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Home My WebLink AboutBLD2004-00666 • I 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 #: BLD04-00666 Received Date 10/21/2004 SITE ADDRESS: 303 SNAGSTEAD WAY Issue Date 10/21/2004 PORT TOWNSEND, 98368 APPLICANT: MICHAEL HEMSLEY PHONE: (360) 379-4948 RITA HEMSLEY 303 SNAGSTEAD WAY PORT TOWNSEND WA 98368-9257 T56+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 001292012 Section: 29 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, MICHAEL HEMSLEY PHONE: (360) 379-4948 if different: RITA HEMSLEY 303 SNAGSTEAD WAY PORT TOWNSEND WA 98368-9257 PROJECT DESCRIPTION: RELOCATE 250 GAL A/G PROPANE TANK, WALL HEATER AND GAS PIPE 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 10/21/2005. REQUIRED INSPECTIONS: Tank/Line/Appliance: (C& t,)/zZ/o FinalApproval: (0 ,(c r`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.c •UILDING PERMIT APPLICA•N B RDOe 00666 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00666 Received Date: 10/21/2004 SITE ADDRESS: 303 SNAGSTEAD WAY PORT TOWNSEND, 98368 OWNER: MICHAEL HEMSLEY PHONE: (360) 379-4948 RITA HEMSLEY 303 SNAGSTEAD WAY PORT TOWNSEND WA 98368-9257 SUBDIVISION: Block: Lot: T56+ PARCEL NUMBER: 001292012 Section: 29 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 DESCRIPTION RELOCATE 250 GAL A/G PROPANE TANK, WALL HEATER AND GAS PIPE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2003 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 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $48.00 KAS 10/18/04 68552 Total: $48.00 JEFFERSON COUNTY COMMUNI•VELOPMENT,621 SHERIDAN ST,PORT TOWNS,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 HEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE / 7�COOKING STOVE OTHER(Please Specify) ( kJ-{" C �'>/+/C Is this appliance (woodstove, htg stove, hot water tank,furnace, etc.) to be installed in a Manufactured/Mobile Home? YES � NO SITE ADDRESS(911 #/Road Name): 3 C / OCT 2 0 4 . 3 OC3�'1� ZIP9 jfr.)EPk r 9 DIGIT PARCEL ID NUMBER no l og 502 d loZ- Legal Description: Subdivision Name Block Lot(s) Section Township _North, Range WM APPLICANT A PHONE J 7/^( 'c MAILING ADDRESS ZIP • PROPERTY OWNER G7C. Y LL_t' <i-+. PHONE MAILING ADDRESS 2p- 2u-1- ZIP CONTRACTOR S LA./1 S Fi I Pr C(J d.r,s2. PHONE 3YJ f 79 7 MAILING ADDRESS I J �� `1uci� I) Pcf i- Lock , • ZIP `j 3 j STATE LICENSE# S -t f1 .4-3 P C n 7 7 Q h EXP.DATE t I/0 FEDERAL I.D.# c7 / C.) I :j S(/y 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 or structure shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE ;C G ) h CJ I � DATE // / FOR OFFICE USE ONLY �� o O BASE FEE $48.00 RECEIPT# CONSISTENCY REVIEW 014.00 CASH/CK# 3csl 3O1 TOTAL IG �v 1Z'° DATE 10 / (iC/ O4 Ial Oft 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. 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