HomeMy WebLinkAboutBLD2002-00706 ey
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 #: BLD02-00706 Received Date 12/2/2002
SITE ADDRESS: 493 SNAGSTEAD WAY Issue Date 12/3/2002
PORT TOWNSEND, 98368
APPLICANT: JOHN P JONES TRUSTEE PHONE: (360)379-9433
E LENORE JONES TRUSTEE
493 SNAGSTEAD WAY
PORT TOWNSEND WA 98368-9258 T 57
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001294005 Section: 29 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
OWNER, JOHN P JONES TRUSTEE PHONE: (360)379-9433
if different: E LENORE JONES TRUSTEE
493 SNAGSTEAD WAY
PORT TOWNSEND WA 98368-9258
PROJECT DESCRIPTION: HEAT 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 12/3/2003.
REQUIRED INSPECTIONS:
o ��
Tank/Line/ pplia ce �dG t l t1/4". e
[ 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
�� BLD02-00706
•UILDING PERMIT APPLIC I 'ON Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00706 Received Date: 12/2/2002
SITE ADDRESS: 493 SNAGSTEAD WAY
PORT TOWNSEND, 98368
OWNER: JOHN P JONES TRUSTEE PHONE: (360)379-9433
E LENORE JONES TRUSTEE
493 SNAGSTEAD WAY
PORT TOWNSEND WA 98368-9258
SUBDIVISION: Block: Lot: T 57
PARCEL NUMBER: 001294005 Section: 29 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 11/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP HEAT STOVE 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:
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 12/02/02 51470
Total: $47.00
JEFFERSON COUNTY COMMUIDDEVELOPMENT,621 SHERIDAN ST,PORT TOWD 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):
f 3 Tom- 4
PJ ZIP i r
9 DIGIT PARCEL ID NUMBER b 0( oZ 9 V 6 O .s—
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT J.P LZ-e_ e---i'J PHONE
3 7 9 4,9_3
MAILING ADDRESS ,(- _
ZIP
PROPERTY OWNER !t'P - PHONE
MAILING ADDRESS J t't-t
ZIP
CONTRACTOR SUNSHINE PROPANE , PHONE
— Quality Energy Services Since 1980
MAILING ADDRESS 10853 Rhody Dr.Hadlock,WA 98339
— (360)385-5797 or 683-4010
www.sunshinepropane.com
• ZIP
STATE LICENSE# S k n S hi *_. 0 77 a r EXP.DATE )//o y
FEDERAL I.D.# C C- 10 7 q c S 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 Jefferson unty 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 appli nt's property or structure shall be requested and shall occur during))reggular business hours.
s
APPLICANT'S SIGNATURE L•e _ DATE 6/ / 7/ v Z
10-6
Y� i
BASE FEE ® [ *IPT# Gj 1 L{-1"Q
CONSISTENCY REVIEW t�DEC - 4SH/CK# Girl to 0
E4 - 2 2002 Tc
TOTAL 1.2-/ 2. /o1.,_
*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. DE PT. OF COtm Mul'ii 1Y CLVLLUPMLN1- j
H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC