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Home My WebLink AboutBLD2005-00451 • . 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 #: BLD05-00451 Received Date 7/12/2005 SITE ADDRESS: 1330 E QUILCENE RD Issue Date 7/12/2005 QUILCENE, 98376 APPLICANT: JAMES E CHRISTIANSEN PHONE: CAROL L CHRISTIANSEN PO BOX 877 QUILCENE WA 983760877 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701191005 Section: 19 Township: 27N Range: 01W CONTRACTOR: PENINSULA HEAT, INC PHONE: (360)457-2775 502 8TH AVE PORT ANGELES WA 98362 60457-2864 Contractor's License PENINHI005DB Expires 3/ 20 6 OWNER, JAMES E CHRISTIANSEN PHONE: if different: CAROL L CHRISTIANSEN PO BOX 877 QUILCENE WA 983760877 PROJECT DESCRIPTION: INSTALL HEAT PUMP AND AIR HANDLER 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 7/12/2006. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: a ft G`PF'6/(, 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 •UILDING PERMIT APPLICAltiN BL vy451 Reviewiew T Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00451 Received Date: 7/12/2005 SITE ADDRESS: 1330 E QUILCENE RD QUILCENE, 98376 OWNER: JAMES E CHRISTIANSEN PHONE: CAROL L CHRISTIANSEN PO BOX 877 QUILCENE WA 983760877 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701191005 Section: 19 Township: 27 N Range: 01 W CONTRACTOR: PENINSULA HEAT, INC PHONE: (360)457-2775 502 8TH AVE PORT ANGELES WA 98362 Contractor's License PEN INH1005DB Expires 3/2/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION INSTALL HEAT PUMP AND AIR HANDLER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 5,700.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: 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 By: Date: Receipt: Approved/Date Propane Tanks/Stoves $49.00 PRB 07/12/05 7:3473 /r► P P R®`v,E [: Total: $49.00 /`� JUL ; 2 2005 OP fferson County Planning Al� & ' �-i,t►I Department �I'Fee_ 4 .1...b IA- 07/E], ,'?c=105 15:09 36113794451 TEFF CO DCD jiiIi� k • �,,ga�r c° JEFFER UNTY ` i DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360(379-4451 Fax e o www.co.jefferson.wamalcommdevelopment JEFFERSON COUNTY DCD Master Permit Application MLA: Project Description(include separate sheets as necessary): J� f U 1 mm t'l� l ( b_ez(21 _l. . Li i'Yl , . el £2l r Y1 a n I e4P^ Tax Parcel I C Property -- Number: Size: (acres/square feet) _ �j I Site Address and/or Directions to Property: I3 3 ) (= , 4i 4 rir'P.y� 11/1 Property Owner(s)of Record: I V►i1 �' r i c-f,4 , • 1 ` Telephone:360 7(o 2 74- Fax: email: Mailing Address: P t) >c `S 77 gvit lzeyie., LArA crei37a, Applicent/Agent(If different from owner):J k &r 1h4-4E' A-1,u1P.rc_,Y1 Telephone: ' F ax: — ` E email: Mailing Address: 00�� Lt,/ �7 p i' e_ , I,S ( --.• 69- tkind of Permit?(Check each box that applies) r wilding ❑Variance(Minor,Major or Reasonable Economic Use) E Demolition Permit r_7 Conditional Use[C(a),C(d),or Cj*" Ja-8trf()le Family 0 Discretionary"D"or Unnamed Use Classification ❑Garage Attached I Detached 0 Special Use(Essential Public Facilities)'* U Manufactured Home 0 Boundary Line Adjustment O Modular 0 Short Plat"* o Commercial* ❑ Binding Site Plan" 0 Change of Use ❑ Long Plat"* o Address o Road Approach ❑ Planned Rural Residential Development(PRRDyAmendments" ❑ Propane ❑ Ptat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** n Site Plan Approval Advance Determination(SPAAD)" 0 Shoreline Management Variance r)Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment o 1M eless Telecommunication* 0 Jefferson County Shorefine Master Program Amendment C Forest Practices Act/Release of Six-Year Moratorium "Max require a Pre Application Conference *4'Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: hereby designateClAtigetCti"Te- �9rca,Scr%sit;#NAT1ON OF AGENT — I 1 ,^(� /+ '(, / to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE �J 1 y V` 04-acc-r �/c, Z(1210S---Piza Date: 7/(7-(oS By signing this application form,the ownerfagent 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(wner/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 attorneys 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 required later inspections.Access and right of entry to this property shall be requested and shalt occur only during regular business hours. Signature: 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"take"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 actions)even If you are in compliance with the Jefferson County development coda.The Applicant admovAtidges that he,she or It holds individual and non-tr r hie re o Ibili r adh r1ng to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: 11/�).5— G:\FermitCenter\FORMS\DttD FORMS\Mauler *mit App1ic eon 74-04,doc 07f O9f 2005 15:09 3603794451 JEFF CO DOT, RAGE +ff YJ2 O/HER 8UILt]ER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contactors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature_ Date: GE RRL CONTRACTOR Oil NUFACTURED HOME INSTALLER: PHONE: _— Fax: :Un l r!5�� .� /�-ice ..oc �57-, �3 c.�MAILING ADDRESS: -�34, � r.tdry -ie, -EMAit �.. '�S 7-� G -- CONTRACTOR'S LICENSE ? 2 WAINs — NUMBER: O�,/117 Al/7[/6C)J �jq'- NUMBER ARCHITECT/ENGINEER: V f PHONE ( } FAX:( ) MAILING ADDRESS: EMAIL Pr sect Type: Frame Type: Bathrooms: Shoreline: Typo of Sewage Disposal: ew L! Wood Existing: �� ❑ Sewer 0 Addition 0 Steel Proposed: Bank ❑ Community System P--Atteration/Remodel r_? Concrete Total: Height: 0 Individual System 0 Repair ❑ Masonry SEP Permit# ❑ Demolition 0 der: Bedrooms: Water Supply: Existing: TypR4f Heat d; Setback: ❑ PrirY well L.; Two Party L. ��C 15 �/ Total: n Public Name of System: If this le a Commercial Project you must answer the fol jowlno:Number of Parking Spaces: Currant: Proposed: Number of RDA Parking Spaces: Number of occupants(lnckides owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yea I No If this Is a Propane Tank angler Anoilartpe Installatl permit mark a tems below that ao Iw. U Underground Tank 0 Above ground Tank Size of Propane Tank: 0 Heat Stove 0 Cook Stove O Woodstove n Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 Other Is this appliance Nana Installed In a Manufactured/Mobile Home Yes / No When applying for a perntft to Install a propane tank you must also submit a site plan showing ell of the buildings,all property lines, tank location and size,distances from the propane tank to all property fines,buildings and septic system components, Including the reserve area. Square Footage _ FP 6•* ce . .Oily t r y Current Proposed M i; r`rr1y,a tdi� e i it Main Floor ♦ I toy� Rev , • Vb- /77 3 "� ,z)°�T - ;. �, +�t',�i$t9�rt t�fl Yaaa.r/� .. y� L�f �t1 1 Jx� r+�A�� $ c 2'4"Floor , r ° t P � ti �' ! sf 3'°Floorf x 5 Vi-1 04 ()Y 11�R4Y 'tff r; 4 h Mezzanine: Plan k,foe: 5 0,4 G p,,jf'Y h�;:f;;({ rt,, ',ate 1 i , • y 'tA i WA 1I Heated Basement 19 L IJ cha `l -j --'4 J *. I`� r c c: a dt ` f r t Unheated Basement �it'At�r �a��L jf, ,< ,,am'a a., 1�1 ; Sa w i ' e' „ I1PG k AV:,"i�, ',. T': '4 Other Unheate •d 6.)14 a'' aaor� I 7�� , i '¢ +y'a ', ' " i.. 9r1Y� S1 xl' ` T� ( � , ' •YAr +4Garage/V�� P Decks ��' $ i 7 a i 1r E-:4f d k-t'" - } t-,. 7 ,A""', r;� � ,, 4 xr+l]rr Re elOt Number ti . � ,k` ,h , . Y i`T ',,r , !;. ' . • 1 A2fr ! l`;J Lt.Tyr'� 'j fufg\ ` �k Other ' ` 'h/Chook Ntiimb.(" wI- °' tii ESTIMATED COST(REQUIRED) tots; . •,' ,, +,,�, ': , ... x, Fait nonce value of eli labor end malarial:foundation to finish ,,, i 4 �' iq t`f $ v,.-. 1r 5 , '-' `' initials: a9 e fY 5, 700 -lnitals: ., ,.,.P, illiw.., r y. AP y,r w p y1�., 1I t G:\PermitCcnter\FORMS\DRD 130104.51Master Ptrrnit Application 7-8-04.doc —~ I 12 2005 . JU \ - nJEFFERSON CUNTY,pr _ OFPI OF COMNIUN'FTY CE,IEL, :: `�_'.