HomeMy WebLinkAboutBLD2001-00570 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 (800)831-2678
PERMIT #: BLD01-00570 Received Date 10/9/2001
SITE ADDRESS: 45 REDEEMER WAY Issue Date 10/10/2001
PORT HADLOCK, 98339 Expiration Date 10/10/2002
APPLICANT: LUTHERAN CHURCH OF REDEEMER PHONE: (360)385-6883
PO BOX 70
CHIMACUM WA 98325
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901114000 Section: 11 Township: 29N Range: 01W
CONTRACTOR: MOUNTAIN PROPANE LLC PHONE:
265 CHIMACUM RD
PORT HADLOCK WA 98339
OWNER,
if different:
PROJECT DESCRIPTION NO MLA REQ'D - PROPANE TANK INSTALLATION
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 10/10/2002.
REQUIRED INSPECTIONS:
[ ank%]Line/Appliance: /09A/!x ®/C /0//Z/®9 Z--421
royal: l
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BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
Inspector's Phone Hours 8:00 a.m. - 9:00 a.m.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Propane.rpt 10/29/19
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BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00570 Received Date: 10/9/2001
SITE ADDRESS: 45 REDEEMER WAY
PORT HADLOCK, 98339
OWNER: LUTHERAN CHURCH OF REDEEMER PHONE: (360)385-6883
PO BOX 70
CHIMACUM WA 98325
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901114000 Section: 11 Township: 29 N Range: 01 W
CONTRACTOR: MOUNTAIN PROPANE LLC PHONE:
265 CHIMACUM RD
PORT HADLOCK WA 98339
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: 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
F&W Landslide
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity plat Condition3
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 10/09/01 41546
Total: $48.00
SR ON COUNTY CQMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH; (360L79-445Q
6v,047JEFFE
�// INSTALLATION PERMIT APPLICATION
WOODSTOVE % PROPANE TANK PELLET STOVE OTHER
SITE ADDRESS: 7
911#/ROAD NAME 115 y y(.e o-i ei,my" \/l/'
0 { ?
port jc1lvL y-f L_l9 , ZIP 9 S 33 9
9 DIGIT PARCEL ID NUMBER 9o) - 4) 9 - 000
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT PHONE 360 3SS--6 O`g"--3
MAILING ADDRESS Mountain Propane
265 Chimacum Rd.
Port Hadlock, WA 98339 ZIP
PROPERTY OWNER )...14 *"J,9r+q/1 CA14r4) 0"P' Redoeo`)iev- PHONE 360-3S- `6 92
MAILING ADDRESS ,�.i' ,n I SO X 70
C)1.1 yngc4Yr! / w4 , 83 ZIP
CONTRACTOR PHONE 3 6o -3 S. --6 853.3
Mountain Propane
MAILING ADDRESS 265 Chimacum Rd.
Port Hadlock, WA 98339 ZIP
STATE LICENSE # /yfa y47 994/ S // EXP. DATE fa- "0g_0/
FEDERAL I.D. # 9l— ..0%4'/SS`
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.
APPLICANT SIGNATURE DATE )O / 9 / o f
FOR OFFICE USE ONLY
BASE FEE RECEIPT# _I 5y b
(�` (� SH/CK# (�j 0
TOTAL pk R � E I
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DEPT.OF COMMUNITY DEVELOPMENT