HomeMy WebLinkAboutBLD2005-00459 • •
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 #: BLD05-00459 Received Date 7/15/2005
SITE ADDRESS: 72 MEGS WAY Issue Date 7/15/2005
PORT HADLOCK, 98339
APPLICANT: SEVEN BRIDGES PROPERTIES LLC PHONE:
PO BOX 1953
PORT TOWNSEND WA 98368
6
SUBDIVISION: ANDERSON COURT LONG PLAT Block: Lot:
PARCEL NUMBER: 931300006 Section: 2 Township: 29N Range: 01W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI98306 Expires 9/26/2006
OWNER, SEVEN BRIDGES PROPERTIES LLC PHONE:
if different: PO BOX 1953
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION: PROPANE TANK W/ HTG STOVE, HOT WATER TANK, & COOKING
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 7/15/2006.
REQUIRED INSPECTIONS:
Tank/Line/Appliance. MiSk 4 �X'r L me 6FC q/4,./4S1 Ip i- '7,-Z2--a
FinaIApprova. ��-
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
RILDING PERMIT APPLICATSN BL v
Reviewiew T Ty459
ype:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00459 Received Date: 7/15/2005
SITE ADDRESS: 72 MEGS WAY
PORT HADLOCK, 98339
OWNER: SEVEN BRIDGES PROPERTIES LL.0 PHONE:
PO BOX 1953
PORT TOWNSEND WA 98368
ANDERSON COURT LONG PLAT
SUBDIVISION: Block: Lot: 6
PARCEL NUMBER: 931300006 Section: 2 Township: 29 N Range: 01 W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI983O6 Expires 9/26/2006
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI PROPANE TANK W/ HTG STOVE, HOT WATER TANK, & COOKING
STOVE
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:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $49.00 SLE 07/15/05 76229
Total: $49.00
JEFFERSON COUNTY COMMUNI•VELOPMENT,621 SHERIDAN ST,PORT TOWN*WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO INSTALLATION
Underground PROPANE TANK* " Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE �OKING STOVE
OTHER(Please Specify)
Is this appliance(htg stove, hot water tank,furnace, etc.) to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911#/Road Name):
7 3- ,47 e,ss L iQ -
f Ort �7iSJbC�{�2'` i /�t(✓���� /�� ZIP 9 6239
9 DIGIT PARCEL ID NUMBER I J 1- 330 - cocp
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT / 2VC?,7!Q/N Pr Ivn t° PHONE 3t1S- —64s4s3
MAILING ADDRESS r C liJ{'l'JQC
n 4 �. K�'-
Part )1q�/Ucle-- w'g - ZIP 915339
PROPERTY OWNER SOge 1't/1/b4m5 PHONE
MAILING ADDRESS ss a-�tS g-7 4 n ,,$t'.
Port 7 7)bvrn5 en ci✓ ZIP 9S3cS
CONTRACTOR sgnie 9$ A/tpl1c9r1t PHONE
MAILING ADDRESS
ZIP
STATE LICENSE# /YJO cow t P.. 9'13306 EXP.DATE 9—626—0 v
FEDERAL I.D.# 4// — .-OS S66--
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 th applicant's property or structure� shall be requested and shall occur during regular business hours.
APPLICANTS SIGNATURE r- tr( — DATE 2 l I—S/ -5
`
j I(] a)FOR OFFICE USE ONLY
�ile �6,i
BASE FEE RECEIPT#
CONSISTENCY REVIEW /Q -1] l`l=5( CASWCK# C-(711) I 2_
'7
TOTAL / ` C5(I DATE l / /
*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
Undergrouncropane Tank Applicationnequirements
When applying for a permit to install an underground propane tank you must submit the following:
1. Site plan showing all of the buildings, all property lines, tank location, distances from the tank
to all property lines and buildings, septic system components including the reserve area.
2. Tank must be installed per NLPGA#401-87. Copies are available in our office for a fee of
$.90.
3. Plans are required. You must submit a section view and a plan view with all dimensions.
4. An additional fee of$23.50 for Consistency Review is required. The total amount due at time
of application is $70.50.
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