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HomeMy WebLinkAboutBLD2001-00153 • 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 #: BLD01-00153 Received Date 3/20/2001 SITE ADDRESS: 42 GARTEN RD Issue Date 3/20/2001 PORT LUDLOW, 98365 Expiration Date 3/20/2002 APPLICANT: ROBERT KLINKERT JR PHONE: (360)297-8210 HEATHER KLINKERT PO BOX 484 SUQUAMISH WA 983920484 T 57 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821344015 Section: 34 Township: 28N Range: 01E CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/01/2001 OWNER, ROBERT KLINKERT JR PHONE: (360)297-8210 if different: HEATHER KLINKERT PO BOX 484 SUQUAMISH WA 983920484 PROJECT DESCRIPTION PROPANE TANK 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 03/20/2002. REQUIRED INSPECTIONS: IL}--- ..__. /Line/Appliance: (t')/C �/z 7/2, çZf2. VaIApprov C2/C 312 2r1©I ..!;Z_C?" BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. HOT LINE AVAILABLE 24 HOURS A DAY is\F_BLD_Permit_Propane.rpt 10/29/19 BUILDING PERMIT APPLICATION • Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00153 Received Date: 3/20/2001 SITE ADDRESS: 42 GARTEN RD PORT LUDLOW, 98365 APPLICANT: ROBERT KLINKERT JR PHONE: (360)297-8210 HEATHER KLINKERT PO BOX 484 SUQUAMISH WA 983920484 SUBDIVISION: Block: Lot: T 57 PARCEL NUMBER: 821344015 Section: 34 Township: 28 N Range: 01 E CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 09/01/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: PROPANE TANK 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 F&W Landslide Routing Date: C` Shoreline Aquifer Forest: Commercial Rural —Proximity - Mat u ditions Type A nt Paid By: Date: Receipt: d/D Approved/Date Propane Tanks/Stoves $48.00 ZAN 03/20/01 38393 Total: $48.00 JEFFERSO I COUNTY COMMUNITY DEVELOPMENT, 621 SHERIDAN ST, PORT TOWNSEND WA 98368 PH: (36C) 379-4450. INSTALLATION PERMIT APPLICATION WOODSTOVE PROPANE TANK PELLET STOVE OTHER SITE ADDRESS: �r4 6C /CA-61/1 911#/ROAD NAME ]/�y� �j ,1 III���...IIIdJJJ((( P111 + I d/cw , u M. ZIP 9F3&6 9 DIGIT PARCEL ID NUMBER Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT ?Ob2 ka-Ih2c K!t l ii�-�ei, PHONE 3(1)6- 7 37 �6 MAILING ADDRESS •D. Eoi( 44 lsl .1D_J/ 'istI. r ZIP 9 � � PROPERTY OWNER CgitiTta., £g. L Y .. PHONE MAILING ADDRESS ZIP CONTRACTOR e_ei( PHONE ( - �� ( ) MAILING ADDRESS ZIP STATE LICENSE # EXP. DATE 1 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 '..-E. C 7 Q./( 1,111�Q�)[ DATE \ / /�/4�/ a( cP FOR OFFICE'USE ONLI! BASE;FEE RECEIPT# CASH/CK# TOTAL DATE / I H:\HOME\PLNCNTR\FORMS\IN STALL.DOC 10/99