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HomeMy WebLinkAboutBLD2004-00674 S UILDING PERMIT APPLICAIN B RD p Review ye: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00674 Received Date: 10/25/2004 SITE ADDRESS: 170 PINECREST DR PORT TOWNSEND, 98368 OWNER: RICHARD E CROSTON PHONE: (360) 379-4142 REBECCA A CROSTON 170 PINECREST DR PORT TOWNSEND WA 98368 1 SUBDIVISION: KALA POINT#6 Block: Lot: 378 PARCEL NUMBER: 965000210 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: SUBURBAN PROPANE PHONE: (360) 385-5096 P 0 BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/12/2005 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP A/G 120 GAL PROPANE TANK, FIREPLACE INSERT AND COOK STOVE, GAS PIPING TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2003 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 Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $48.00 KAS 10/25/04 67939 Total: $48.00 • ti 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 #: BLD04-00674 Received Date 10/25/2004 SITE ADDRESS: 170 PINECREST DR Issue Date 10/25/2004 PORT TOWNSEND, 98368 APPLICANT: RICHARD E CROSTON PHONE: (360) 379-4142 REBECCA A CROSTON 170 PINECREST DR PORT TOWNSEND WA 98368 378 SUBDIVISION: KALA POINT#6 Block: Lot: PARCEL NUMBER: 965000210 Section: 27 Township: 30N Ranpe: 01W CONTRACTOR: SUBURBAN PROPANE PHONE: (360) 385-5096 P O BOX 989 PORT TOWNSEND WA 98368 Contractor's License SUBURPL044DA Expires 03/12/2005 OWNER, RICHARD E CROSTON PHONE: (360) 379-4142 if different: REBECCA A CROSTON 170 PINECREST DR PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: A/G 120 GAL PROPANE TANK, FIREPLACE INSERT AND COOK STOVE, GAS PIPING 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 10/25/2005. REQUIRED INSPECTIONS: Tank/Line/Appliance: So P� 1 /9xt-ay FinalApproval: 9L9 'to vie\ /4(l , < 1�1�1•G�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:\F_BLD_Permit_Propane.rpt 10/29/19. 10/25/2004 14:07 36038 15 KELLEY sHIEL INC PAGE 03 r_ 1 . -J JO wvD1 JEFF CO DC;� PAGE 02 % JEFF RSON COUNTY N `i OEPA*TMENT OF COMMUNITY DEVELOPMENT 821 Sheridan Street• Port Townsend •Washington 98368 4, 360/379-4450 • 360/379-4451 Fix �9,�. w'ww. o.Jefferson.wa.us/comntdevaloprnent Master Permit Application MLA: Protect Description(include separate sheets as nets - �- • Tax Panel Number: _5 -C/f -c2 / 0 Property /� ,r� `! 70r 0i3O ,L.T _ acres/, uquare feet Site Address and/or Directions to Property: �_ �, ►r I IL' Property her(e)of Record: 'let C. r~d - . Mailing 2inaeg: email:_ . S 4i- 2 Applf nt(If different from owner)ie/ � r T.I.phon :i i Fax: , — Maiiia. �/ ii 5//1,1 emali: ` J o/ What kind of Permit?(Check each box that applies)- - - ❑ Building C Verlenoe(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(s),C(d),or C)" ❑ single ramify Discretionary"D"or Unnamed Use Classificetaor, Gorse* Attached ed/ G Special Use(Essential Public Feelfkies)"* ❑ Modular 0 Boundary Line Adjustment Commen ial* r Slices Pert r' ❑Change of Use 0Binding Site Plan'* n Address �Long Piet� o Road Approach - ti Punned Rural Residential Development(PRROyAmendrrments" Propane ❑Plat Vacation/Alteration" C Mewed-yes-Use Conalstiency Analysis 0 Shoreline Master P .. ❑ Stbrmwater Merregem ant rt>flnam ExomptiarVPerml►Reevisiana C Site Plan Approval Advance t]eterminetion(SPAAD)* 0 ShoreSholine M nagem Management Variance agement Develeprrr,sot U Temporary Use G Comprehensive Plan/UDC/Land Use DistrMap Amendment CI Wireless Telecommunication munication• Q Jefferson County Shoreline Master P mAmendment 0 Forst Practices Act/Release of Six-Year Moratorium .P : .Oen 0O,111brerea. •. Please Identify any other local,state or federal a �rMM �-- ---. permits required for this propose!, If known: ' I hereby designate, ( BIQItATIf i(�F AOpNT — to act as my agent in matters relating to this application for perrnh(e), OWNER SIGNATURE _ - -- Y_ _____ bate: qy signing this application fonts.the owner/agent attests that the Information provided herein,and In any attachmends,is true end correc.t to the best of his,her or We knowedpe. Any materiel taisehood or any omission Of a metertel sect made by the owner/agent with reapers to this application pareet may resat in this permit being nil and void. I further agree to save,Indemnity and hold harmless Jdteracxt County against all Nobilities,judgments•coup ctmts.reasonable attorneys fees and ekpenaaa which may in any way apprys against Jefferson County es a result of or in conlierpuence of the granting of this Permit I further acme to provide access and right of entry to Jefferson County and Its employees,rrprsoentatives or agents for the Pole purpose of appilcation review ard seetnequiatd later inspections,Moms e right of entry b this property Shall be requested and steel!ocour only during rag r hrs. sig4ature: I /?k. `5 7,e anion or actions Applicant wet undertake as a resort of the issuance of this permit may negatively Impact upon one or mum threatened or endangered species and toted lead to a potential"take`of an endangered species as those terms ere defined In the Worse law known as the "Endanger Speaiae Act'or"ESA,"Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has ad will net violate the ESA Any Indlvinuel,group or agency can file a lawsuit on behalf of an endangered spades rags ding your arution(e)oven if u In compliance wl e Jeffersc County development cogs.The Applicant acknowledges that hi,she or de individual and non-lean ab epon dinky m en mplying with the ESA. The Applicant has read tills disclaim ands tits it below. S�gnetur ' Dear — G:\Pcy+naCee4x\T^Olthr5\DM PC).RNS\M a r r F)a lhit Application 7-3-04.doe 10/25/2004 16:22 3603115 KELLEY sHIELDINC PAGE 03 ''.0/25/2J J4 13:29 3EAPLI451 JEFF CU DCD PAGE 03 fV.PMMI, Minim ra ncosnt 3TATEMCNT The signer of thlr statement does hereby certify that they are the O eners of the par el referenced heroin,tat they are not licensed cen they vat he essumt►e the tesponsibiity of tho General Contractor for the proposed project. tracexs and that sror"tu _ _... corn S GeNeFYY�CO�TM.P9 OReMANuFArr!ratio HOVE INSTALLER IFS CoNTRACTcpr a LxegNee - WAINs / 1 Nur.IBER: NtltrrNR AtrcttrrttCVENCoh v New ( — ) Oak !Mut*Moore & - -.---- Project Type: Frame ypa: roars: + ❑ New //oral no: Type of plapo"� ; Q Wood Existing: 0 Sower G Addition CI Steel Proposed: 0 lern CotnmeeltY 6ya 0 AlterationlRentodel C] Concrete Tom: Height 0 Indlvh hied system 0 Repair C Demolition 0 Other.ry Bedrooms: -- ___ Water SEP 8uppply. Existing: Setback: V Private well D Two Party Type of Heat; Proposed: Total: ____. _, 0 Punic - - Name of Syetam: itthl l — Nuamber of Peddrig Spaces: Current_ _ Pero posed: Number of 8DB Piing Sp ces Number of oocupfint (includes owners.tenants,employees,ate) Current Proposed ,BC Occupancy: I8C Type of r atttx ton: WM you have Food Service? Yea / No if this bi•-Emma and/or•Apatlanca lnshrl4 on earmlt mark fl( ,,,may urn that a Qjy, C Underground Tame s ground Tank Size cif Proptene Tunic (' l' 4 f tit Stove � Stove Q Woodatove Firepinoe invert 0 Hot Water Tank ❑ Pellet Novo n Other is this oeolittrice)Vino inetallad to a Mahufecturafl/Mobile Hornet Yoe / No When applying A,r a permit M Instal!a propane tank you must also submit a ate plan showing all of the baslklingst,all p up.rty lJ mea. tank/*cedla and size,distances from rho pmapana link fo all pmperly Hiatt,bulk nos and sap&sYalem canponerifs. lncluoing the reserve area, Squad Foote. o r s r�� icF wZ a Yq r .L --�- 4 ' r 3 of c1 e "'e '1'+t(� M b�77 l r,+ Ile S�'.4;11£ i,kV.,r,•. E mean '.. Pro r.• • . .. r�J r� ". a �' K. f`' k1 c Sr,N41t"�.Y"•i tF;.f , a+.l ei !�a!y, h t °. xi 6 Main Floor A,,: x: n ; ' ' NF, T-'(.�' ��s L •jr°fr t aa�" , L la✓ - Li r ,!!Y !p }'r Tip�`,� r,, le; 1.4 F Ail -µ 9r z• � �"RTvk' t" �� 1 I 2 Fi00: , -`i•R l� -ri: •1+L r •, ,,, ? 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E':5f1MAT1�B CQ4'i7(REQUIRED) — t,• : "' a v. +.*"It r •• V 1 'it"43.t 1r° {It:;.,v ,e a r:: I QUIRED .,: ' .tom' 4 kt"o .,ti .!!uF a�+3,w� eft 2`1 ,m Fa"ra..7 X � 491.41 r� trn-r�L, /M �� .P*markat r sj:.11V 11 b ' +�''( " 1 r} t °J♦S�.er vahag or'af!terror end rnarrrr6Na MltndBNote b Redact ', ,!'. -k a�i i+ ,'hl' � er(.-y 1 O !;� pa-t�:.�• -t 1, !x'�Y+�7ArAr jT.r rlE'..,,...,�--...-- „ r.. s.,k�. 6` <.s,in'nr, fvjrss 7 ;• O:\ArsnveCptarx\FOR.NN\DM.PUPLIutC\/4 ter Pe mt AppL.L.don 7•11o4.dc 10/25/2004 16:00 36038' 15 KELLEY SHIELD NC PAGE 02 w / 200' •41( A _ C T , Prim's+d Pewits Per T.P0Z A. s,% cue ca m, n N;. � • '\\ 1 71, . 55' �f 70' w%WtI:V.1 ¢bwr<:, } �\ c f:t.,.. A