HomeMy WebLinkAboutBLD2002-00083 BUILDING PERMIT APPLICA B Review
000 83
N
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00083 Received Date: 2/19/2002
SITE ADDRESS: 970 BECKETT POINT RD
PORT TOWNSEND, 98368
OWNER: CYNTHIA HANSON PHONE: (425)486-0780
PO BOX 146
SNOHOMISH WA 98291
SUBDIVISION: BECKETT POINT SOUTH BEACH Block: Lot: 15
PARCEL NUMBER: 931960009 Section: 23 Township: 30 N Range: 02 W
CONTRACTOR: OWNER PHONE:
REPRESENTATIVE(S):
PROJECT DESCRIPTIO WOODSTOVE 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
F&W Landslide
Routing Date: Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 02/19/02 45737
Total: $48.00
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 (800)831-2678
PERMIT #: BLD02-00083 Received Date 2/19/2002
SITE ADDRESS: 970 BECKETT POINT RD Issue Date 2/19/2002
PORT TOWNSEND, 98368 Expiration Date 2/19/2003
APPLICANT: CYNTHIA HANSON PHONE: (425)486-0780
PO BOX 146
SNOHOMISH WA 98291
15
SUBDIVISION: BECKETT POINT SOUTH BEACH Block: Lot:
PARCEL NUMBER: 931960009 Section: 23 Township: 30N Range: 02W
CONTRACTOR: OWNER PHONE:
OWNER, BECKETT POINT FISHERMEN'S CLUB PHONE:
if different: % DAVID G GOODING
PO BOX 146
PORT TOWNSEND WA 983685717
PROJECT DESCRIPTION WOODSTOVE 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 02/19/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:
[ ] FinalApproval:
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 DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
WOODSTOVE PROPANE TANK PELLET STOVE OTHER
Is this appliance (htg stove, hot water tank,furnace,etc.)to be installed in a Manufactured/Mobile Home?
YES ()C NO
SITE ADDRESS(911#/Road Name):
Po. Tour! ZIP 9Dt0g
��
9 DIGIT PARCEL ID NUMBER 93 i Ch'"A.% (pep l,z)e"
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range VVM
APPLICANT CAjI(Q {��yC PHONE � �=p " 118le-0
MAILING ADDRESS f 0 go( I 1 to
Uyl061 S-A I ZIP 97),e)
PROPERTY OWNER 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 applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANT SIGNATURE l� 4 A41^'!I�'GG DATE I% / I j /r96)(-),1,_
FOR OFFICE USE ONLY 1r
BASE FEE "I ✓�(>
Q E � � OME EIPT#
.._... _..__ 45H/CK#
CAS E
/C�
TOTAL FEB 1 y
V1�4 9 RM TE Z /{ l / O7
1r �
H:\HOM E\PLNC NTR\I NFOB LDG\FORMS\I NSTALL.DOC 11/05/01
JLr NJ i v llt,Y�
DEPT.OF COMMUNITY DEVELOPMENT
�X +