HomeMy WebLinkAboutBLD2002-00625 ® • • •
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
PERMIT #: BLD02-00625 Received Date 10/21/2002
SITE ADDRESS: 150 E RHODODENDRON DR Issue Date 10/21/2002
PORT TOWNSEND, 98368
APPLICANT: MARY M CROSS PHONE: (206)365-4736
13261 2ND AVE NW
SEATTLE WA 98177
12
SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 6 Lot:
PARCEL NUMBER: 938400611 Section: 12 Township: 30N Range: 02W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 05/01/2004
OWNER, MARY M CROSS PHONE: (206)365-4736
if different: 13261 2ND AVE NW
SEATTLE WA 98177
PROJECT DESCRIPTION UNDERGROUND PROPANE TANK TO MODULAR HOME
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 10/21/2003.
REQUIRED INSPECTIONS:
[ Tank/�iue/Appliance: Z /r :`}
[ 1. FinalApproval: �-/LDiii -% - ik-c,15
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 APPLICA ION BLD02-00444
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00625 Received Date: 10/21/2002
SITE ADDRESS: 150 E RHODODENDRON DR
PORT TOWNSEND, 98368
OWNER: MARY M CROSS PHONE: (206)365-4736
13261 2ND AVE NW
SEATTLE WA 98177
SUBDIVISION: CAPE GEORGE COLONY DIV 3 Block: 6 Lot: 12
PARCEL NUMBER: 938400611 Section: 12 Township: 30 N Range: 02 W
CONTRACTOR: PETTIT OIL CO PHONE: (360)385-1420
PO BOX 1031
PORT TOWNSEND WA 98368
Contractor's License PETTIOCO88CC Expires 5/1/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION UNDERGROUND PROPANE TANK TO MODULAR HOME
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 SHORELINE:
GARAGE: SETBACK:
CONST TYPE: DECK:
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
Type Amount Paid By: Date: Receipt: Approved/Date
Total: 1'01 ��J"Y\ C\�
04,4�0
i
DlS U t�
l5
OCcTz1U
in 0 _ ,_.
1EFFERSON QOUNfY COMMUNITY DEVELOPMENT,621 SHERIDAN ST,PORT TOWNSEND WA 98368 PH: (360) 379-4450
JEOMMSUN COUNTY INSTALLATION PERMIT APPLICATION
DEPT.QF COMMUNITY DEVELOPMENT ,1Jt.1h Ei421-4 :'A-kt Al)
• W00DSTOVE \ PROPANE TANK PELLET STOVE OTHER -TO `DU')( , S,v�E , r V.
I �u tki - 2 11\/
—
SITE ADDRESS: �` € �. P , 1:; q� `
911#/ROAD NAME 150 1 , \ J i 'yci.�,+�/�, \1 f�F—'','X-- MD 41 V
s tV O i 1i oi.. o J i t)( to-t ZIP Li S A
9 DIGIT PARCEL ID NUMBER
Legal Description: _ Block LiLot(sl ��
Subdivision Name CJ\If�1- (-1e() `J k DAMP"(
Section Township North, Range j�WM
APPLICANT ` f 11//�-� I , \ "�L:/��S NW
PHONE 9-O i d5( J `T1�.A,
MAILING ADDRESS i r)1-2I .?'tJ7 - ,Y
gF. trrJ- UA 1i ZIP ilC,i I
PROPERTY OWNER .7 A t't/ PHONE
MAILING ADDRESS
ZIP
p� C)IL
CONTRACTOR '
PHONE -
t
p
MAILING ADDRESS
411(44119
LIP 11 ) ��
STATE LICENSE# r y� _ 4 ] EXP.DATE 1("L^ -t.J Z-
/am ' /
FEDERAL I.D.# "`° 59 .Pfi
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.
...---n/V ,
APPLICANT SIGNATURE fl�LA.,. � (4,,,�_ ILA-14------/ DATE i / / .._
C " a 'F P E USE ONLY t
Y :€ " m,.
` 'SASE FEB-
+; x a s' S a °fie' t < � -a n?-^ 4 e
TOTAL + !Ak s 1 ~x x• S . ;,.
r �J 'i, .�7 %, c : ..,. ,"�4 fiic. ,€. :.fw.r e• .. ;iV:.
H:\HOME\PLNCNTR1FORMS\INSTALL.DOC1 0/99
_ _ _Z '_4:13 2063642632 OFFICE DEPOT #907 PAGE 02/02
rJ — fir '
IT— .... ...Nti
R ' AI 1
/ �Y
Oxp
a
2 04 .• - 1 i go I i I Y
c#0 4 1 :'. 1 r
1 ...,_
titm • /NI
--,?Is‘ , : ,
, . .,.. .,, ,
I •
2 stii ;
,..- 7 . - . i ;Al
1 / •
•
I K p rN wF t_ � ---
___
-•
.-...
-1"4-)4N1 -1., ! _i 7.
[. t
k•J 1(:) -•\xt i .1
�. LI
x
{
.▪ � '. _ • f ADZ
5.:.t.-----;:-.-;.1-,.:----, ....-,,,:_•,,-,_ ,,,-. •_•,-... . •. ti i ..�I XZ[ < SET 6GC.. St _--
s.'. _. i _ ..� - _ - _ -- .. ---�
`4 `4 r GIs i" v- �c
'# 1Y ; +-- 1
s
_ A
_..r �e. —▪ Y4e%ws�aQ�4, - .. - _ - ._ �i , r 6`r,
S,. x
• � w" —-_ - _ f fr: \ , . j n l- .
.. ¢yz ,A\fir ✓''
4 .i AUG 21
‘ ._▪F Jsy_iJlst+i 'at T
- ,JYrD
—....
_
. -
� rUE JuA ( C1—
GPT J;J.r" �JrN E0 'If)! ,2-.1aA -/_.1—( 1 _