HomeMy WebLinkAboutBLD2002-00707 • •
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#: BLD02-00707 Received Date 12/2/2002
SITE ADDRESS: 77 MARTINGALE PL Issue Date 12/3/2002
PORT LUDLOW, 98365
APPLICANT: ANTHONY H LOUGHRAN PHONE: (360)437-9943
JEAN K LOUGHRAN
PO BOX 65349
PORT LUDLOW WA 98365 44
SUBDIVISION: BAYVIEW VILLAGE DIV 3 Block: Lot:
PARCEL NUMBER: 931900044 Section: 16 Township: 28N Range: 01E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP'077QP Expires 11/17/2004
OWNER, ANTHONY H LOUGHRAN PHONE: (360)437-9943
if different: JEAN K LOUGHRAN
PO BOX 65349
PORT LUDLOW WA 98365
PROJECT DESCRIPTION: PROPANE TANK& PIPING
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 12/3/2003.
REQUIRED INSPECTIONS:
[ ] Tan,`k®eI ppliance: 4( I�Q/ /I
[ ] FinalApproval: a f Z Z-
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_Perm it_Propane.rpt 10/29/19
BUILDING PERMIT APPLICISON BLD02-00707
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00707 Received Date: 12/2/2002
SITE ADDRESS: 77 MARTINGALE PL
PORT LUDLOW, 98365
OWNER: ANTHONY H LOUGHRAN PHONE: (360)437-9943
JEAN K LOUGHRAN
PO BOX 65349
PORT LUDLOW WA 98365
SUBDIVISION: BAYVIEW VILLAGE DIV 3 Block:
PARCEL NUMBER: 931900044 Section: 16 Township: 28 N Range: 01 E Lot: 44
CONTRACTOR: SUNSHINE PROPANE (U rOVM t4
10853 RHODY DR / _ PHONE: 385 5797
PORT HADLOCK WA 98339 �� l(��" t 5
Li
LC,›P70
Contractor's License SUNSHP*077QP Expires 11/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOt PROPANE TANK & PIPING 4 i NW
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:
CONST TYPE: GARAGE: SHORELINE:
DECK: SETBACK:
SEWAGE DISPOSAL: BANK HEIGHT:
WATER SYSTEM:
BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO
STORMWATER: YES NO AREA
Exist: Exist: Wetland
Prop: Prop: Erosion
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 12/02/02 51470
Total: $47.00
JEFFERSON COUNTY COMMU.DEVELOPMENT,621 SHERIDAN ST,PORT TOWt D WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* V Above Ground PROPANE TANK HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE
OTHER(Please Specify) r")
l l
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):
P 4 4'34S ZIP
9 DIGIT PARCEL ID NUMBER 13/ 90O D 7 IK
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range/ !!!!J)) WM
%
APPLICANT PHONE 3 7 f5'7
MAILING ADDRESS 7O 6 /o )11 P% ZIP 7'scr)..J 6-1
PROPERTY OWNER Yf f -� - PHONE
MAILING ADDRESS /
ZIP
SUNSHINE PROPANE
CONTRACTOR Quality Energy Services Since 1980
10853 Rhody Dr.Hadlock,WA 98339 PHONE
MAILING ADDRESS (360)385-5797 or 683-4010
www.sunshinepropane.com
•
ZIP
STATE LICENSE# 54fl,s//-/P > 0 17 QP EXP. DATE it/0 !�
FEDERAL I.D.# 9 ( — !°71 6 37
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 ap icant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT'S SIGNATURE CC% jam DATE `1 / 7 /6
F= •k
BASE FEE D E , W C' )I,14 L�
CONSISTENCY REVIEW / K# c1l(Q Q
P
TOTAL [ DEC — 2 2002 'iL.
*Underground Propane Tank applications require additional i formationlo be submitted. PI ash contapt our office at 360-379-4450 if the back of
this application is blank. DEPT. OF COMMUNITY DEVEi_OP.IENT I
H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC ��