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Home My WebLink AboutBLD2005-00670 41PU ILDING PERMIT APPLICA1N BLRDOe 00670 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00670 Received Date: 10/24/2005 SITE ADDRESS: 372 E ISLAND VIEW AVE PORT TOWNSEND, 98368 OWNER: LYNNE W WEBSTER PHONE: 550 PINECREST DR PORT TOWNSEND WA 98368 PROSPECT VIEW ESTATES SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 989600002 Section: 35 Township: 30 N Range: 01 W 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 DESCRIPTIOF A/G 250 GAL PROPANE TANK, ZERO CLEARANCE FIREPLACE, 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: 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 Propane Tanks/Stoves $49.00 KAS 10/24/05 77149 Total: $49.00 • • 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 #: BLD05-00670 Received Date 10/24/2005 SITE ADDRESS: 372 E ISLAND VIEW AVE Issue Date 10/24/2005 PORT TOWNSEND, 98368 APPLICANT: SUNSHINE PROPANE PHONE: (360)385-5797 10853 RHODY DR PORT HADLOCK WA 98339 2 SUBDIVISION: PROSPECT VIEW ESTATES Block: Lot: PARCEL NUMBER: 989600002 Section: 35 wnship: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE \ HONE: 385-5797 10853 RHODY DR \ PORT HADLOCK WA 98339 Contractor's License SUNSHP*077 pires 11/17/2006 OWNER, LYNNE W WEBSTER PHONE: if different: 550 PINECREST DR PORT TOWNSEND WA 98368 iU PROJECT DESCRIPTION: A/G 250 GAL PROPANE TANK,ZERO CLEARANCE FIREPLACE, 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 10/24/2006. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 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 BLD_Permit_Propane.rpt 10/29/1 9.c • SITE VISIT REPO RT (PLOT PLAN) SOB E. ;):)t DATE : i0( 17-I'S CONTACT: ADDRESS Z E , I SLApD Jt6U) PHONE #: DIRECTIONS FAX #: Email PLANNER: v r Dow N Vosr \ i f 1.11_111J! ,\ Liv " OCT 2 4 2005 };I ejili / JEFFERSON C NTY . , i� ! t DEPARTMENT OMMUNITY DEVELOPMENT • `- 621 Sheridan Street • Port Townsend •Washington 98368 • , ..._.,,. 360/379-4450 • 360/379-4451 Fax OK.O� www.co.jefferson.wa.us/commdevelopment Master Permit Application BALA: „1F' RS(1N r(lUNTY nf',I Project DesRiption(include separate sheets as necessary): - f I 0 p ol'hoe..-- ( 0.41.1c, ; +A Z e.-- VIA" eff24--c-co Tax Parcel qpG r fr 1" Property Number: l O l &Od DQ zSize: Size: (acres/square feet) Site Address and/or Directions to Property: 3 7� "-'-cam 4u Property Owner(s)of Record: 4t,„. .-�_ LJ .-.6 .m., Telephone: 3 FS ,S�- 0 Fax: email: Mailing Address: 51 T C. 550 T7IN) e�2'.ST l►2. r f01€1 `r"ot,vm iss1.11c, t,4_,4 C 3 c,g Applicant/Agent(if different from owner): emu.►)S /L!/1 e. 1°2.-Ol'0A-»€ Telephone: 3( 0 3 8 S -S 7 1 -7 Fax: 3 VS S 8 7S email: Mailing Address: f 0 R5 3 I h o d ci Br• SO? . .fHn19 Lo CW, Lt.)/9 58337 What kind of Permit?(Check each box that applies) ❑ Building [I Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑Garage Attached/Detached 0 Special Use(Essential Public Facilities)** ❑ Manufactured Home 0 Boundary Line Adjustment ❑ Modular 0 Short Plat** ❑Commercial* 0 Binding Site Plan** ❑Change of Use 0 Long Plat** ❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)IAmendments** Propane ❑ Plat Vacation/Alteration*" Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline l' anagement Varia ❑Temporary Use ❑ Comprehensive Pian/UDC I e'Distict a t ^ 0 Wireless Telecommunication* 0 Jefferson County Shoreline 't p�yj, n ^ ❑ Forest Practices Act/Release of Six-Year Moratorium ,f II *May require a Pre—Application Conference **Requires a Pre-Application anfere c ' Please identify any other local, state or federal permits required for this proposal, If known:'! 24 2U05 I ,Il DESIGNATION OF AGENT I here. de 'gnat: �/ �i.s-d y age -;.slating to • . •lion for permit(s). OWNS' IGNATURE `/ ` '4.' 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 its 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. \b 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 ISreview and any required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business iithours. �� rgnature: qSiliDate: f,o/ Zo'/09- 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 v..) 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 114action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or It holds individual and non-transfer- le responsibility for a� dh ri g to and cot plying with the ESA. The Applicant has read this disclaimer a d signs and dates it below. ignature: �.� Date: 10/2-0 o✓Y G:\PemutCentcr\FORMS\DRD FORMS\Mastcr Permit Application 7-8-04.doc q---(30/ a BUILDER STATEMENT The signer of this statement does hereby ceriat they are the Owners of the pal they will be assuming the responsibility of the General Contractor for the proposed�proje rented herein,that they are not licensed contractors and that a Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Su-nstii ,,^0?,n)--10._- ( 0 ) 38S=57? 7 ( ) MAiLwGADDRESS: l/0853 7 /u'!0 Off, EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: hshli0 07!7 a rJ NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: MAILING ADDRESS: ( ) EMAIL Project Type: Frame Type: Bathrooms: ❑ New Shoreline: Type of Sewage Disposal: 0 Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: Bank Height: 0 Individua l S 0 Alteration/Remodel ❑ Concrete Total: 0 Commualt System ystm ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: , Type of Heat: Proposed: P blic Weii ❑ Two Party Total: 0 Public 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: ❑ Underground Tank kAbove ground Tank Size of Propane Tank: e2/', O ❑ Heat Stove ❑ Codk Stove LiWoodstove ❑ Fireplace Insert ❑ Hot Water Tank 0 Pellet Stove Other GQe Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying fora `"' f�I"� ° Ft "" permit to Install a propane tank you must also submit a site plan sho ing 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 s j Y < Current Proposed • A.s 4 + ' o',tiji` Main Floor Y ;" 'Consistency.Review .t.. . f f 1.7 r 2�'o Floor .Y, : Base fee: x tt /l, rrFloor , ; , b #' •�i .. Additional Section: , : �� t�. , Mezzanine: ------- _._.__ , „ , Plan Check fee: 4 i1 Heated Basement — y State Surcharge fee: t-V r? ; ;1:41 .- Unheated Basement :' 1, `, c 1>; , (, (�_ _ (� Pot Water Revie Plsfee.T, 'G!r" y j s it r 11.. a Other Unheat t6r {G LS ' r" ' 4) . '�: D _ 911/Rd Approach fee: . ,I- < x� `.41A�r A n f C TOTAL: } ;,u �,,., 4 � ��, �� Decks 2 A f. r �� ;=� -�C j — I Receipt,Number � , 3. Other ` �r ;, {* Cash/Check Number. 1 �� 7 >t ESTIMATED COST(REQUIRED) fix':t � Date: •Fair market value of all labor and materials foundation to finish .,. 'k4 h u O Initials: � ,,' " r i —0 (.i:\Pemutanter\FORMS\DILL)FORMS\nCuter Pcnnit Applicauugti-ts-lW.Joc