HomeMy WebLinkAboutBLD2005-00011 ILDING PERMIT APPLICATI BLD05-00011
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00011 Received Date: 1/5/2005
SITE ADDRESS: 41 CORBRIDGE PL
PORT TOWNSEND, 98368
OWNER: LAWRENCE MC NULTY PHONE: (360) 821-9487
CAROLINE MC NULTY
41 CORBRIDGE PL
PORT TOWNSEND WA 98368
SUBDIVISION: KALA POINT#3 Block: Lot: 153+
PARCEL NUMBER: 965000011 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTP198306 Expires 09/26/2006
REPRESENTATIVE: KELLEY SHIELDS INC PHONE:
260 KALA POINT DR
PROJECT DESCRIPTIOr A/G 120 GAL PROPANE TANK, GAS PIPING, COOK STOVE AND
FIREPLACE INSERT
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:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
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
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $48.00 KAS 01/05/05 69026
Total: $48.00
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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 #: BLD05-00011 Received Date 1/5/2005
SITE ADDRESS: 41 CORBRIDGE PL Issue Date 1/6/2005
PORT TOWNSEND, 98368
APPLICANT: LAWRENCE MC NULTY PHONE: (360) 821-9487
CAROLINE MC NULTY
41 CORBRIDGE PL
PORT TOWNSEND WA 98368 153+
SUBDIVISION: KALA POINT#3 Block: Lot:
PARCEL NUMBER: 965000011 Section: 27 Township: 30N Range: 01W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTP198306 Expires 09/26/2006
OWNER, LAWRENCE MC NULTY PHONE: (360) 821-9487
if different: CAROLINE MC NULTY
41 CORBRIDGE PL
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION: A/G 120 GAL PROPANE TANK, GAS PIPING, COOK STOVE AND
FIREPLACE INSERT
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 01/06/2006.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: 5/(1 his
FinalApproval: ie/ //?/5
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 1 0/29/19�
r�4gSON t^O�I JEFFERSOUNTY •
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan.Street• Port Towns '..:Washington 98368
360/379-4450 • 360/379-4451 Fax 4-e
o www.co.jefferson.wa.us/commdevelopment JAN - 5 2005
Master Permit Application MLA:
Project Description(includ rate sheets as necessary):
Tax Parcel 9 roperty _
Number: �5- _ O d o - O
Size: yro... o r.e__, acr square feet)
Site Address and/or Directions to Property: / (7 / 0ali) r?a/
Property Owner(s)of Record: /
Telephone0k0' Ka I -qy _",i,I QX:
email: —
Mailing Address: i'h-e aa____.) ck..)-)d ir-e
Applicant/ ent(if different from owner): �e I( cS h i e ( �'i 5 �.h e�
Telephonet3(Fp> 3$ -7 15(p Fax 3( b) 385 -3 0 15 email: 8 s t;e l d s o f ( v°s . f)e
Mailing Address: 2LQ 0 •KQ I c 1 h -(- r . ) - r)✓-(- D LI. sk iA (4, I,Jct 9 g 3 Co 81
What kind of Permit?(Check each box that applies)
0 Building 0 Variance(Minor,Major or Reasonable Economic Use)
❑Demolition Permit 0 Conditional Use[C(a),C(d),or C]**
❑ Single Family 0 Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)'*
❑ Manufactured Home 0 Boundary Line Adjustment
0 Modular 0 Short Plat**
0 Commercial* 0 Binding Site Plan**
❑ Change of Use 0 Long Plat**
0 Address 0 Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments**
Propane 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management 0 Shoreline Management Substantial Development"
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
0 Forest Practices Act/Release of Six-Year Moratorium
*May require a Pre-Application Conference **Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date:
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent 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 attomey'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 acr.r. s and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and anyrequiredlater inspections Access and right of entry to this property shall be requested and shall occur only during regular business
hours. ; 'j
i
Signs `(Let i o�• /�
Date:
The action or actions Appli nt will undertake as a result of the issuance tfithis permit may negatively impact upon one or more threatened or
endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"or"ESA."Jefferson Co tty makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate the ,�1ny individual,group or agency can file a lawsuit on behalf of an endangered
action a species s individngual
yourl(�evemif y�,are in compliance 'th the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-try rabteesponsi ' ffor adhetin�§to an mptying with ESA,,The Applicant has read this disclaim and ' ns a d dates it below.
Signature ; .2-� D
\ —g� Date: 1�
G:\PemvtCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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OWNER BUILDER STATEMENT
The sigc er of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
theywi be: ngme responsrb4ity of the General Contractor for the proposed project. .
Signature:
Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER:
PHONE: FAX:
D v, !k0 an u&O )(j 5-- g ( )
MAILING ADD ESS: GoS'
CONTRACTOR'S LICENSE a d EMAIL:
NUMBER:
P/r9 Goa G�8`3 3� WAINS
LE::E:ER:
RCHIT t D NUMBER
PHONE ( ) FAX ( )
EMAIL
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Project:Type._
❑ New , frame Type: - -Bathrooms: .,_ Shoreline: T
❑ Wood Existing: Sewer of Sewage Disposal:
❑ Addition ❑ Steel Proposed: ❑
❑ Alteration/Remodel ❑ Concrete Total: Bankig ❑ Communitya Systemm
❑ Repair ❑ Masonry Height: ❑ Individual
❑ Demolition El Other: Bedrooms: SEP Permit#
Type of Heat: Water Supply Existing: Setback:
Proposed: ❑ Private well ❑ TwoParty
Total: ❑ Public
Name of System:
If this is a Commercial Pro ect ou must answer the followin :
Number of Parking Spaces: Current:
Number of occupants(includes owners,tenants,employees, tc) Current Number of ADp Parking Spaces:
IBC Occupancy: IBC Proposed
Type of construction: Will you have Food Service? Yes / No
If this Is a Pro ane Tank and/or A liance Installation rmit mark all items below that a I .
a Underground Tank XAbove ground Tank
❑ Heat Stove � Size of Propane Tank: a .1(_
Is this a liance 'Cook
In a Woodstovenufaaiured Fireplace Insert ❑ Hot
Water
Tank ❑ P et Stove ❑ Other
When applying for a Mobile Home? Yes
permit to Install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
includin. the reserve area.
S.uare Foots.a `"�.$' ^'
IMEMMNIPro•. 3'r' - "rt i k 6 Nz.rfE * # ..r�.3.. R:t.. ,* iei ne
Main Floor *m #L�.. i-A ug rs h ..ri~ ,� v 'S . T fit' " F3 9 ? ' `3 �?
r 1',0 `e v� i� yb .3 I9+ti, a r.. ,.4 t t z`•`
r } '�' tip#.1'` t` .. ' h .,t
2 Floor 11 ,_ r� T �wx r
�f ,rt,t i T,3� C£ �rai •- .. ,f f-+=dt- °- `.- r ^t '7,,
3, Floor .•" 4 J '? 7+ mot 4 .. •; }a, wFF .1.4 _, 4U1`,4TS i.
,[�� aye Y r �/Y 1'0 cj i a• `„ ..1 9 ri i,a ,k, btt'4 7 .cC.' ar '"°"- �
Mezzanine: +rye}4' �s .-1 x 4 k� _`:.-' ' sue
,r� 1 ,.r ,n o I ..-,'. t et,F C..4.,,,$' k : = Win..' '3'
Heated Basement t w a r,,11 ), '1 { ' t?
, " t '' -: `O t t° f , �ia a'te'.. V:4'r` t, + F. _ -UnheatedBasement -' eha
Other Unheated -6'a ,-,..l f '$t�L '- �i`R_r r `�kr -. , '' �jJ.,x.
Gal efcalport "' } ,, m_� � "
�,:',1 ��± w "t. '.ut'( 'x ,a� `l'£t- a 1_'ns�` r��p�, t
Decks
11 4 yf, 7 tb 4 . -? .a , 1 :, .c',iiii �'- ' r �y ..• ,°'''r,. �1 fir—Int c;..
Decks a ik 4 �y Lk xai P } ^h l
�/
Other � "�'' "�� � ��t.�i+,, ��� � -� : .�A � �"�'�:'�,s`3�,`�����:
st- t tfa,w 4 fit. 3a, .,,y T, l` h .J f
+s.. g 3.t} t +.^ty� -'vt: �t Y �eo5.,..ner ;+t.?vV a Y tt'+'yYr;�v-+�� ��'�_
yrti -''t;'{ !s(ott i . ] is �p'S r. r zeirif: .
ESTIMATED CO .- �.� .- „,,1 ,v, �l:
COST(REQUIRED) _
R` y t s" S.e -- a i wu p sly 8 °s'yrT-� - aruzi7r.„r'. -x
•Fair market value of all labor and materials foundation to finish ? �` tfk ��}IC; �r �j
-a. �+�i`t�*..� '` �. ap"'? r !v �6 rS`siat:SL "`�ASx y�Y`51...'a
G:\PemtitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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p A,. -�.: . Property:
�� 0 Parcel #: 96.5000011
Lot 153, Div.3. Kala Point
20 (q+yt- Owner:
PckP Lawrence and Caroline McNulty
T,,,,mt, 261-10 Sailview Dr.
Pt. Townsend, WA 98368
JAN - 5 2005 Phone: 821-9487
Contractor:
Kelley Shields Inc
260 Kala Point Dr.
Pt. Townsend. WA gR2RR