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Home My WebLink AboutBLD2004-00509 ill/JILDING PERMIT APPLICA BLD04-00509 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD04-00509 Received Date: 8/4/2004 SITE ADDRESS: 555 BLUE SKY DR PORT TOWNSEND, 98368 OWNER: THOMAS M WYLIE PHONE: 360-385-2559 GABRIELLE E LAROCHE 555 BLUE SKY DR PORT TOWNSEND WA 983689686 SUBDIVISION: DISCOVERY RIDGE DIV III Block: Lot: 20 PARCEL NUMBER: 001195120 Section: 19 Township: 30 N Range: 01 W 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 500 GAL ABOVE GROUND PROPANE TANK AND PROPANE HEAT STOVE 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: 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 Total: • • 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 #: BLD04-00509 Received Date 8/4/2004 SITE ADDRESS: 555 BLUE SKY DR Issue Date 8/4/2004 PORT TOWNSEND, 98368 APPLICANT: THOMAS M WYLIE PHONE: 360-385-2559 GABRIELLE E LAROCHE 555 BLUE SKY DR PORT TOWNSEND WA 983689686 20 SUBDIVISION: DISCOVERY RIDGE DIV III Block: Lot: PARCEL NUMBER: 001195120 Section: 19 Township: 30N Range: 01W 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, THOMAS M WYLIE PHONE: 360-385-2559 if different: GABRIELLE E LAROCHE 555 BLUE SKY DR PORT TOWNSEND WA 983689686 PROJECT DESCRIPTION: 500 GAL ABOVE GROUND PROPANE TANK AND PROPANE HEAT STOVE 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 08/04/2005. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: / ,-AA,11( z 4 c /k t , 'Ls-t,.-/ j/c!j LI/✓S ai< C [ ] FinalApprova r ll- \5,0y, 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 COMMUNITY•ELOPMENT,621 SHERIDAN ST,PORT TOWNSE,A 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 S Z C,,tk HEAT STOVE HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE OTHER(Please Specify) Is this appliance (woodstove, htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home? YES NO SITE ADDRESS(911#/Road Name): • -e,kt42 , 6 f/ ZIP Q3t 9 DIGIT PARCEL ID NUMBER PC) / / /3/ 742 Legal Description: Subdivision Name Block Lot(s) Section //�J,�,, Township North, Range WM APPLICANT Urh 9 5 �"l, �y PHONE �'�� 3 - — Z 5 5 J MAILING ADDRESS 57 7 0/-• Pt '%c� 115Crtc<2 cvA - ZIP le.56 PROPERTY OWNER PHONE MAILING ADDRESS C54.44 �y,S1YG ZIP CONTRACTOR c _ PHONE 3bC/ 73 2- `4-1S Kr 5 MAILING ADDRESS / /5 n h o 047 A- Lln Yvt C. , ; l A ZIP J J L c STATE LICENSE# ( (- /# r / A/r Ylir "/A ?J 9 O Z EXP.DATE FEDERAL I.D.# (p 2 e§ /44 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 applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANTS SIGNATURE DATE 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. 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