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Home My WebLink AboutBLD2003-00522 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 #: BLD03-00522 Received Date 8/20/2003 SITE ADDRESS: 86 N BAYVIEW DR Issue Date 8/20/2003 PORT LUDLOW, 98365 APPLICANT: DAVID F HOLT TRUSTEE PHONE: SUSAN HOLT TRUSTEE 46 VILLAGE WAY, PMB 161 PORT LUDLOW WA 98365 4 SUBDIVISION: GAINER SHORT PLAT Block: Lot: PARCEL NUMBER: 921332026 Section: 33 Township: 29N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2004 OWNER, DAVID F HOLT TRUSTEE PHONE: if different: SUSAN HOLT TRUSTEE 46 VILLAGE WAY, PMB 161 PORT LUDLOW WA 98365 PROJECT DESCRIPTION: UNDERGROUND PROPANE TANK, HEAT STOVE, HOT WATER TANK, COOKING STOVE, PROPANE FURNACE 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 08/20/2004. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance:4;M( It (xt PRoPAkir LIME dk Øi/43 4JA6111deLon&S [ ] FinalApproval: dif —Par �� 1�z/1/0 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_Perm it_Propane.rpt 10/29/19.c 110 BUILDING PERMIT APPLIATION BLReview D03-005e 2 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00522 Received Date: 8/20/2003 SITE ADDRESS: 86 N BAYVIEW DR PORT LUDLOW, 98365 OWNER: DAVID F HOLT TRUSTEE PHONE: SUSAN HOLT TRUSTEE 46 VILLAGE WAY, PMB 161 PORT LUDLOW WA 98365 SUBDIVISION: GAINER SHORT PLAT Block: Lot: 4 PARCEL NUMBER: 921332026 Section: 33 Township: 29 N Range: 01 E 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 DESCRIPTIOP UNDERGROUND PROPANE TANK, HEAT STOVE, HOT WATER TANK, COOKING STOVE, PROPANE FURNACE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: 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 i 2 2_0 ilio 3 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 ZAN 08/20/03 58387 P �[� v ED Total: $47.00 r�" pUG202003. Je{tetson County Planning .-&Building department di JEFFERSON COUNTY COMillTY DEVELOPMENT,621 SHERIDAN ST,PORT TO^" SEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICA 1 N MARK ALL ITEMS BELOW THAT PERTAIN TO THIS IN. ATION �/ underground PROPANE TANK* Above Ground PROPANE TANK /\ HEAT STOVE J� HOT WATER TANK WOODSTOVE FIREPLACE INSERT PELLET STOVE X COOKING STOVE OTHER(Please Specify) ere Pay,,_ fr.Vv WAC4. 1 Is this appliance (htg stove, hot water tank,furnace, etc.) to be installed in a Manufactured/Mobile Home YESi NO SITE ADDRESS(911 #/Road Name): gee A) gayvl-ew 19r )v-e-• PDY4. L u a I / ww) W 5 ZIP v/ S 3 eO� 9 DIGIT PARCEL ID NUMBER 9 Z/33 Z 0 Z Ge Legal Description: Subdivision Name 6 a%vt'r 1\A 0It t Pak Block_ Lot(s) Section 33 Township Z.G'1 North, Range WM APPLICANT D V►d F 1 b,'f' / 5 V so.r N [Z d PHONE 3 t,O-437-2 $Z- L MAILING ADDRESS 41 I, V %\IAA e. Wel), ?vv1 1s Ha 1 7+. LUaI U w ZIP ei 8 56 PROPERTY OWNER C PHONE MAILING ADDRESS p A VH.e) ZIP CONTRACTOR G>a e. r Q pane 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. APPLICANTS SIGNATURE J j€44....-tiVl AZ•l-a DATE gr./ L 0 I 03 S 1i I� FOR OFFICE USE ONLY 5/'S r'1 BASE FEE +-� RECEIPT#al j CONSISTENCY REVIEW CASH/CK# ? TOTAL I 0 ,S 0 DATE i/ / —63 'Underground 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. _* H:\HOME\PLNCNTR\I N FOBLDG\FORMS\I NSTALL.DOC NW BUILDING PERMIT APPLICATION B RDOe Oype 2 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00522 Received Date: 8/20/2003 SITE ADDRESS: 86 N BAYVIEW DR PORT LUDLOW, 98365 OWNER: DAVID F HOLT TRUSTEE PHONE: SUSAN HOLT TRUSTEE 46 VILLAGE WAY, PMB 161 PORT LUDLOW WA 98365 SUBDIVISION: GAINER SHORT PLAT Block: Lot: 4 PARCEL NUMBER: 921332026 Section: 33 Township: 29 N Range: 01 E 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 DESCRIPTIOI UNDERGROUND PROPANE TANK, HEAT STOVE, HOT WATER TANK, COOKING STOVE, PROPANE FURNACE TYPE OF WORK NON SQUARE FOOTAGE: I TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 1997 ADD'L: HEAT TYPE: �, OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: (4AV • CONST TYPE: OTHER: SHORELINE: C� CONST TYPE: GARAGE: SETBACK: U\V/V/. 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 2.0 (�3 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 ZAN 08/20/03 58387 Total: $47.00 GAT 0 Y pf Rol T # BID 3� � 0 ° 3_052 w JffffRSON FENCE COUNTY D D \ z 82 o 83 �I �INa TcNitl�'d 'P, PP, :J ow b�a�c+0 A , I�� 000r •� rirAMWG WALL ; i i 10" FIR x CONCRET APR❑ L 4 0 ---- - `t ASPHALT D < CONCRETE T � I i a v-r CONTRACTOR WILL INVESTIGATE THE POTENTIAL DRAIN SYSTEM EXISTING ON PROPERTY a 2 w 0 6 r 16 1; APPROX. TOP OF BANK —� 30 2� 84 A 1 q � (*I I � PRI ED 1000 GAL. SEPTIC TANK W/ ❑ NCO PUMP. CONTRACTOR TO CO INATE WITH LOCAL BUILDING AU RITY i 24" CHE i + 24" F I R Z I APPROX, LINE OF HIGH TIDE Ins 85