HomeMy WebLinkAboutBLD2002-00566 • •
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 #: BLD02-00566 Received Date 9/24/2002
SITE ADDRESS: 940 BECKETT POINT RD Issue Date 9/24/2002
PORT TOWNSEND, 98368
APPLICANT: BECKETT POINT FISHERMEN'S CLUB PHONE:
% DAVID G GOODING
1819 LAKEHURST DR SE
PORT TOWNSEND WA 98368-5717 11
SUBDIVISION: BECKETT POINT SOUTH BEACH Block: Lot:
PARCEL NUMBER: 931960006 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 11/17/2002
OWNER, BECKETT POINT FISHERMEN'S CLUB PHONE:
if different: % DAVID G GOODING
1819 LAKEHURST DR SE
PORT TOWNSEND WA 98368-5717
PROJECT DESCRIPTION: PROPANE TANK& RANGE 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 9/24/2003.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance:___
[ FinalA oval:______ 6 2Z-=_
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
UILDI BLD02-0 66
NG PERMIT APPLICON Review Type:05
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00566 Received Date: 9/24/2002
SITE ADDRESS: 940 BECKETT POINT RD
PORT TOWNSEND, 98368
OWNER: BECKETT POINT FISHERMEN'S CLUB PHONE:
DAVID G GOODING
1819 LAKEHURST DR SE
PORT TOWNSEND WA 98368-5717
SUBDIVISION: BECKETT POINT SOUTH BEACH Block: Lot: 11
PARCEL NUMBER: 931960006 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 11/17/2002
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION PROPANE TANK & RANGE 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
Routing Date: F&W Landslide
Shoreline _Aquifer _
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 MAM 09/24/02 51052
Total: $47.00
•
Y JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWN ND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION /�
WOODSTOVE ✓ Above Ground PROPANE TANK PELLET STOVE 'OTHER +`a""
Is this appliance (htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?
YES X NO
SITE ADDRESS(911#,/Road Name): /�
C'17 0 aec1i Poi' t 249-
1 r f o GtN.s1e 04-- ZIP ` 3 6 a
9 DIGIT PARCEL ID NUMBER 1 ✓ / i 67 U D 0
Legal Description:
Subdivision Name Block Lot(s)
j I SectionL l Township North, Range WM
v APPLICANT 2' A - I.
pJ1.,rJ; s on , PHONE
q MAILING ADDRESS 18 i k'-Ice M l t ri _ g. (= -
OLlyi-pta , 1n/R ZIP q i s0
PROPERTY OWNER / P // C. 44 PHONE .34 o - 36 7 -7 ( 83
MAILING ADDRESS
ZIP
CONTRACTOR U G1 /)S n lap-aw a-1-4—.1 PHONE
MAILING ADDRESS 1 o t3 S31 404.1 Q r
P( r190 (A) c-A — k4lti ZIP ga p
) 3y
STATE LICENSE# SHp* 677 Q
SIAA EXP.DATE
QQ /p1--
FEDERAL I.D.# -t l I OZ Ct 851
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 i;)4 ►"`rSr• DATE q / 2-5 / 0 Z'
FOR OFFICE USE ONLY
BASE FEE RECEIPT#
CASH/CK#
TOTAL DATE / /
H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC 11/05/01