HomeMy WebLinkAboutBLD2002-00446 ! 9
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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 #: BLD02-00446 Received Date 8/8/2002
SITE ADDRESS: 1210 BECKETT POINT RD Issue Date 8/9/2002
PORT TOWNSEND, 98368
APPLICANT: BECKETT POINT FISHERMEN'S CLUB PHONE: (408)438-1508
JAMES HEMPLER
5981 CHESBRO AVE
SAN JOSE CA 95123 3
SUBDIVISION: BECKETT POINT SOUTH BEACH AN Block: Lot:
PARCEL NUMBER: 931970014 Section: 23 Township: 30N 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, BECKETT POINT FISHERMEN'S CLUB PHONE: (408)438-1508
if different: JAMES HEMPLER
5981 CHESBRO AVE
SAN JOSE CA 95123
PROJECT DESCRIPTION: PROPANE TANK, HEATER& PIPES
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 8/9/2003.
REQUIRED INSPECTIONS:
p/( ank/Line/Ap I' :
[ r FinalApproval:
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
OF
•UILDINGBLD02-00445 PERMIT APPLICA N Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00446 Received Date: 8/8/2002
SITE ADDRESS: 1210 BECKETT POINT RD
PORT TOWNSEND, 98368
OWNER: BECKETT POINT FISHERMEN'S CLUB PHONE: (408)438-1508
JAMES HEMPLER
5981 CHESBRO AVE
SAN JOSE CA 95123
SUBDIVISION: BECKETT POINT SOUTH BEACH AN Block: Lot: 3
PARCEL NUMBER: 931970014 Section: 23 Township: 30 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: PHONE:
PROJECT DESCRIPTION PROPANE TANK, HEATER & PIPES
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:
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 Bv: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 08/08/02 49416
Total: $47.00
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JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNS•WA 98368 PH: (360)379-4450
/ INSTALLATION PERMIT APPLICATION � (
WOODSTOVE y Above Ground PROPANE TANK PELLET STOVE MOTHER d ( / '"�"`��
_
Is this appliance(htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?
YES X NO
SITE ADDRESS(911#/Road Name):
(tit o .. .el t.(ciftC 1 T ' v..-0--
Q - `rodvt
Sel4S
ZIP
9 DIGIT PARCEL ID NUMBER -l*1, O((0 0ttf
Legal Description:
Subdivision Name Block Lot(s)
Section W
, _,, Township North, Range M
APPLICANT 34 ►meS A�fv/ PHONE O g - Li)i - t S o e
MAILING ADDRESS 5 18 ) C.he�s ,rn iclv.4.
flMA f e ( CR- °t5u3 ZIP
PROPERTY OWNER4p4utms( PHONE q°g
MAILING ADDRESS I
ZIP
N� SUNSHINE PROPANE
CONTRACTOR $4 Quality Energy Services Since 1980 PHONE
1 10853 Rhody Drive(Hwy. 19)
MAILING ADDRESS I 1t Port Hadlockt WA 98319.9745
(360)385.5797 or r883.4010 ZIP
STATE LICENSE# SG(,Ii,Skir9* o 77 Q 0 EXP.DATE I (1 Z
FEDERAL I.D.# a I ` I o 7�t 2 J 7
By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material
falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void.
I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorneys fees and expenses which
may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any
required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE 4/,�/" U --- DATE ii? / 6 / 0 L
FOR OFFICE USE ONLY , �q
BASE FEE /CI
(S (� (� D (�/] IE
RECEIPT# �-}q1 L t hi�� lvJ '�" UCASH/CK# {d. .5TOTAL AUG _ 82 DATE _/$/QI--
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DEPT. OF�COMMUNITY DEVELOPMENT