HomeMy WebLinkAboutBLD2002-00013 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 #: BLD02-00013 Received Date 1/7/2002
SITE ADDRESS: 10 BLUEJAY LN Issue Date 1/8/2002
PORT LUDLOW, 98365 Expiration Date 1/8/2003
APPLICANT: SHERRY A WALKER PHONE: (360)437-7838
10 BLUEJAY LN
PORT LUDLOW WA 98365
1
SUBDIVISION: BRIDGEHAVEN DIV 3 Block: Lot:
PARCEL NUMBER: 934500001 Section: 9 Township: 27N Range: 01 E
CONTRACTOR: ALL WEATHER HEATING &COOLING INC PHONE: (360)452-9813
302 KEMP ST
PORT ANGELES WA 98362
Contractor's License ALLWEHC15OKU Expires 09/01/2002
OWNER, SHERRY A WALKER PHONE: (360)437-7838
if different: 10 BLUEJAY LN
PORT LUDLOW WA 98365
PROJECT DESCRIPTION NO MLA REQ'D -PROPANE TANK&STOVE 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 01/08/2003.
REQUIRED INSPECTIONS:
[ ank/Line/Appliance O,Ck /.i7-oI-
_ //o[ I FinalApproval: ®/ o JJ b iz;l 07--
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_Perm it_Propane.rpt 10/29/19
t
D02BUILDING PERMIT APPLICATION BReview 0013
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00013 Received Date: 1/7/2002
SITE ADDRESS: 10 BLUEJAY LN
PORT LUDLOW, 98365
OWNER: SHERRY A WALKER PHONE: (360)437-7838
10 BLUEJAY LN
PORT LUDLOW WA 98365
SUBDIVISION: BRIDGEHAVEN DIV 3 Block: Lot: 1
PARCEL NUMBER: 934500001 Section: 9 Township: 27 N Range: 01 E
CONTRACTOR: ALL WEATHER HEATING &COOLING I PHONE: (360)452-9813
302 KEMP ST
PORT ANGELES WA 98362
Contractor's License ALLWEHC15OKU Expires 09/01/2002
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - PROPANE TANK & STOVE 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:
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: Shoreline Aquifer
Forest: Commercial Rural
Proximity_ Flat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 MAM 01/07/02 43893
Total: $48.00
01r`03/2002 12:31 36 3734ra51 JEFF CO IICD PALE 011/01
,lEFF TY ITY DE VE LOP 41ENT Rat$ R DAN ST pQRT T01NTI5E • 17c der n
INSTALLATION PERMIT APPLICATION
WOODSTOVE ,,, ,PROPANE TANK _ PELLET STOVE OTHER % r 19 e. lU10 tog r(,t am 510tee
is this appliance(htg stove,hot water tank,furnace,etc.}to be Installed in a Manufactured/Mobile Home?
YES NO
SITE ADDRESS(911#I Raul Name):
Ib eIlAi J(Iti Liuti M,Y1 /ti(I/6-7/1-;
ZJP
9 DIGIT PARCEL ID NUMBER 7 :'/.t 6 ice). ._
_ _,
SebfdM Dent ipam x P,Y0�y j GaU n ( l: �j f 8ubdfwisipll CJame �. Blc�tts Lot(e) ! .`
�� Section �j �(_ 1Township/1 / North, Range / �/ 7 V1 M
APPLICANT A i i (U/ .I tt( *PA,tiff"/f c' 1. G a'(/IC//i'l�• PHONE 3/ 6 5 - -9,73
MAILING ADDRESS (,'il}<e✓n4' S/ 'eef' .. / p (�?
��e } N'I/1�I nY'5. G't'I - SIP et J LC '
PROPERTY )tit1,9 (Cri.IkE�i PHONE 31,C' 497-7/A3"
MAILING ADDRESS I L.U' JC:9 L Ct/t(
R`YF L ii//i/ ,l' ZIP
CONTRACTOR I ( �`�!C H ( _V 1 (�(�l( j 5 L`G'G'�IJC (Et IC. PHONE . EIS,lf-—9 1?.)
MAILING ADDRESS. L- 1'&fill)5/
PO' i-t 19''C'iPe), 604 zIP zy f:?V .
STATE LICENSE 0 /41 (J W !a. 15G 16 d -7
/ /� _ EXP.DATE 7j/jai
FEDERAL LD.M q 1 - 1 i-L [ Z 71
By signing the application form,the applicant/owner attests that Ma information provided herein is true and correct to the be of ti aiir knowledge. Any materiel
feleenood or any omission of a materiel foot made by the applicant/owner with respect to this application pocket may result in this permit being dull and vod.
I further agree to seve, indemnify and hold harmless Jefferson County against all liabilities,Judgments,court costs,reasonable attorney's fees and expenses which
may in ants wily worue against lafforoon County co u eeault of,er Ie aama41 l,ti 5d Lr LISb y,w,l„„v,.r Lide,ea,.,.rL.
I further agree to provide soeaae end right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application renew and any
required later'inspections.. Apneas and right of entry to the applicant's property or structure shell be requested and chaff occur during regular business hours.
APPLICANT SIGNATURE 1.9t&117. c Cl.I 'S DATE q I - f
FOR OFFICE USE ONLY
FEE RecairoT# 43293
CASH/OK# J?I..`=( `ut
r.1'iromelei.aCNTRaNPQaI.oafORM5INSTALL.DOC11105/01 D c o V E
JAN - 7 2002
J:r'i'....14 J 4 c,.,..M,Y
DEPT. OF COMMUNITY DEVELOPMENI