The URL can be used to link to this page

Home My WebLink AboutBLD2005-00416 S 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 #: BLD05-00416 Received Date 6/23/2005 SITE ADDRESS: 210 SHINE RD Issue Date 6/23/2005 PORT LUDLOW, 98365 APPLICANT: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 3+ SUBDIVISION: R SHAW SHORT PLAT Block: Lot: PARCEL NUMBER: 821333022 Section: 33 Township: 28N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2006 OWNER, DAVID W FINDLAY PHONE: (425) 867-1802 x22: if different: LINDA T FINDLAY 16401 NE 50TH ST REDMOND WA 98052-5293 (425) 867-1937 PROJECT DESCRIPTION: 500 GAL U/G PROPANE TANK AND 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 06/23/2006. REQUIRED INSPECTIONS: Tank/Line/Appliance: EPLAC‘:- Ex/5rWe TALC 4 EXTEND LIAJE - T/6 or o /51IA "-"c OK / 9/O5 FinalApproval: tg -Par . /ma.I 1005 V 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 0 • SPECIAL CONDITIONS FOR CASE#BLD05-00416: 1.) NFPA#58 REQUIRES THAT ANY CONTAINER SUBJECT TO ABRASIVE ACTION OR PHYSICAL DAMAGE FROM VEHICULAR TRAFFIC SHALL BE PLACED NOT LESS THAN 2 FEET BELOW GRADE OR EQUIVALENT PROTECTION SHALL BE PROVIDED I.E. CONCRETE SLAB TO PREVENT IMPOSING THE WEIGHT OF A LOADED VEHICLE DIRECTLY ON THE CONTAINERS SHELL I:\F_BLD_Permit_Propane.rpt 10/29/19. SJILDING PERMIT APPLICA•N B Review 00416 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00416 Received Date: 6/23/2005 SITE ADDRESS: 210 SHINE RD PORT LUDLOW, 98365 OWNER: DAVID W FINDLAY PHONE: (425) 867-1802 x223 LINDA T FINDLAY 16401 NE 50TH ST REDMOND WA 98052-5293 R SHAW SHORT PLAT SUBDIVISION: Block: Lot: 3+ PARCEL NUMBER: 821333022 Section: 33 Township: 28 N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP 500 GAL U/G PROPANE TANK AND 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: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Propane Tanks/Stoves $49.00 KAS 06/23/05 73333 Total: $49.00 1 1 -0,, ,c2:--- w --_ 1 1 I I 1 . -_ I 1 \I -�_ 41 1 13u•2b' 42 / , - - 40 ` � IT' ' '', --r----. ' RE , i,>,.,,-........_. 1 ____., ',.' ,_._....,__iisoinsekiw... A c"r h 1 h :.,' .%,./ filti IINSI ; 56 I . i • 'T ifaillip-- !,• . • ' - --Ottlitit,r4":-L:,,40),LLA.•*, -v. ,,,i , . \ • 4. 4 mi6.44110/ y''.• lFFFET Ats‘sok 14. ! \,_ \ .. - / IAN ' . C:ptAg.71 0 gC))°19 ' 641; t.'.7 • .011\tta i 2.6, i 4111s \%litit GPI' Ott ilk Atisi 111 1 1 8,11 hilfila\WINS 1" .1 1 Flo` . , _ Tirinmnriq (3,877 sq.fk.) Ts co JEFFERSON •�G�` -'i�V t b� NTY � �'�; ,� DEPARTMENT 0F'COMMUNITY DEVELOPMENT ` '4 621 Sheridan Street • Port Townsend •Washin ton 98368 360/379-4450 • 360/379-4451 Fax 9 4.. ' O� www.co.jefferson.wa.us/commdevelopmertt `sBING� If7r7:7Pg0N COUNTY [" Master Permit Application MLA: Project Description(include separate sheets as necessary): rO C) s 6_ (Vl C 4 r 0 4 'f�-k (pi- Tax Parcel Property Number: e l 3 3 3 n Z.)_ . Size: (acres/square feet) Site Address and/or Directions to Property: r I U N -/ /,7 I. --l9 1) r - L_LLTJ L C.) Li Owner(s)of Record: U t/i V vtl - i✓-i 0 t-A '>! Telephone: It ZS- g�7- I8 0 L X 2.13 Fax: 4 ZS — P( 7- 1937 email: Mailing Address: l(,..L1--o/ N E 5611-` -ST• Ri=yjManl C WA. `j80 52_ Applicant/ if different from owner): 3 L-t--n.S rH rt_i2,_ /Loy,84.,,c - -/j-t1) - 0 C ) 2 / Telephone: 9 C=O 3 8S -5 7 -7 Fax: email: 1 Mailing Address. I (3 es 3 P-E}v 0 L1 012 , P ; - '1•1 P-()U3 Uc W A F-3)7 j What kind of Permit?(Check each box that applies) u Building ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ 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 ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address Li Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ 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 he by si ate to ac m agent in s rel 'ng to this ' tion f rmit(s). rvcR SIGN Ka: Da /'.--- 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 access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any re 'red lfer�ctions.Access and right of entry to this property shall be requested and shall occur only during regular business hours. Date: The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential lake"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if yo •re in • •liance ' the Je er on County development code.The Applicant acknowledges that he,she or it holds individual and non-trans f es•enl�jy)) erin d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: /� / �3''b c�7-' Date: (/ ;:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • lir OWNER BUILDER STATEMENT The signer of this statement does hereby certify tiiat they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be a-cciiming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: S Pn ,.„ p (36.o ) 3,83 s71-7 ( ) ..(,) .3b's sg7S MAILING ADDRESS: 1 U ,__S3 *" -0 Dr. P 1-6,c{(OLEMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: St-t-h S ff19 -4k 6-7 7 C.,Q C NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: U New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System O Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System O Repair ❑ Masonry SEP Permit# rl Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Li Private well 11 Two Party Type of Heat: Proposed: 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: XUnderground Tank ❑ Above ground Tank Size of Propane Tank: 56tr �A ❑ Heat Stove ❑ Cook Stove ❑ Woodstove Li Fireplace Insert ❑ Hot Water Tank lLi Pellet Stove Other i PLfj-Q-- 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: , 2N0 Floor Base fee: 3fa 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: $ ' �) . Decks Receipt Number: )-)— Other Cash/Chock Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish . Initials: G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc