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HomeMy WebLinkAboutBLD2002-00221 • 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 #: BLD02-00221 Received Date 4/17/2002 SITE ADDRESS: 140 OLYMPUS BLVD Issue Date 4/17/2002 PORT LUDLOW, 98365 APPLICANT: GORDON N BYRNE TRUSTEE PHONE: (360)437-2269 DOROTHY BYRNE TRUSTEE 140 OLYMPUS BLVD PORT LUDLOW WA 98365-9431 55 SUBDIVISION: OLYMPUS BEACH Block: Lot: PARCEL NUMBER: 978900034 Section: 4 Township: 28N Range: 01 E CONTRACTOR: CENEX SUPPLY& MARKETING PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CENEXHS022NQ Expires 9/6/2002 OWNER, GORDON N BYRNE TRUSTEE PHONE: (360)437-2269 if different: DOROTHY BYRNE TRUSTEE 140 OLYMPUS BLVD PORT LUDLOW WA 98365-9431 PROJECT DESCRIPTION: PROPANE TANK 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 4/17/2003. REQUIRED INSPECTIONS: [ ] Tan A ppliance: NE - 5-t eER.t IQEauEsrEz 5/z/i3 /v/ [ l = if naTkpproZ/.03 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 • IP JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan St. Port Townsend, WA 98368 INSPECTION RESULTS Owner: Caovciov1 6\frn-e Date: 1 --ib '')_________ Address: 14 O OLt6 WI ► ipr,�,.S I3LV Y0 Contact Phone: �3a - Lis g 1 , Permit #: `-LOO)- - )- - 1 Type of Insp: 1— nd l - +a I'l IC- Results: Approved Approved with ❑ conditions Failed ❑ Must call for reinspection prior to proceeding Failed with penalty ❑ Must call for reinspection and pay reinspection fee prior to proceeding CONDITIONS: agiopp,05 -i41)ks "14A1 N 1 FoLDEZ ToGF- l o CaiucFte- �-644/g. iL LZt/ = /jv 11Se- rolt A YE4l'�- _ ith1 �,eeS3k ee- -1 AvA/L.aBcg Inspector & DatlGA / // 5 4? BUILDING DIVISION (360) 379-4450 INSPECTION HOTLINE (360) 379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE ORIGINAL - CUSTOMER COPY - OFFICE H:/Permit/Plnctr/Infobldg/Forms/Inspection Results Form • JEFFERSON COUNTY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNS D WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION l/ WOODSTOVE A PROPANE TANK PELLET STOVE OTHER Is this appliance (htg stove,,hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home YES A NO SITE ADDRESS(911#/Road Name): ,/` Vc 4` � Wk..S.7 .1✓,a 9 DIGIT PARCEL ID NUMBER 7;78 �� J Legal Description: Subdivision Name Block Lot(s) Section Township • North, Range WM APPLICANT ` 'e1� � '���'�� ' PHONE T �4 • MAILING ADDRESS < T� C// r ) "1 ,1�15Le!�/�/ / lr�� ZIP ��,.s PROPERTY OWNER V©/ (1.1-7 1-6 C/� 5 -3 PHONE 7- 2-2MAILING ADDRESS / �/ l�s /:9-d-2:7 i 0i i7 L! /LlY ZIP 98�C CONTRACTOR l -e-- rE ' r PHONE 7$? 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. APPLICANT SIGNATURE - : Q ig{ DATE % l / 2 / f� J1 ',� �� RieF_ t L BASE FEE `''1� ! . OIRECEIPT# • 17 +�y ASH/CK# Q �� TOTAL t / o`� irtrM�. DATE -l/ l7/ CYL H:\HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC11/05/01 DEPT. OF COMMUNITY DEVELOPMENT