HomeMy WebLinkAboutBLD2003-00549 •
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 #: BLD03-00549 Received Date 9/3/2003
SITE ADDRESS: 960 BECKETT POINT RD Issue Date 9/3/2003
PORT TOWNSEND, 98368
APPLICANT: BECKETT POINT FISHERMEN'S CLUB PHONE:
% DAVID G GOODING
920 PIKE PL NE
PORT TOWNSEND WA 983685717 13&14
SUBDIVISION: BECKETT POINT SOUTH BEACH Block: Lot:
PARCEL NUMBER: 931960008 Section: 23 Township: 30N Range: 02W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI983O6 Expires 9/26/2004
OWNER, MIKE STEVENS PHONE: 1-800-937-5453
if different: 30205 108TH AVE SE
AUBURN WA
PROJECT DESCRIPTION: NO MLA REQ'D -ABOVE GROUND PROPANE TANK AND 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 9/3/2004.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: 6 -rlVA- 1 nj r Z-i
[ ] FinalApproval: -cnr t ricz ( �,/216S
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
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JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PERTAIN TO THIS INSTALLATION
Underground PROPANE TANK* I Above Ground PROPANE TANK / HEAT STOVE HOT WATNK a
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVEI"rEi /
OTHER(Please Specify)
Is this appliance (htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911#/Road Name):
96o J,3r e k'e ,t 12a/' Q
?oft 10 w1 �5 L�`!6� , w4 . 9 536� ZIP 5..?6 c
9
9 DIGIT PARCEL ID NUMBER ! 5U 0 - o d s
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range WM
APPLICANT O y,1 1Qln Pro p911 t° PHONE 360 - Sg3
MAILING ADDRESS zes Cb,ly+ cie y yr, /Zp/.
Port
ii-JQG/)vc.14, 1-v4. ZIP 45339
PROPERTY OWNER 717/ .S1-10I/Ca/75 PHONE /` '- 93?-.33 3
MAILING ADDRESS 3b2o5 /O S � / vrp p
,�14wrr► , W� ' ZIP f o7 ?'"
CONTRACTOR /I7ONp 7�41n ProPQQe PHONE 360 - 345s -6g$3
MAILING ADDRESS o't(7S Ch/)r_ pgC I4)7 pz�'
�7
PO{fi <i /iOck , Iti,4 . ZIP '6339
STATE LICENSE# ,4 'Lint ?l 9 30 6 EXP.DATE 7 p ` 026-b4'
FEDERAL I.D.# y})-
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 f entry to the applicant's property or structure shall be requested and shall occur during regular business hours.
APPLICANTS SIGNATURE � "'' DATE 9 / 3 / 03
h do FOR OFFICE USE ONLY
BASE FEE 7 7, RECEIPT# / Ono/
CONSISTENCY REVIEW CASH/CK# C (6
TOTAL 4/ 7. dV DATE ! / 3 ,/ 3
*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 NFOBLDG\FORMS\I N STALL.DOC
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BUILDING PERMIT APPLICATION BL Review03-00549 Type:
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00549 Received Date: 9/3/2003
SITE ADDRESS: 960 BECKETT POINT RD
PORT TOWNSEND, 98368
OWNER: BECKETT POINT FISHERMEN'S CLUB PHONE:
DAVID G GOODING
920 PIKE PL NE
PORT TOWNSEND WA 983685717
SUBDIVISION: BECKETT POINT SOUTH BEACH Block: Lot: 13&14
PARCEL NUMBER: 931960008 Section: 23 Township: 30 N Range: 02 W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI98306 Expires 9/26/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOF NO MLA REQ'D -ABOVE GROUND PROPANE TANK AND HEAT
STOVE
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 MJA 09/03/03 60001
Total: $47.00