HomeMy WebLinkAboutBLD2005-00785 BUILDING PERMIT APPLIC•ION BLD05 00785
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00785 Received Date: 12/23/2005
SITE ADDRESS: 80 MARINER PL
PORT LUDLOW, 98365
OWNER: BEVERLY J PARDIS PHONE: 360-437-7885
80 MARINIER PLACE
PORT LUDLOW WA 98365
BAYVIEW VILLAGE DIV 2
SUBDIVISION: Block: Lot: 5
PARCEL NUMBER: 931900005 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: NORTHWEST ELECTRICAL & HEAT'NG PHONE:
1611 198TH ST
ARLINGTON WA 98223
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI REM & REPL FURNACE
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION 810.00 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
Permit $38.75 LYK 12/23/05 78813
Plan Check $25.19 LYK 12/23/05 78813
State Building Code $4.50 LYK 12/23/05 78813
Total: $68.44
• 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 #: BLD05-00785 Received Date 12/23/2005
SITE ADDRESS: 80 MARINER PL Issue Date 12/27/2005
PORT LUDLOW, 98365
APPLICANT: BEVERLY J PARDIS PHONE: 360-437-7885
80 MARINIER PLACE
PORT LUDLOW WA 98365
5
SUBDIVISION: BAYVIEW VILLAGE DIV 2 Block: Lot:
PARCEL NUMBER: 931900005 Section: 16 Township: 28N Ranqe: 01 E
CONTRACTOR: NORTHWEST ELECTRICAL & HEATING SVC. PHONE:
1611 198TH ST
ARLINGTON WA 98223
OWNER, BEVERLY J PARDIS PHONE: 360-437-7885
if different: 80 MARINIER PLACE
PORT LUDLOW WA 98365
PROJECT DESCRIPTION: REM & REPL FURNACE
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 12/27/2006.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: Pi-FK, k ry K- t1-?-c 10 C 1-tc cf- )ti t.;
06Gi✓ C(.i;C,Z'2_,tG 15 vt { N;t i C-0V c.�=1- �' C j%r-{C-L Liu
FinalApproval: gat U-,ifi) M PCO� A-wk op L (-)2j'14 I
o n. {1.E44 m`'T� r�E C N r-iV v c.itt_ r- n% - I - -
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
12 '15/2005 17: 14 3603794451 JEFF CO DCD PAGE 81
' !.-'CEC--14-2005 10:53 • 368 652 54yz r.lal�e�
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. JEFRERSON COUNTY
?' , ..,. ,. DEPARTMENT OF C
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:�:'�+ •- ,• A. 36Q/378-4450 Streetp T n d ._ �h 9 9 2 Zo�r:1
4 DEC
. .;,04 • www.eo.jeffencon.wa. tiq mdewlopment i
Master Permit Application l , DEC• 1 4 2(105 ; ! .
pp atlon MLA:
P et Description(include separate sheets as new - '
12-4919"
Tax Parcel r '
i ', Number / 9 oo oo �� Property
Size: (acres/square feet)
••Site Address and/or Directions to Property: Q ..111116.1
-Property Owner(e)of Record:
l leohone:_ 340 — `131— "7 irfrS Fax:
"� m e 41t.
Mailing Address. 8444.>rNr4 f
• • Aopocant/Apent(if different fromowner): a . .s♦ , •� .
IPA Tel®phonte: '3 Fax it
.f l i? t�tJ��^- g� email;.gP 1 1U_� r•a
malting
Address: ✓
Whet kind of Permit?(Check each box that applies) -'•— __
Building Variance(Minor,Major cr Reasonable Economic Lite)
Demolition Pen!! ; Conditional Use IC(a),C(d),er Cj•'Single FAntiIy ' Discretionsry'D"or Unnamed Use Claasiflcatlon
Cartage Attached/Detached Special Use(EAoential Public Pao/fetes)w
Menukoturad Home • 0 Boundary Line Adjustment
_ Modular _ Short Plot"
Commercial' • = Sanding Site Plan'"
Change of Use . Long Plat
• : Address I Road Approo/li Planned Rural Residential Development(PRRD)IAmendments
Po o \�I• r��,:5- �`-A Plat Vocation/Alteration••
Allwuad Yea' o slam Ana ysis Shoreline Master Program Exemption/Permit Revinlons•`• _. Stermwater Management Shoreline Management Substantial Development
Site Plan Approval Advance Determination(SPAAD)• • Shoreline Management Variance
Temporary Use Comprehensive Plan/UDC/Land Use District Map Amendment
VVlrolees Tnlodammun,catlon• Jefferson County Shoreline Master Program Amendment
7..,Forest Practices AcVRetease of Six•Year Moratorium
-May require a Pre-Applcarlon Conference "Requires a Pm-Application Conference
Please Identify any other local, state or federal permits required for this proposal, if known:
-
i Mersin designate. bail 3NATION O F AGENT •
to act as my agent In matters relating to thia application for permit(s),
OWNER SIGNATURE
__ _ Dete:
8y signing this application form,the ownerlageet attests that theinfomiation provided herein,end In any attachments,is true and correct to the best of
his,her or It's knowtedge, Any material felaehood or arty omission cif a material fact made by the owner/agent with respect to this application packet
I.
may reouk in this wearer being null and void.
I further agree to save,indemnify and hold harmless Jefferson county against all l)Oblatles,judgments,court coots.reasonable attorneys fees and
expenses which may in any way some against Jefferson County es a result of or In consequence of the granting of this permit.
I further agree to provide aocass and right of entry to Jefferson County and itn employees,representatives or agents for the sole purpose of application
review and any required later actions,Access and tight of entry to MIS property shall be requested and shalt occur o during regular business
Si; ,urec,0
Date:
I'rht scaler•or acetone Applicant will undertake as a resul f the Issuance of this permit may negatively impact upon one or more threatened or
i 7.7ndangered specks and could lead to a potential'take'of an endangered species as those term('are defined in the federal law known as the
i Endenotited Species Act"or"ESA."Jefferson County making no aasurances to the applicant that the action'that will be undertaken because this
Eaermlt has been Issued will not violate the ESA. Any Individual,group or agency can file a lawsuit on Perhalf of an endangered species regardlnp your
ection(s)even if you ere in compliance with the Jefferson County development node. The Applicant acknowledges that he,she or it holes Individual
arrd non-transferable responsibility for adhering to and complying with the ESA. The Applicant has road this disclaimer and signs and dates it below.• Signature:
r Dale:
C:\Documents and Vettinge\rrp,ch.L\Desktop\ttaatur Permit Apntiatdon 7-8.O4.Jr,c
12/15/2005 17: 14 3603794451 JEFF CO DCD PAGE 02
17C= 4-'2085 10 54 360 652 5491 P.02/02 ,
`i OWN6R Out T /'LI:n-1\
,',' , 7►>,a bagnereif 1hm�atealent dose hereby lh.t th :I ' ��'lip' '" ""�,eyWtll er epaaiatp the.es ey the OwnerafoPthe referenced herein
•'f: PonslbfAly of Ih®General Contrecbo;rot the p, propk1i2d
a , t Iloen9ea r�ntraaors and that
9f9nalWe: n ta. . D �
: 3MERAL CONTRACTOR OR MANUFACTUREDii
F�OM6 INBTALL@R: •I'PRQNq ;1.7ti. ..._.....
AILING DDRESS: r L. T ji..., '3 .. V�)�irl—
CONTRACToit'S LICENSE: G// i�gr~ $T k MM.:
NuMeER: uARCH Sdla-.1 R WAIaNSS
ARCHITECT/ENOINE@q; •
I: f/Ig141kG ADDRESS: PrtoNE ( ) FAx:( )
EMAIL '
•
'Frojeot ps: tame T
New ❑ WoodType: Betltrocma: Shoreline: TYPO b SewageDisposal:
Existing: Dhlpoeal:
Flddftion Steel Proposed: ❑ Sewer
Alteration/Remodel 3 Steel to Bank f� Community System
Repair Total: Height ❑ Individual 6yatem
i` Demolition Masonry 'Bedrooms: SEP Permit#
Existing; Setback: Water Supply
Type Heat: proposed ❑ Private well Two Party
Total: '�' �.Public
""—`-- Name of System;
/r this le a Commercial Projaa2_vou mltatanewer the fOQowine!
Number of Parking Spaces: Current: I
Proposed: Number of ADA Parking Speces.
Number Of oeoupents(includes owners.tenants,employees,etc) Current
1BC Occupancy: 18C T Proposed
Type of construction: WIII you have Food Service? / o
1 no n It ce t e ma
•
1 Underground Tank t Above ground Tank low at
I Heat Stove 1 Cook Stove i 9iz®of propene Tank:
Woodetova 1 Fireplace Insert 1 Hot Water T• k 1 Pellet Stove I Other ,jaitupp __...nceyein Metalled In a Pitil11ilfwCtthrad/Mobile Homp? Yea /(L�'
When applying for a permit to install a propane tank you must also submit a site plan showing
linos,tank location and size,distances from the propane tank to all property llne ,buildingsand septic s stemgs,all rents,
lnpludlgg the reserve area. p system components,
Square Foofa at Curt:nt Pr a i + x� r x ty as
�„ -� o•deed # ) s.^fi , ;i i , l'1 q,-q ,•'
,�.r•r .!^ICOr 1 �' �� �,�;drrl + "NL G�, -4I� i '+'v'„':; ,►',l
`�T ST �I J-� ,, q,n 01 I '1'rT 1 r ,' TA aril`'^ , r �'1: ;?
2.�laOOr :I t +J..`'71r ;'A. V'•1 ]" a X ', 1f{I :` M"r
!�1 rl ' 1 hf '•.. I ti•1 S.I r:, }R.i'.7.N,/11, ,�\A •_
M9u.anin iyq��yyMFS;�* .`•�
9: • ., y, •.5,,• , , ut
Hea :aseinent .1 ;,' .. .: . . a5 1q
-B b A1'u r~harof e,fe a•.
i
. . -•,_
1,
i... 5 r0sheeted Basement Y• 7�h (. , fi r, ! :d K ',i.o. `r s.,rtti I
•
Wa .41),. .up ,r . r,; t x L1 4 , }r )u i `0• or fnheated ,T, .r L e, t yt , If •: r � fl l d r hqi,l, nr Mr i&�� w E1^ l�ir� tl 3'L ''1i . �4' t ,..P, or„ •Gar.ge/Ca Ott ';lr 0.4 ;tlit •r f r�y' ',�• ; i4a � "i+.� JuflT�T' roi ? M ', 'V ;, . / 4, 'r?,DeGte
•NM'.' '::1'''§i'Other �' f .iW ) v�S+H I�' $_a '`ixr4� 4 1(�'"i'! ice{
ESi TNMAT Q C C. .T .ii A,e.,:.°2 .e ' ,6 �' . ,, ';{ ' i;.v4,F?,�7°,";d� t �4,,0d, lYr i i 1," ,1 1,7.v,' , 1t 3
�QUIR•'O) , a ,� , il' if;,kt<. ,• .s is r '' 'y' Ai °Ff(Iii kf''
eltRlstk,t value ofaN Neer and n►ale,fals foundation to AniaA 'tlt0 st' ': , •�;f;.. a ,h'✓4, r.• • ,1.,,, ;p
(R >r t f . b )atk ta' •N�, k F ;p ae `i
�� •j I . J 0 F+ k+ i °,1,.,,t`•',s1,'i'.,• '.;:q, p ..•
:r. ..:II�rM �i .fr.1
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( -t- — 10836
fG 12_, Za o5 TOTAL P.02.