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HomeMy WebLinkAboutBLD2002-00133 • 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 #: BLD02-00133 Received Date 3/12/2002 SITE ADDRESS: 580 RAINIER LN Issue Date 3/12/2002 PORT LUDLOW, 98365 APPLICANT: MICHAEL BULLEN PHONE: (360)301-5659 PO BOX 957 PORT HADLOCK WA 98339 SUBDIVISION: PORT LUDLOW NO. 3 Block: Lot: PARCEL NUMBER: 990700040 Section: 8 Township: 28N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE LLC PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPL994BH Expires 12/14/2002 OWNER, DON L KYLE PHONE: if different: 580 RAINIER LN PORT LUDLOW WA 98365-8710 PROJECT DESCRIPTION PROPANE TANK INSTALLATION , F/Rer 12_,, te/7-676//L IF- I4t/7 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 03/12/2003. REQUIRED INSPECTIONS: [ ] eqfiliine ppliance:'73Kt/ /P ,J,(Cr �'102 97,__9( riree 2-4¢C(' 1Nn7g/7,c [ ) FinalApproval: Ok cot- 0 311/03 Gk 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 BUILDING PERMIT APPLICATION BeDOw Type3 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00133 Received Date: 3/12/2002 SITE ADDRESS: 580 RAINIER LN PORT LUDLOW, 98365 OWNER: DON L KYLE PHONE: 580 RAINIER LN PORT LUDLOW WA 98365-8710 SUBDIVISION: PORT LUDLOW NO. 3 Block: Lot: PARCEL NUMBER: 990700040 Section: 8 Township: 28 N Range: 01 E CONTRACTOR: MOUNTAIN PROPANE LLC PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPL994BH Expires 12/14/2002 REPRESENTATIVE(S): MICHAEL BULLEN PO BOX 957 PORT HADLOCK WA 98339 PROJECT DESCRIPTIO PROPANE TANK INSTALLATION 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: Shoreline Aquifer Forest: Commercial Rural Proximity Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 MAM 03/12/02 45845 Total: $48.00 JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION WOODSTOVE ,)< PROPANE TANK PELLET STOVE OTHER 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): 5' FJ R4i -' E k L, �c�- L � � �� � - V4 zIP �. r'3GC- 9 DIGIT PARCEL ID NUMBER 9 9 ( / o : o `1 o Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT 11 I C I-I A r_ W &u L L.,Az ej PHONE 3(, 0 - 3 v I - G S q MAILING ADDRESS f .© • 0}c 9 5 7 fo,t,- (-1. 1) L0cK W 4 ZIP 9 3 ' °/ PROPERTY OWNER I M 1 1 C 14 P i 1. 4 , L'1 L- L =N PHONE MAILING ADDRESS S ; \ f-I �- ZIP CONTRACTOR K. 1 c lc (1 '- E'Q PHONE MAILING ADDRESS " r/'�4 N 12v f';4�+ 6 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. APPLICANT SIGNATURE ' S • DATE 3 I Z / ° Z j�( FOR OFFICE USE ONLY BASE FEE 1 C� RECEIPT# LI 5 g LIS CASH/CK# I %4 9- Ir' TOTAL —1 8 • DATE 3/I'1/ cy-)____ HA HOME