HomeMy WebLinkAboutBLD2002-00317 0 !
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 #: BLD02-00317 Received Date 6/3/2002
SITE ADDRESS: 221 FRANK BECK RD Issue Date 6/3/2002
QUILCENE, 98376
APPLICANT: THOMAS L GILMORE PHONE: (360)765-3306
PO BOX 52
QUILCENE WA 98376-0052
10+
SUBDIVISION: LITTLE QUIL ESTATES Block: Lot:
PARCEL NUMBER: 968400010 Section: 13 Township: 27N Range: 02W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, THOMAS L GILMORE PHONE: (360)765-3306
if different: PO BOX 52
QUILCENE WA 98376-0052
PROJECT DESCRIPTION: PROPANE TANK&STOVE 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 6/3/2003.
REQUIRED INSPECTIONS:
[ ]` Tank/Line/Appliance o i<)< 6 -d.b -o-,..
[ ] FinalApproval: 0 r< j -a C -Uz.. ..
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
BLD02-00317
ilitUILDING PERMIT APPLICA N Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00317 Received Date: 6/3/2002
SITE ADDRESS: 221 FRANK BECK RD
QUILCENE, 98376
OWNER: THOMAS L GILMORE PHONE: (360)765-3306
PO BOX 52
QUILCENE WA 98376-0052
SUBDIVISION: LITTLE QUIL ESTATES Block: Lot: 10+
PARCEL NUMBER: 968400010 Section: 13 Township: 27 N Range: 02 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTION PROPANE TANK & STOVE INSTALLATION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION
CODE EDITION: 1997 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
Propane Tanks/Stoves $47.00 MAM 06/03/02 47820
Total: $47.00
JEFFERSON COUNTY PERMIT CEN, 621 SHERIDAN ST, PORT TOWNSEND W.368 PH: (360) 379-4450 7
INSTALLATION PE
RMIT APPLICATION
WOODSTOVE )( PROPANE TANK PELLET STOVE OTHER —
SITE ADDRESS: r F114 ?* 1c/ /2J911#/ROAD NAME '
,t, i 4)p ZIP
9 DIGIT PARCEL ID NUMBER qt0E - 900- 0 / u
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT rh r S Yvl r5 Q-JChyt..- -e- PHONE 7G S 3 a C.
MAILING ADDRESS e C) Z_
ZIP 9cF137C
PROPERTY OWNER 6�1
a ` . PHONE Cr
MAILING ADDRESS
ZIP
CONTRACTOR Skv1 S H I n Q. Pa-0 9 14 SL PHONE 3 6S-- Sly 7
MAILING ADDRESS (0 $5 3 (Z1-1-0 a j 0 Q, .
Parr 14-eho Lc c.lc Lae% . ZIP S d' 33 ci
•
STATE LICENSE # SLA VI S t{-p. 07 7 Q P EXP. DATE 1 I r 09.
FEDERALI.D. # 91- 1O0178S7
•
APPLICANT SIGNATURE C(.GGr-c- ,4tn-, a DATE J / 30 / 0.2-
FOR OFFICE USE ONLY
BASE FEE D E C cF, O W E CEIPT # 14 9-810
C SH/CK # 3-�y -
TOTAL t. JUN - 3 2002 `f TE f/ 3 /
.. --
H:\HOME\PLNCNTR\FORMS\INSTALL.DOC4/98 DEPT. OF COMMUNITY DEVELOPMENT