HomeMy WebLinkAboutBLD2002-00622 • 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
PERMIT #: BLD02-00622 Received Date 10/18/2002
SITE ADDRESS: 91 E MAUDE Issue Date 10/21/2002
PORT HADLOCK, 98339
APPLICANT: CAROL A BAKER PHONE: (360)385-2933
91 E MAUDE ST
PORT TOWNSEND WA 98368-0609
47&4E
SUBDIVISION: IRONDALE Block: 9 Lot:
PARCEL NUMBER: 961800913 Section: 35 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2002
OWNER, CAROL A BAKER PHONE: (360)385-2933
if different: 91 E MAUDE ST
PORT TOWNSEND WA 98368-0609
PROJECT DESCRIPTION: PROPANE TANK, HEAT STOVE &GAS PIPE
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 10/21/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: 0 j<
i------
[ ] FinalApproval: W 0000 k I - (1 -aL
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
3UILDING PERMIT APPLIC•ON B Review
2
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00622 Received Date: 10/18/2002
SITE ADDRESS: 91 E MAUDE
PORT HADLOCK, 98339
OWNER: CAROL A BAKER PHONE: (360)385-2933
91 E MAUDE ST
PORT TOWNSEND WA 98368-0609
SUBDIVISION: IRONDALE Block: 9 Lot: 47&4E
PARCEL NUMBER: 961800913 Section: 35 Township: 30 N Range: 01 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 DESCRIPTIOI PROPANE TANK, HEAT STOVE & GAS PIPE
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 By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 10/18/02 51191
Total: $47.00
JEFFERSON COUNTY COMMUN•EVELOPMENT,621 SHERIDAN ST,PORT TOWN WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* 1/Above Ground PROPANE TANK _HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE
ADTHER(Please Specify) C 'aJ i(
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): >�
E. G�€"1-fie.-_--
ivy_ l ZIP '<-52-,)3
9 DIGIT PARCEL ID NUMBER l6/ eoc.) r 1..-3
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range VVM
APPLICANT ( �re PHONE y--o_i
MAILING ADDRESS -
ZIP
PROPERTY OWNER 6Pa't?-' PHONE (,
MAILING ADDRESS LZ_-
ZIP
CONTRACTOR SUNSHINE PROPANE PHONE
Quality Energy Services Since 1980
MAILING ADDRESS 10853 Rhody Dr.Hadlock,WA 98
85-5797 or 683-4010
11111111.. y
�u ZIP J
STATE LICENSE# k//,5 7�7'//30 7? Q 0 EXP. DATE ///0 2 ..
FEDERAL I.D.# i/ /Oi CJ 7 Si-- /
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 unty and it's employees, representatives or agents for the purpose of application review and any
required later inspections. Access and right of en
try
to the applic is property or structure shall be requested and shall occur during regular business hours.
APPLICANT'S SIGNATURE '' DATE /4) / /? / 0?------
FOR OFFICEr
E n (gyp 4
BASE FEE II
U U
CONSISTENCY REVIEW CAS)
TOTAL -� OCT 1 8 2O02DA / /
*Underground Propane Tank applications require additional information to be Submitted.',JeaseYcontact our office at 360-379-4450 if the back of
this application is blank. DEPT. OF COMMUNITY DEVELOPMENT
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