ROBERT L WHITNEY JR PHONE: DIANA WHITNEY 5663 CAPE GEORGE RD PORT TOWNSEND WA 983689042 SUBDIVISION: DISCOVERY RIDGE DIV II Block: Lot: 3 PARCEL NUMBER: 001195003 Section: 19 Township: 30 N Range: 01 W CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/12/2005 REPRESENTATIVE: PHONE PROJECT DESCRIPTIOl 250 GALLON ABOVE GROUND PROPANE TANK AND HEAT STOVE 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: GARAGE: SHORELINE: CONST TYPE: 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 ZAN 02/24/04 62631 Total: $48.00 JEFFERSON COUNTY COMMUrEVELOPMENT,621 SHERIDAN ST,PORT TOWIlIOD 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* SIZE OF PROPANE TANK KHEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE OTHER(Please Specify) Is this appliance(woodstove, htg stove, hot water tank,furnace, etc.) to be installed in a Manufactured/Mobile Home? YES K NO SITE ADDRESS(911#/Road Name): 5-6g3 0 `7,- 6e 07, a PT WA /� ZIP �j 9 DIGIT PARCEL ID NUMBER no i - 1 `j 5-' 00 - Legal Description: Subdivision Name Block Lot(s) Section Township,1t North, Range WM APPLICANT S _.) f bC \ 1 ` /44 . PHONE J��--5 3/0• MAILING ADDRESS Pd )( '8 P.-T. (_._) 8 � ZIP 98J� PROPERTY OWNER , 1X \- U k) 4 kAc PHONE .- / OJ/€ 0'�MAILING ADDRESS 5-6 _S o l) C D/yy')e_ C� 1 D ff r / 1 . \ �t' ` ZIP / G7 S CONTRACTOR b.-v( bc� P'l- v '"� PHONE 3?---5 ' ' MAILING ADDRESS Stile_/•�C__ A 04- &N:_ ZIP STATE LICENSE# S(.n) 3 R pi___ ( / / P 4 EXP.DATE C.7 3/a- FEDERAL I.D.# 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 unty 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' y or structure shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE DATE Z. /1t'/ / 09 FOR OFFICE USE ONLY BASE FEE $48.00 RECEIPT# ( 7 3 1 CONSISTENCY REVIEW $24.00 CASH/CK# l-,I .6 14 TOTAL ~I,- -C° DATE Z /Z7/ VY Propane Tank applications require additional information to be submitted. OVER 4Please contact our office at 360-379-4450 if the back of this application is blank. 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