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Home My WebLink AboutBLD2005-00740 • 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 #: BLD05-00740 Received Date 11/28/2005 SITE ADDRESS: 353 NELSONS LANDING RD Issue Date 11/28/2005 APPLICANT: RICHARD STAHL PHONE: DOLLY STAHL 353 NELSONS LANDING RD PORT TOWNSEND WA 983689637 SUBDIVISION: STAHL SHORT PLAT Block: Lot: PARCEL NUMBER: 001173017 Section: 17 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2006 OWNER, RICHARD STAHL PHONE: if different: DOLLY STAHL 353 NELSONS LANDING RD PORT TOWNSEND WA 983689637 PROJECT DESCRIPTION: SWAPOUT 120 GAL A/G PROPANE TANK 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 11/28/2006. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 7✓1-Vle %Z -23 • � 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 APPLIC•ON BLD05-00740 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00740 Received Date: 11/28/2005 SITE ADDRESS: 353 NELSONS LANDING RD OWNER: RICHARD STAHL PHONE: DOLLY STAHL 353 NELSONS LANDING RD PORT TOWNSEND WA 983689637 STAHL SHORT PLAT SUBDIVISION: Block: Lot: PARCEL NUMBER: 001173017 Section: 17 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 DESCRIPTION SWAPOUT 120 GAL A/G PROPANE TANK 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: p Appr v d/uDate Propane Tanks/Stoves $49.00 PRB 11/28/05 77441 `►-�° Total: $49.00 NOV 2005 Jefferson County Planning & • • g Department RDI R ) A • • SITE VISIT REPORT (PLOT PLAN) JOB i►Q N C. DATE : 1 I (z t OS CONTACT: ADDRESS PHONE #: DIRECTIONS FAX #: Email PLANNER: R.6 Lc,r)o� — S00' S Op(' 1 JYi b Q_. NOV 2 8 2005 V 1 OE�'1 CrCGn„v� ,, ' LE\E:_OPMENT ( Nov 21 05 08:58a Richard Stahl 509-996-4348 p.1 Nov 21 05 08: 52a Le. 1-36 3t35-St375 p. 2 risoN caG� JEFFERSON COUNTY . \ DEPARTMENT OF COMMUNITY DEVELOPMENT kill621 Sheridan Street-Port Townsend •Washington 98368 3601379.4450- 360/379-4451 Fax \ 11F111111-R: www.co.jefferson.wa.us/cornmdeveloprnerit • Master Permit Application MLA: Project Description(include separate sheets as necessary): n 0_0 . 7-6_,...4c_ ,2.,._,....i,10_5„..*___ . Tax Parcel �'7 U ape Number. 3 ( ify Size: (acres/square feet) Site Address and/or Direcions to Property: 35 3 N eIS o nS �/1 el i'n ProperlyOwner(s)of Record: kw-y 4 Dok-c y 5�-A4 i_ J Telephone: Fax: emai: Mailing Address: 3SZ i•J'a 4 T C h e e c4,LA.c(n R-9 , LJ I N T t(r2_D lA t c)ih. Applicant/Agent(if different from owner): 51.f NsN/Ni- /012 0 PA Al E Telephone: .?SS-S 7 l 7 Fax: email: Mailing Address: /OBS.? 6 R . F'i. //n1)1OG1‹., CJ R What kind of Permit?(Check each box that applies) 0 Building p Variance(Minor,Major or Reasonable Economic Use) 0 Dernoliiion Permit O Conditional Use[C(a),C(d).or CJ 0 Single Family ❑Discretionary'O'or Unnamed Use Classification O Gage Attached/Detached O Special Use(Essential Public Facilities)** O Manufactured Home 0 Boundary Line Adjustment o Modular O Short Plat" ❑Commercial* O Binding Site Plan" 0 Change of Use O Long Plat". >cr Address 0 Road Approach 0 Planned Rural Residential Dev pane 0 Plat Vacation/Alteration" eioprrnent{PRRD)/Arrrertdmenis" 0 Mowed"Yes'Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions"0 Stormwater Management 0 Shoreline Management Substantial Developmert" 0 Site Plan Approval Advance Determination(SPAA))' 0 Shoreline Management Valance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map O Wireless Telecommunication' 0.tefferson County Shoreline Master Programe AmendmentO Forest Practices ActJRelease of Six-Year Moratorium AtnetMrrtertt 'flfeyrequirea Pre—Application Conference "RegtdneaaPresappscatM Cordbrenee Please identify any other local,state or federal permits required for this proposal,if known: Ides) DES OF AGENT as my matt relab• ica6o perma(s). rlNtE By signing this appll alion form,the owner/agent attest that he)formation provided herein.and in any aibch,MMs,Is true and his,her or It's knowledge. Any material falsepod or any omission of a material tact made by the owner/agent with respect to this correct to hood appGplien the best of reset in this permit being nuN and void packet I hither expenses which agree to save.indemnify and hold harmless Jefferson Courtly against at liabilities,judgments,court costs,reasonable aaorfiey s fees may ' any y aco'ue against Jefferson Canty as a result of or In consequence of the granting of aria permit and I further agree to provide access and right of enby to Jefferson County and its employees,representatives or agents for the sole of app iiisi review and any required later inspections.Access and right of entry to this ptaperty suet be and shall occur only during regular llaar business hours. p � Signature: / , ,r .L1�t/.,,litt Dale: t1— zr-os' The action or actions Applicant wail undertake as a result of me Issuance of this permit may negatively imaaet upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terns are defined it the federal law blown as the "Endangered Species Act"or'ESA,-Jefferson County makes no assurances tithe applicant that the actions that will be undertaken because his , permit has been issued will not violate the ESA. Any individual,group of agency can file a lawsuit on behalf of an endangered species regarding your adion(s)even if you are in ccnpiance with the Jefferson County development code.TheApplicant a and non- �77bbti.' responsibility for to andcomplyingwith ye E� The ntread Ibis dOds that he,she or and holds individual below. Signature:'n �, ,,11 (...A adheringAPPYexrt etas this di imer and signs dates it NDale: 1!-2/ - Qc. G:\Pam;Kmia 1FORMS\DAD FOltA151ttasru?«mil Appticitio,n -SO4.7 doc NOV 2 8 2L3 J OWNER BUILDER STATEMENT 4. 1 The signer of this statement does hereby certify ihat'tlfey 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. L Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: P/1-9 (3ba ) 385-S757 ( ) MAILING ADDRESS: )iJ,5 n 1.9--I-- EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: Su Y1,5- ft P 44 D7 7Q / NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System O Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ 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 i Underground Tank Above ground Tank Size of Propane Tank: ( _ 2r,Q. T-'4:- '-f' 0 ut Li Heat Stove l I Cook Stove ❑ Woodstove Li Fireplace Insert [l Hot Water Tank ❑ 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: � ' 2"u Floor Base fee: 3Floor Additional Section: Mezzanine: Plan Check fee: Heated Basement State Surcharge fee: Unheated Basement _ ."- Pot Water Review fee: Other Unheated Nov a 8 2005 911/Rd Approach fee: I Garage/Carport I TOTAL: $ 4 c -- ,f�^ Decks !! 1 1 t_.-._ Receipt Number: L 7`7 1 ( Other Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish ( 12 Z1 C. _) Initials: .-- C4-2 . (::\Fermin:enter\FORMS\DRD FORMS\MAster Pcniut Application 7-8-04.doc