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Home My WebLink AboutBLD2004-00357 • • 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 #: BLD04-00357 Received Date 6/2/2004 l�SITE ADDRESS: 20t ,,� Issue Date 6/3/2004 PORT LUDLOW, 98365 APPLICANT: EDUARDO JARAMILLO PHONE: 360-437-9678 WANDA C JARAMILLO 20 GOLIAH LN PORT LUDLOW WA 983659661 SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: PARCEL NUMBER: 990600282 Section: 9 Township: 28N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 09/26/2004 OWNER, EDUARDO JARAMILLO PHONE: 360-437-9678 if different: WANDA C JARAMILLO 20 GOLIAH LN PORT LUDLOW WA 983659661 PROJECT DESCRIPTION: 120 GAL ABOVE GROUND PROPANE TANK, FIREPLACE INSERT, PIPING 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 06/03/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance [ ] FinalApproval 6 /D a y 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 BLD04-00357 UILDING PERMIT APPLICN Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD04-00357 Received Date: 6/2/2004 SITE ADDRESS: 20 GOLIATH LN . `1oA .- PORT LUDLOW, 98365 OWNER: EDUARDO JARAMILLO PHONE: WANDA C JARAMILLO 20 GOLIAH LN PORT LUDLOW WA 983659661 SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: PARCEL NUMBER: 990600282 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTP198306 Expires 09/26/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION 120 GAL ABOVE GROUND PROPANE TANK, FIREPLACE INSERT, PIPING 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 $48.00 ZAN 06/02/04 64497 Total: $48.00 JEFFERSON COUNTY COMMUNEVELOPMENT,621 SHERIDAN ST,PORT TOWND WA 98368 PH: (360)379-4450 -y INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION Underground PROPANE TANK* X Above Ground PROPANE TANK* SIZE OF PROPANE TANK I a-' HEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE ✓OTHER(Please Specify) //A/h Is this appliance(woodstove, htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home? YES V NO SITE ADDRESS(911#/Road Name): 0-0 &o)':A 1L n ,Port Li-ip/o W , w p A . ZIP 7 836.- 9 DIGIT PARCEL ID NUMBER 9 90 6Dd 2` a- Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT Mountain Propane PHONE 3 s- 6 SS z�•3 265 Chimacum Rd. MAILING ADDRESS Port Hadlock,WA 98339 ZIP Q PROPERTY OWNER E o/ 3-9 r9 m///0 PHONE 4/3 2 9,6 7 S" MAILING ADDRESS t o//c/iA )- .7 • ?or I- .Z-N�`Ut../ , W.4 ZIP %QQ S 36s CONTRACTOR Mountain Propane PHONE 3 SS - 6'Sg3 265 Chimacurn Rd. MAILING ADDRESS Port Harfiock,WA 98339 ZIP Q STATE LICENSE# ,n O Lim 7`pr 95306 EXP.DATE ,/ --7-.:4 '"O 5/ FEDERAL I.D.# y/- aosS .65:5- 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 a//gqlicant's property or structurect shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE Q�Gf� ✓�Go DATE 6 l .v.- / o 7�/ FOR OFFICE USE ONLY BASE FEE $48.00 RECEIPT# CONSISTENCY REVIEW $24.00 CASH/CK# TOTAL /67 DATE / / Propane Tank applications require additional information to be submitted. OVER Please contact our office at 360-379-4450 if the back of this application is blank. G:\PermitCenter\FORMS\BLDG FORMS\install-revised 01-26-04.DOC All Prone Tank Application RecSrements b. When applying for a permit to install a propane tank you must submit the following: 1. Site plan showing all of the buildings, all property lines, tank location, distances from the propane tank to all property lines and buildings, septic system components including the reserve area. Indicate the size of the tank and whether or not it is above ground or below ground. 2. An additional fee of$24.00 for Consistency Review is required. The total amount due at time of application is $72.00. Nib et It Iv yrc G- .pito dowAsoidr, oQ r soy G:\PermitCenter\FORMS\BLDG FORMS\install-revised 01-26-04.DOC