HomeMy WebLinkAboutBLD2002-00690 • •
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 #: BLD02-00690 Received Date 11/22/2002
SITE ADDRESS: 320 SUNSHINE RD Issue Date 11/25/2002
SEQUIM, 98382
APPLICANT: CHARLES F BACHMANN PHONE:
320 SUNSHINE RD
SEQUIM WA 98382-9681
13
SUBDIVISION: RONDELAY MEADOWS Block: Lot:
PARCEL NUMBER: 991900013 Section: 28 Township: 30N Range: 02W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
OWNER, CHARLES F BACHMANN PHONE:
if different: 320 SUNSHINE RD
SEQUIM WA 98382-9681
PROJECT DESCRIPTION: 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 11/25/2003.
REQUIRED INSPECTIONS:
[ ] an Line/Appliance:"—pt2J✓C �.h/t / Z-- 5--a
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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.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_B LD_Perm it_Propa ne.rpt 10/29/19
*BUILDING PERMIT APPLIC•ON BLD02-00690
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00690 Received Date: 11/22/2002
SITE ADDRESS: 320 SUNSHINE RD
SEQUIM, 98382
OWNER: CHARLES F BACHMANN PHONE:
320 SUNSHINE RD
SEQUIM WA 98382-9681
SUBDIVISION: RONDELAY MEADOWS Block: Lot: 13
PARCEL NUMBER: 991900013 Section: 28 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 11/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION PROPANE TANK INSTALLATION
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 MAM 11/22/02 51399
Total: $47.00
JEFFERSON COUNTY COMMUS DEVELOPMENT,621 SHERIDAN ST,PORT TOWOD WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* )( Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE
OTHER(Please Specify)
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):
.S 2- 0 jar,A..,2_ 69—
sE`C11 u ( ,,,,_ tAi Pr ZIP -I O 3c
9 DIGIT PARCEL ID NUMBER 9g( 90 d 0l/3
Legal Description:
Subdivision Name Block Lot(s)
Section W
�,,O Township North, Range M
/� i
APPLICANT � Oil 'Qi„j__ PHONE />- 733 4
MAILING ADDRESS . -4 C.
ZIP
PROPERTY OWNER killPHONE
MAILING ADDRESS
ZIP
I� ' SUNSHINE PROPANE
CONTRACTOR �� Quality Energy Services Since 1980
` 10853 Rhody Dr. Hadlock,WA 98339
MAILING ADDRESS �, '� (360)385-5797 or 683-4010
www.sunshinepropane.com
.
I
STATE LICENSE# 3(AY) S / ► / z 0 77 Q P EXP.DATE t/ / 0 4/
FEDERAL I.D.# - 1( - ' 0 79. C?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 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 Jefferso 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 app cant's property or structure shall be requested and shall occur during regular business hours.
APPLICANTS SIGNATURE r Tif Vii r'''�� DATE f / / V Z--
f
\--F-(7•R OFFICE USE OlIIIY
- -- -- Ili:
BASE FEE FLf NOV 2 2 2002 ?L RECEIPT# 5t CI
CONSISTENCY REVIEW g, CASH/CK# -` 15�j
TOTAL DEPT. OFJCO�°'' . iTv r,;t j DATE / 1-/
*Underground Propane Tank applications require additional information to be submitted. Please contact our office at 360-379-4450 if the back of
this application is blank.
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