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Home My WebLink AboutBLD2004-00475 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 #: BLD04-00475 Received Date 7/15/2004 SITE ADDRESS: 684 BYWATER WAY N Issue Date 7/15/2004 PORT LUDLOW, 98365 APPLICANT: MARK MC MAHON PHONE: 360-437-0322 684 BYWATER WAY NORTH PORT LUDLOW WA 98365 14 SUBDIVISION: WHITE ROCK COVE TRACTS DIV II Block: Lot: PARCEL NUMBER: 821265026 Section: 26 Township: 28N Range: 01 E CONTRACTOR: C H S PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 09/06/2004 OWNER, if different: PROJECT DESCRIPTION: 250 GAL ABOVE GROUND PROPANE TANK, GENERATOR, 2 - HEAT STOVES, BBQ 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 07/15/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: Z:rt fz1& e //A)1- ¢ia,� q 1;fpg zve 7/*, [ ] FinalApproval: ‘Extcg,9T2l,e_, CRE-Arreeeku f P ~7 fiASrAse„eye re I>k( AA,PB6"i srus oKr 1J 0� —g r 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 0049 UILDING PERMIT APPLICATION BL Review Type: Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00475 Received Date: 7/15/2004 SITE ADDRESS: 684 BYWATER WAY N PORT LUDLOW, 98365 OWNER: MARK MC MAHON PHONE: 360-437-0322 684 BYWATER WAY NORTH PORT LUDLOW WA 98365 SUBDIVISION: WHITE ROCK COVE TRACTS DIV II Block: Lot: 14 PARCEL NUMBER: 821265026 Section: 26 Township: 28 N Range: 01 E CONTRACTOR: C H S PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**9790Z Expires 09/06/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI` 250 GAL ABOVE GROUND PROPANE TANK, GENERATOR, 2 - HEAT STOVES, BBQ TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2003 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 $48.00 ZAN 07/15/04 66531 Total: $48.00 JEFFERSON COUNTY COMMUNINEVELOPMENT,621 SHERIDAN ST,PORT TOWN•WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION Underground PROPANE TANK* X Above Ground PROPANE TANK* SIZE OF PROPANE TANK 2 5O 2. HEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE OTHER(Please Specify) G t1CM-To ie 13AR,(3AcoL% Is this appliance(woodstove, htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home? YES X NO SITE ADDRESS(911#/Road Name): (Q �{ Vt1)ret- --=tR wR.j N , PoRi' L,�cL.ot , w . gtw3 ZIP clS 36 9 DIGIT PARCEL ID NUMBER ?2 I Z (o C ) 2.C> Legal Description: Subdivision Name Block Lot(s) ! Section Township North, Range WM APPLICANT MARK 1' ` L_ ON; CT 0 l'• PHONE V,00 7 - c -3,7_7 MAILING ADDRESS 6,�n� B y L_ TL 2 W 446 L- & Lo W QA, ZIP /5-36 PROPERTY OWNER SR m C—r PHONE MAILING ADDRESS ZIP CONTRACTOR PHONE MAILING ADDRESS ZIP STATE LICENSE# EXP.DATE 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 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 a plicant's property or str ture shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE MC Ma DATE 7 I /6 / <) 9' FOR OFFICE USE ONLY BASE FEE $48.00 RECEIPT# CONSISTENCY REVIEW $24.00 CASH/CK# TOTAL DATE / / Propane Tank applications require additional information to be submitted. OVER Please contact our office at 360-379-4450 if the back of this application is blank. G:\PermitCenter\FORMS\BLDG FORMS\install-revised 01-26-04.DOC • 'yTAq� STAR : RENTALS 41r.4SEATTLE PHONE 622-7880 ARK ttM f r00 BELLEVUE PHONE 885-5522 6 ey ty to�Tc Q 1t)A-al ,�� TACOMA PHONE 474-0577 AUBURN PHONE 854-3922 O�f-c- 1 l�J!J Lo to WA LYNNWOOD PHONE 348-6969 K 9 El34tc- i-/37 d3zx .r- QI `�- d 'NO 1` y J/ A6 400 ./+odd er fi 0- ( 4C' flt/9 OS c%) A-4 Pop THE COMPLETE CONTRACTOR RENTAL SERVICE