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HomeMy WebLinkAboutBLD2002-00422 I 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#: BLD02-00422 Received Date 7/24/2002 SITE ADDRESS: 31 MARINER PL Issue Date 7/24/2002 PORT LUDLOW, 98365 APPLICANT: ROBERT R RETKE PHONE: MARY K RETKE 31 MARINER PL PORT LUDLOW WA 983659765 17 SUBDIVISION: BAYVIEW VILLAGE DIV 2 Block: Lot: PARCEL NUMBER: 931900017 Section: 16 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 09/06/2002 OWNER, ROBERT R RETKE PHONE: if different: MARY K RETKE 31 MARINER PL PORT LUDLOW WA 983659765 PROJECT DESCRIPTION PROPANE TANK AND FIREPLACE 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 07/24/2003. REQUIRED INSPECTIONS: [ ] Tank/Line/Appliance: 0� [ ] FinalApproval: DA' 29/3/O2- 1, 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:1F_BLD_Permit_Propane.rpt 10/29/19 BLD02-00422 411LUILDING PERMIT APPLICA ION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00422 Received Date: 7/24/2002 SITE ADDRESS: 31 MARINER PL PORT LUDLOW, 98365 OWNER: ROBERT R RETKE PHONE: MARY K RETKE 31 MARINER PL PORT LUDLOW WA 983659765 SUBDIVISION: BAYVIEW VILLAGE DIV 2 Block: Lot: 17 PARCEL NUMBER: 931900017 Section: 16 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 09/06/2002 REPRESENTATIVE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO PROPANE TANK AND FIREPLACE 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 _ Plat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $47.00 PRB 07/24/02 49273 Total: $47.00 JEFFERSON COUNTY COMMOTY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360)379-4450 INSTALLATION PERMIT APPLICATION JUL 2 4 2002 WOODSTOVE PROPANE TANK PELLET STOVE OTHER c)►2-CPi- Is this appliance(htg stove, hot water tank,furnace, etc.)to be installed in a Manufactured/Mobile Home? IL'`.; YES -X NO SITE ADDRESS(911#/Road Name): . / r).a,t./)E/.. Pi_ RUn'r Z--1 c.•oI'd 7 OA ZIP ( F34, . 9 DIGIT PARCEL ID NUMBER 9 3/ ' C� 9 o - h/ -7 Legal Description: Subdivision Name Block Lot(s) Section Township North, Range \NM APPLICANT /3 0 ie i" re • g,3 PHONE 7 ,7 '^ 4 47.20 MAILING ADDRESS 31 /72/4 it 4 f4 p 4_, P a/2 T C_4'(bi t 7 1 44;44 ZIP (,f EIS- PROPERTY OWNER / ,3 42V T, PHONE - ( 3 7 - i 4 7 0 MAILING ADDRESS `3 I /n,''2 /t2 724- L� Po/27 L41 z etc) l Lc)7 ZIP L S23I6 S CONTRACTOR (9,_.„),..,- PHONE 23 2 1145 S?5 MAILING ADDRESS Pd , a)- a-ZIO 7 ."pi ALit,�l tk 1" ZIP �'© 3.25 � STATE LICENSE# 45 Z 744 q 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 ' f r o the applicant's property or structure shall be requested and shall occur during regular business hours. APPLICANT SIGNATURE DATE -7 / 2 / d` . LP TO M/� FOR OFFICE USE ONLY �f.Q ^7 BASE FEE [ .00 RECEIPT# �( l Z CASH/CK# CM1-1 TOTAL 4t-7•c(J DATE 2_/25f/02—' H:HOME\PLNCNTR\INFOBLDG\FORMS\INSTALL.DOC11/05/01