HomeMy WebLinkAboutBLD2003-00751 •UILDING PERMIT APPLICA N B Review Type:
ype:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00751 Received Date: 12/4/2003
SITE ADDRESS: 40 BROOKHAVEN PL
PORT TOWNSEND, 98368
OWNER: EDWARD E ZINSER TRUSTEE PHONE:
BARBARA L ZINSER TRUSTEE
40 BROOKHAVEN PL
PORT TOWNSEND WA 983689518
SUBDIVISION: KALA POINT#3 Block: Lot: 237
PARCEL NUMBER: 965000039 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP"077QP Expires 11/17/2004
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI A/G 500 gallon Propane Tank (swap out)
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:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PARCEL TAGS: YES NO n,
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland J .L Erosion
Prop: Prop: Seismic .s 0 Streams w
Total: Total: Flood Way _ t� Floodplain .2)
Routing Date: F&W 4 Z o„n�+-(6e�'`"t'andslide I
Shoreline .,/Or Aquifer t7.Ri�1
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $47.00 CJZ 12/04/03 60551
Total: $47.00
4110 •
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 #: BLD03-00751 Received Date 12/4/2003
SITE ADDRESS: 40 BROOKHAVEN PL Issue Date 12/5/2003
PORT TOWNSEND, 98368
APPLICANT: EDWARD E ZINSER TRUSTEE PHONE:
BARBARA L ZINSER TRUSTEE
40 BROOKHAVEN PL
PORT TOWNSEND WA 983689518 237
SUBDIVISION: KALA POINT#3 Block: Lot:
PARCEL NUMBER: 965000039 Section: 27 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
Contractor's License SUNSHP*077QP Expires 11/17/2004
OWNER, EDWARD E ZINSER TRUSTEE PHONE:
if different: BARBARA L ZINSER TRUSTEE
40 BROOKHAVEN PL
PORT TOWNSEND WA 983689518
PROJECT DESCRIPTION: A/G 500 gallon Propane Tank(swap out)
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 12/05/2004.
REQUIRED INSPECTIONS:
[ ] Tank/Line/Appliance: iuk iv�+� � /L /63 d
[ ] FinalApproval: e' `f043 '
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
SPECIAL CONDITIONS APPLY - SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
• •
SPECIAL CONDITIONS FOR CASE#BLD03-00751:
1.) The application was reviewed by the Jefferson County Department of Community
Development staff on 12/4/03 for the potential presence of Environmentally Sensitive
Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an
initial Geographic Information Systems mapping review and an investigative site
inspection, the following ESAs were confirmed to be present on the subject property:
Heritage point(eagle habitat) &slight landslide hazard over western edge of property.
2.) This proposal is to swap out an existing 500 above ground propane tank with a 500 gallon
above ground propane tank in the same location. Therefore, there should be no issues
with environmentally sensitive areas.
3.) Per the uniform fire code a 10 foot setback is required between the 500 gallon above
ground propane tank and sturctures& property lines than can be built upon. From the site
plan dated 11/26/03 the proposed tank meets this setback requirement.
4.) This approval is for a 500 gallon above ground propane tank only. Any future permits on
this site are subject to review for consistency with applicable codes and ordinances and
does not preclude review and conditions which may be placed on future permits.
I:\F_BLD_Permit_Propane.rpt 10/29/19c
Nov 2G 03 04: 45p • p. 1
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SITE VISIT REPORT
JOB 2.1 Ti S t 4? DATE
ADDRESS BY t
PHONE
Draw a simple plot plan: include property lines and proximity to lines, tanks, wells, driveways,
shrubs & trees, exhaust vents, air intake, combustible sources, relevant windows and doors. In
Clallam County, include septic. House Mobile Home Commercial
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Description:
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JEFFERSON COUNTY COMMUEVELOPMENT,621 SHERIDAN ST,PORT TOWN•D WA 98368 PH: (360)379-4450
INSTALLATION PERMIT APPLICATION
MARK ALL ITEMS BELOW THAT PFRTAIN TO THIS IN,IALLATI( CCIA)6TD
_—AbSoo Ci.Underground PROPANE TANK ove Ground PROPANE T HEAT STOVE HOT WATER TANK
WOODSTOVE FIREPLACE INSERT PELLET STOVE COOKING STOVE
OTHER(Please Specify)
Is this appliance (nlg stove, hot water tank,turnace, etc.)to be installed in a Manutacwured/Moblie Nome?
YES NO
SITE ADDRESS(911#/Road Name):
17I a r 0&- ho ve4,_) Pt-
101 - locu-rv2-0-A.4 ( IA)e._. ZIP ge366
9 DIGIT PARCEL ID NUMBER 9 t 5 -0 0 o _ 03 f
Legal Description:
Subdivision Name Block Lot(s)
Section Township North, Range ,Q / `/ WM
•
APPLICANT Ck de-4-6r•—if"<— I7 f 3 PHONE v (p5(O
MAILING ADDRESS 6
�(�.Q� .�r- ZIP
PROPERTY OWNER J'��e / `�,.i""' PHONE
MAILING ADDRESS
ZIP CONTRACTOR �� , 0/14 2 PHONE (PS 6777
77
MAILING ADDRESS /0 g',5 3 1 h od7 oc
X/ 'c-k ZIP 9 �J c
STATE LICENSE# 5 L(,f�.J•fj/P 0 7 7 CI /a EXP.DATE I / / o q
FEDERALI.D.# -I 1 - / 0 "nn Gq 8S7
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 appli ant's property or structure shall be requested and shall occur during
/regular business hours.
APPLICANT'S SIGNATURE Oe- DATE 4 [ / )1/ 03
FOR OFFICE USE ONLY /`n
BASE FEE RECEIPT# (F'05s
CONSISTENCY REVIEW 43 50 CASH/CK# �� �✓7
TOTAL IV 5U DATE 1 o� / /2O O
Underground Propane Tank applications require additional information to be submitted. 0 V E R 10
Please contact our office at 360-379-4450 if the back of this application is blank. y`
g:\permitcenter\forms\bldg forms\install-revised 10-23-02.doc
NOV 26 2003
JEFFERSON COUNTY DCD