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HomeMy WebLinkAboutBLD2004-00248 S • 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 #: BLD04-00248 Received Date 4/20/2004 SITE ADDRESS: 559 BECKETT POINT RD Issue Date 4/20/2004 PORT TOWNSEND, 98368 APPLICANT: BECKETT POINT FISHERMEN'S CLUB PHONE: % DAVID G GOODING PORT TOWNSEND WA 983685717 14&1 E SUBDIVISION: BECKETT POINT HWY HEIGHTS A Block: Lot: PARCEL NUMBER: 931910005 Section: 23 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, BECKETT POINT FISHERMEN'S CLUB PHONE: if different: % DAVID G GOODING PORT TOWNSEND WA 983685717 PROJECT DESCRIPTION: NO MLA REQ'D - 100 GAL AG PROPANE TANK CHANGE OUT AND MOM- 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 04/20/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: [ ] FinalApproval:,"G )Ei �j' `L ( I--2—"O ' r10, ?1 Fq 1 t-'' t� 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 I:\F_BLD_Permit_Propane.rpt 10/29/19, JEFFERSON COUNTY COMMUNITYYDEVELOPMENT,621 SHERIDAN ST,PORT TO SE WA 98368 PH: (360)379-4450 -� ..,-' •IitALLATION PERMIT APPLICA MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION Underground PROPANE TANK* ' '/Above t✓Above Ground PROPANE TANK* SIZE OF PROPANE TANK /2 ' XHEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT • PELLET STOVE COOKING STOVE X OTHER(Please Specify) Z--0 P t'Ir "e-' is this appliance(woodstdve, htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home? YES 1,, NO SITE ADDRESS(911#/Road Name): /' , l 4 (5: k t,)cl r7, 1..tv10 6(i VC, ZIP qe3 S 9 DIGIT PARCEL ID NUMBER 9 6 1 6 e0 l 6. () ( . Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT `J lT_ (2 -1-ts C L --t--_, PHONE Vie''7/ - 5-6 (- 333 7. MAILING ADDRESS c&vim ZIP PROPERTY OWNER C cZ_.,4 PHONE u) —C 0,-,.,..a MAILING ADDRESS -C_G--- Cy ZIP CONTRACTOR S L- VI 5 N I)•-) e_ Pi C 0(.114-\-0— PHONE MAILING ADDRESS /nI O,$)53 t�)(loci LA 0 r . P©r'r llaci L 6c.k, 1,vl6 • ZIP C--V33 , STATE LICENSE# SLtf 1;S 1--19 X ).-7 7 Q A EXP.DATE 1 I/0 `t FEDERAL I.D.# 9. 1 - / 0 f/q 83 ri , 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 td the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE C) ti-r, Q—y-1 DATE V / /'-) / 0 FOR OFFICE USE ONLY SASE FEE " $48.00 Y se,£ q;,:, RECEIPT# z« CONSISTENCY REVIEW�:_- $24.00 ��8 CASH/CK# � ; TOTAL �' _ R , 33 �a ' l' C k tyy 4 * Propane Tank applications require additional information submitted. Please contact our office at 360-379- 450 if the back of thisl L plicationi9rl✓fian4 9 2004 `�,VE R 4 + 4 _ Arr f�11 i 1i , t :Al.OFCj r; vE' , .:E .OpML:i 3 G:\PermitCenter\FORMS\BLDG FORMS\install-revised 01-26-04.DOC •BUILDING PERMIT APPA ON BLD04-00248 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00248 Received Date: 4/20/2004 SITE ADDRESS: 559 BECKETT POINT RD PORT TOWNSEND, 98368 OWNER: BECKETT POINT FISHERMEN'S CLUB PHONE: % DAVID G GOODING PORT TOWNSEND WA 983685717 SUBDIVISION: BECKETT POINT HWY HEIGHTS A Block: Lot: 14&1E PARCEL NUMBER: 931910005 Section: 23 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 DESCRIPTIOD NO MLA REQ'D - 100 GAL AG PROPANE TANK CHANGE OUT AND 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 Total: • 0 SITE VISIT REPORT (PLOT PLAN) JOB -- /0 i,_ * ( 1�ei DATE : CONTACT: ADDRESS PHONE #: DIRECTIONS FAX #: Email • PLANNER: , .—.....+''f5..k- rr g r"). 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