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HomeMy WebLinkAboutBLD2003-00110 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 #: BLD03-00110 Received Date 2/26/2003 SITE ADDRESS: 620 MC MINN RD Issue Date 2/27/2003 PORT TOWNSEND, 98368 APPLICANT: FRANK K TOWNSEND PHONE: LINDA TOWNSEND 620 MCMINN RD PORT TOWNSEND WA 98368-9004 3 SUBDIVISION: HILDEBRANDT SHORT PLAT Block: Lot: PARCEL NUMBER: 002014007 Section: 12 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, FRANK K TOWNSEND PHONE: if different: LINDA TOWNSEND 620 MCMINN RD PORT TOWNSEND WA 98368-9004 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 2/27/2004. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: [Z FinalApproval: 0(c' . `z`// /C5, 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 •UILDING PERMIT APPLICAON BLDOe 00110 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLDO3-00110 Received Date: 2/26/2003 SITE ADDRESS: 620 MC MINN RD PORT TOWNSEND, 98368 OWNER: FRANK K TOWNSEND PHONE: LINDA TOWNSEND 620 MC MINN RD PORT TOWNSEND WA 98368-9004 SUBDIVISION: HILDEBRANDT SHORT PLAT Block: Lot: 3 PARCEL NUMBER: 002014007 Section: 12 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 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: 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 02/26/03 55107 Total: $47.00 •EFFERSON COUNTY COMMUIJEVELOPMENT,621 SHERIDAN ST,PORT TOWD WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION 1 JJ 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): I l oWncr / k / ZIP e_d(J d 9 DIGIT PARCEL ID NUMBER 0 0 ©/ e.pe o 7 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT ��- (�— 41-.1Aa-e- 144-‘4.4-fra PHONE efd MAILING ADDRESS c4A- L� ZIP PROPERTY OWNER 1�'I .ee,c_ PHONE MAILING ADDRESS ZIP CONTRACTOR PHONE W W W.SUNSHINEPROPANE.COM MAILING ADDRESS Quality Energy Services Since 1980 10853 Rhody Hadlock,WA 98339 it, (360)311111 or 683-4011 _ ZIP STATE LICENSE# `-514 cr ' (f O7 7 car EXP.DATE FEDERAL I.D.# Q/ - / 0 7 t cfJ-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 Jeff rson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of ntry to th pplicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT'S SIGNATURE DATE / / 0 3 FOR OFFICE USE ONLY BASE FEE RECEIPT# SS L CONSISTENCY REVIEW CASH/CK# R232 TOTAL --` Q IL ($T Z / ! 03 * Iif {Underground Propane Tank applications require additional infor o to itted. V E R Please contact our office at 360-379-4450 if the back of this applica' lank. H:\HOME\PLNCNTR\INFOBLDG\FORMS\I NSTALL.DOC FEB 2 6 2003 J i DEPT. OFVCOMMUNilY DEVELOPMENT,: