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Home My WebLink AboutBLD2005-00372 0 • 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 #: BLD05-00372 Received Date 6/8/2005 SITE ADDRESS: 146 FOXTRAIL RD Issue Date 6/8/2005 PORT TOWNSEND, 98368 APPLICANT: JERRY L NUTTER PHONE: KAREN C HUTTER 3025 N ARROYO DR SAN DIEGO CA 92103 4+ SUBDIVISION: DEER RIDGE Block: Lot: PARCEL NUMBER: 001295013 Section: 29 Township: 30N Range: 01W CONTRACTOR: STAPF CONSTRUCTION PHONE: (360)385-6540 PO BOX 212 PORT HADLOCK WA 98339 Contractor's License STAPFC*249J8 Expires 04/25/2007 OWNER, JERRY L HUTTER PHONE: if different: KAREN C NUTTER 3025 N ARROYO DR SAN DIEGO CA 92103 PROJECT DESCRIPTION: Convert ZERO Clearance Propane Fireplace to ZERO Clearance Wood Fireplace 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 06/08/2006. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: ct'v23O.j 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. 05-00372 OUILDING PERMIT APPLICATION BL Review Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00372 Received Date: 6/8/2005 SITE ADDRESS: 146 FOXTRAIL RD PORT TOWNSEND, 98368 • OWNER: JERRY L NUTTER PHONE: KAREN C HUTTER 3025 N ARROYO DR SAN DIEGO CA 92103 DEER RIDGE SUBDIVISION: Block: Lot: 4+ PARCEL NUMBER: 001295013 Section: 29 Township: 30 N Range: 01 W CONTRACTOR: STAPF CONSTRUCTION PHONE: (360)385-6540 PO BOX 212 PORT HADLOCK WA 98339 Contractor's License STAPFC*249J8 Expires 04/25/2005 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI Convert ZERO Clearance Propane Fireplace to ZERO Clearance Wood Fireplace 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: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: • Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit • $49.00 INT 06/08/05 73351 APPROVED Total: $49.00 JUN 8 2005 Jefferson County Planning &Building Department er e c\ S\ • aQ ��Sox co . JEFFERSOf' OUNTY ti ' yj DEPARTMENT OF COMMUNITY DEVELOPMENT `4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax /S 47INGc3 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets,as necessary): G L E—A R eVO C F P IZo PA n]E F I R r"P t A'F "To •.-0,. C C EA iz.AaJ LE //OoD Tax Parcel Property // ril?_r—Pr A'F Number: DOJ2950/3 Size: /I fs (acres/square feet) Site Address and/or Directions to Property: /y(O FO,Vr/24/L AZL /SORT 7:3 SEn/O, Gt/,4. 9236P Property Owner(s)of Record: f Xh'y .? ,('.C C. /la7TRie Telephone: (&19)-890 - 65Z0 Fax: email: Mailing Address: Li4ZO PAC IF►C I-iW / SAni OiE6-0i A . 92.110 Applicant/Agent(if different from owner): S I A PR rEw S?-Ru GT►WO Telephone: '/:O) 3S5 — 319ct Fax: (3601 3635 -67Z1 email: S fey rj0 cable s'Deco(- Mailing Address: Z 72-7 14ASTI M S Ave. POP r To vvN Se.,J0 /WA , LI 331.43 What kind of Permit?(Check each box that applies) 0 Building ❑Variance(Minor, Major or Reasonable Economic Use) 0 Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached U Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** 0 Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** Propane FIRr'Pi 'c r ColuvFr (orJ io vJOo o F,K reimF7 Plat Vacation/Alteration** 0 ilicowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑ Jefferson County Shoreline Master Program Amendment ❑ 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 - 'f /? " to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: (glib;S— By signing this applica• n 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 knowl ge. 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 ha less Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any wa accrue aga' t Jefferson County as a result of or in consequence of the granting of this permit. I further agree to pr.-,de a :s . . righ entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any r-. red late . •: ti s. cce and rightpf entry to this property shall be requested and shall occur only during regular business hours. _.----- Signature: Date: (p/1/ 0 S"^ The actio .r action Applicant will undertake as a result of the issuance of this permit may negatively impact upon one[[[ or more threatened or endang: ed species and could lead to a potenti.l"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferso ounty makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will no vi. . : the A. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if : :re in . I - it' th- Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf: . - re .o - . .1 ...- . . complying with the ESA. The Applicant has read this disci ' and signs and dates it below. Signature: ,/ �/�T�• Date: 6 Q) G:\PermitC- ter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • OWNER BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: TAPF 1'nn1S1rX.UC.1/o4 (360 ) 305 -3199 (36o)38T-6,727- MAILING ADDRESS: EMAIL: Z7Z� F}AsT�Nvs A� -4up )0 Ctil>lespeed-coM CONTRACTOR'S LICENSE ( p T Ex(' WAINS NUMBER: S-f- f,Y C, Zl-1-I J s ti Z5/01 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: [1 Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System X Alteration/Remodel 0 Concrete Total: Height: C1 Individual System O Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: r 1 Private well [1 Two Party Type of Heat: Proposed: I 1 Public Total: Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i 1 Underground Tank [1 Above ground Tank Size of Propane Tank: I I Heat Stove [I Cook Stove ,Woodstove i i Fireplace Insert I i Hot Water Tank I I Pellet Stove [[ Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a 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, including the reserve area. Square Footage For Office Use Only Current Proposed Amount Main Floor Consistency Review: ''‘i(3\ 21°D Floor Base fee: — 3a Floor Additional Section: Mezzanine: Plan Check fee: Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport TOTAL: $ 419 Decks Receipt Number: 73 35-( Other Cash/Check Number: Ln ?" , / ESTIMATED COST(REQUIRED) Date: r ` •Fair market value of all labor and materials foundation to finish (Y Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc