HomeMy WebLinkAboutBLD2003-00112 • •
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 #: BLD03-00112 Received Date 2/27/2003
SITE ADDRESS: 85 FLEET DR Issue Date 2/27/2003
PORT LUDLOW, 98365
APPLICANT: JAMES L BEEBE PHONE: (360)437-0153
SHIRLEY W BEEBE
PO BOX 65472
PORT LUDLOW WA 98365-0472 97
SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot:
PARCEL NUMBER: 990600397 Section: 8 Township: 28N Range: 01 E
CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096
P 0 BOX 989
PORT TOWNSEND WA 98368
Contractor's License SUBURPL044DA Expires 3/8/2003
OWNER, JAMES L BEEBE PHONE: (360)437-0153
if different: SHIRLEY W BEEBE
PO BOX 65472
PORT LUDLOW WA 98365-0472
PROJECT DESCRIPTION: PROPANE TANK& UNIT HEATER FOR GARAGE
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:
[ ] ank/ in pplianc ; dte 3/7 dgA
[ ] FinalApproval: OK co sr 5/A3
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
103U PERMIT APPLICON B Review
2
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00112 Received Date: 2/27/2003
SITE ADDRESS: 85 FLEET DR
PORT LUDLOW, 98365
OWNER: JAMES L BEEBE PHONE: (360)437-0153
SHIRLEY W BEEBE
PO BOX 65472
PORT LUDLOW WA 98365-0472
SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot: 97
PARCEL NUMBER: 990600397 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: SUBURBAN PROPANE PHONE: 385-5096
P 0 BOX 989
PORT TOWNSEND WA 98368
Contractor's License SUBURPL044DA Expires 3/8/2003
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI PROPANE TANK & UNIT HEATER FOR GARAGE
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 Bv: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 02/27/03 55152
Total: $47.00
JEFFERSON COUNTY COMMU.EVELOPMENT,621 SHERIDAN ST,PORT TOW,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 IINSE"R�T� /� PELLET STOVE COOKING STOVE
OTHER(Please Specify) vY\tk Vlt.�i"1c-,P terra. Carr n•e_.
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):
`85 ./. -C+ `o �..
cp, ,A(c)ts-> ( A ZIP 9136
9 DIGIT PARCEL ID NUMBER (7 0-:o /
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range car VVM
APPLICANT Si t' V 1 p r PHONE 3 0%/O 5--5
MAILING ADDRESS Z-S— k
1C7
iCir c-.�1, -�! ZIP ?C 5 '3
PROPERTY OWNER 3-i q`i4/ S/_ ' z/ /PHONE / 3 -OI ' 3
MAILING ADDRESS 'S' k/ -'11 t2, rr
�'2. ik-
ZIP 9f 36: 5
CONTRACTOR L7b..) , Pf 4— PHONE
MAILING ADDRESS ---�"1'1 .V i4:
rt� q elZIP
STATE LICENSE# CTh.. CD 12,EL, 0 q.0 14 EXP.DATE 3/ o 3
FEDERAL I.D.#
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 on County and it's employees, representatives or agents for the purpose of application review and any
required later inspections. Access and right of entry applicant's
property or structure shall be requested and shall occur during regular business hours.
APPLICANT'S SIGNATURE DATE / ✓ / cD 3
BASE FEE FOR OFFICE USE ONLY RECEIPT# 55 IS
CONSISTENCY REVIEW 0 K#
TOTAL ' F /- .-- T 0)
Underground Propane Tank applications require additional informatio ` o sni6. i%-? ti
.0 E O 't R
Please contact our office at 360-379-4450 if the back of this application i - -,
H:\HOME\PLNCNTR\INFOBLDG\FORMS\I NSTALL.DOC
FEB 27 �
x 36 ) DEPT, OF COMMUNI 1 Y DEVELOPMENT I