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Home My WebLink AboutBLD2003-00362 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#: BLD03-00362 Received Date 6/12/2003 SITE ADDRESS: 310 HADLOCK BAY RD. Issue Date 6/12/2003 PORT HADLOCK, 98339 APPLICANT: PORT HADLOCK/K S C LLC PHONE: C/O REALVEST CORP 1111 MAIN ST STE 700 VANCOUVER WA 986602970 T 31+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 901014007 Section: 1 Township: 29N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI98306 Expires 9/26/2004 OWNER, PORT HADLOCK/K S C LLC PHONE: if different: C/O REALVEST CORP 1111 MAIN ST STE 700 VANCOUVER WA 986602970 PROJECT DESCRIPTION: ABOVE GROUND PROPANE TANK INSTALLATION , EXTERIOR PIPING AND ZERO CLEARANCE FIREPLACE. 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 6/12/2004. REQUIRED INSPECTIONS: [ I Tank/Line/Appliance' ivlC Yg/CE3,/' [v FinalApproval:. I?._1I D� 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 APPLIITION B RDOe w 00p362 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00362 Received Date: 6/12/2003 SITE ADDRESS: 310 HADLOCK BAY RD PORT HADLOCK, 98339 OWNER: PORT HADLOCK/K S C LLC PHONE: C/O REALVEST CORP 1111 MAIN ST STE 700 VANCOUVER WA 986602970 SUBDIVISION: Block: Lot: T 31+ PARCEL NUMBER: 901014007 Section: 1 Township: 29 N Range: 01 W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTP198306 Expires 9/26/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI ABOVE GROUND PROPANE TANK INSTALLATION , EXTERIOR PIPING AND ZERO CLEARANCE FIREPLACE. 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 PRB 06/12/03 57958 Total: $47.00 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#: BLD03-00362 Received Date 6/12/2003 SITE ADDRESS: 310 HADLOCK BAY RD Issue Date 6/12/2003 PORT HADLOCK, 98339 APPLICANT: PORT HADLOCK/K S C LLC PHONE: C/O REALVEST CORP 1111 MAIN ST STE 700 VANCOUVER WA 986602970 T 31+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 901014007 Section: 1 Township: 29N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2004 OWNER, PORT HADLOCK/K S C LLC PHONE: if different: C/O REALVEST CORP 1111 MAIN ST STE 700 VANCOUVER WA 986602970 PROJECT DESCRIPTION: ABOVE GROUND PROPANE TANK INSTALLATION , EXTERIOR PIPING AND ZERO CLEARANCE FIREPLACE. 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 6/12/2004. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance .t}K Gf ! /g/Q3/ [✓if FinalApproval:y. I1"±D3 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 is\F_BLD_Permit_Propane.rpt 10/29/19 JEFFERSON COUNTY COMMY DEVELOPMENT,621 SHERIDAN ST,PORT TO\ND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TOTHIS INSTALLATION Underground PROPANE TANK* V Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK WOODSTOVE ,FIREPLACE+N6eRf' PELLET STOVE COOKING STOVE OTHER(Please Specify) ert .tO(L Q( k or— 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): -!0 fiAO IrcJ L 1Z0)? P,.,v1- O la to M ZIP %3 3 1 9 DIGIT PARCEL ID NUMBER `Iv d LI' 00 1 Legal Description: Subdivision Name Block Lot(s) Section Township 25 Al North, Range 01 id WM APPLICANT .-NO,1 On \. .e e r.3 kv '"-v'+ PHONE 3r - MAILING ADDRESS t Cr \ P\CA1 el Cadcf5 dr� \J4011,,c, ZIP q 3 39 PROPERTY OWNER ?A ` U\ �Lv 15)-1,,l1S9v PHONE 3w! ,. be1q' 060fb MAILING ADDRESS 310 1, AO CKIK Pj j� Qev 1 kAC)1 ZIP CnS 34 CONTRACTOR IT CIifyr)-A,i e1;D`l1vp1 PHONE ?'tS' Vol 3 MAILING ADDRESS -LADS C \ 2 Pc/ r),or ZIP 913 3=' STATE LICENSE# rlYl e1( yy1 j \C\7 0 it.0 EXP.DATE lW1OL1 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 aganst 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 rig)tt of entry to.jeffer,n County and :''s employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to applica' s pro rt,or structur ` all be requested and shall occur during regular business hours. APPLICANTS SIGNATURE DATE I i / 17. / r/? �1 0J FOR OFFICE USE ONLY BASE FEE ~I�.. RECEIPT# CONSISTENCY REVIEW . ::(a_ CASH/CK# TOTAL `( /r w DATE / / *Underground 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. IMMk H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC