HomeMy WebLinkAboutBLD2006-00159 ItILDING PERMIT APPLICAT IC BL v
Reviewiew T Ty159
ype:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00159 Received Date: 4/4/2006
SITE ADDRESS: 86 PARKVIEW LN
PORT LUDLOW, 98365
OWNER: ALAN J MINISH PHONE: 360-437-9174
JANE MINISH
86 PARKVIEW LN
PORT LUDLOW WA 983659718 BRIDGE VIEW ESTATE TR DIV II
SUBDIVISION: Block: Lot: 4
PARCEL NUMBER: 821355016 Section: 35 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 DESCRIPTION PROP GENERATOR & GAS PIPING
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION 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: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date: ,
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $51.00 LYK 04/04/06 80939
Total: $51.00
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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 #: BLD06-00159 Received Date 4/4/2006
SITE ADDRESS: 86 PARKVIEW LN Issue Date 4/4/2006
PORT LUDLOW, 98365
APPLICANT: ALAN J MINISH PHONE: 360-437-9174
JANE MINISH
86 PARKVIEW LN
PORT LUDLOW WA 983659718 4
SUBDIVISION: BRIDGE VIEW ESTATE TR DIV II Block: Lot:
PARCEL NUMBER: 821355016 Section: 35 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, ALAN J MINISH PHONE: 360-437-9174
if different: JANE MINISH
86 PARKVIEW LN
PORT LUDLOW WA 983659718
PROJECT DESCRIPTION: PROP GENERATOR& 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 4/4/2007.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: TRopi L4 K 4///rn DK */p1alft
CAIEEVS 5'41AT bFP(PfSceAJIJEGr) VALVE IA1irtigILF�
FinalApproval: }Gr cjylt � ,3f/L/67,
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
APR-03-2006 04 :35 PM P. 01
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JEFFERSON COUNTY' c� �� S O ; , ft C
DEPARTMENT OP COMMUNITY DEVELOPMENT 6 ak
826 Sheridan Street'Port Townsend Washington 9836B J
86013 o.je490 3wa. sIoo S1 Fax
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Master Permit Application MLA:
Project Deststptlon(include separate sheets es neoeasery):
—f?S Pi Pill G .
Tax r t+eet r��/ 3SS- D/c Property
Nurrbsr O // SRN: s (screslsOttere feet)
Site Address andlor Directions to Property to p��/� v/�- /7✓ LUG c.p�
Property Owner%)of Record: ...//91-7 t° L / /h/J,
Telephone; ' ft.1 7 — 1/Icy Fax email:
Maiing Address: </7-67-
Apprloant/Aoant(If different from owns': c —
Teleplone: _s- Z---7 5.7 Flex: email:
Mating Attdtees: f'<",) Y,- - -- P%' L_gd2L 1=
What kind of Permit?(Check each bus that apples)
0 9uliding J Variance(Minor,Major or Reasonable Economic Use)
G Demolition Psrmk 0 Conditional Use[C(a),C(d),or C]"
0 9 ngis Family C Discretionary'D-or Unnamed Use Classlfiastlon
Cl°Wags Attadled/Detached 0 Spedal Use(Essential Public Facilities)"
0 Manufactured Horne t]boundary Lino Adjustment
0 Mot:odurarCisl r 0 Short Piet"
Cl Binding Site Plan"
C Change of Use G Long Plat•"
dress a Road Approach C Planned Rural Residential Development(PRROYMlendrnante"
1 e C'Piet Vacaeon/Atteretion"
AllOwed'YN-Use Cone) tency Analyrtle C Shoreline Meeter Program Exemption/Parma Revlssons"
0 8tormwater Management C.Shoreline Mertagemsnt Substantial Development"
, o Site Plan Approval Advents DetarmItetlot(SPAAD)• C'Shoreline Management Valence
a Temporary Use C Comprehensive PlarvUDCQ.end Use District Map Amendment
0 Wh+sless Tetacommurticetlon' CI Jefferson County Shoreline Master Program Amendment
0 Forget Pintoes Ms/Rebase of Six-Year Moratorium
• e Pr-Appricalron Cate "Rmairiell a P r..*p reolian COnlerarrva __1
Plus*Identify any other local,state or federal permit*required for this proposal,If known:
( - 31QNAT10 DENT --.
I h t, Ant I a e s).
I _ 'J-_ te:
r ay signing fhb ePPilcatbn form,the troneda ant aarrefe that fie Intormptlon provided herein,end In any attachments,Ware and correct to the beet of
his,her or ire knowledge. My material felsahood or eny omission of a material tad trade by the orrnerlagenl weft respect b Rid application packet
may read'in this Writ being null and void.
I haft(NOW q luvu Indemnify and bald rtaanias&Jefferson County aesinsl all Ileblttoe,Judgments,court coats,reasonable eborneya fees ono
expenses which may In arty rosy accrue Kernel Jefhnon County as a result of cc In consequenta of the granting of this permit,
I ketharegteeb} vWa lateens and 11Q f entry lb Jefferson County end ie employees,rspreasntatves or aaenta kx the sole purpose of appicatbn
rem, and any red r aler lire olt and rightpf entry to this properly shall be requested end snail occur only during rower bushels
--- -
The actors Appi ntvwe undertake as a result of tie issuenoe of this permit may negatively Impact upon one or more Sweetened or
end spades end xuid lead to a potential"lake'of an endangered species es those torts we defined In the federal law known ea the
'endang.ad speolw Ad'or'ESA.'Jefferson County retakes no essuranoes to ere appttoant Viet the means that wit be undertaken becalree this
Whit has been Issued wet rapt vlorab the ECA. My Individual,group or party can me a lawsuit on behalf of an endangered spades regarding your
action(s)on °molar' Jefferson County development ode.The AppllcaM acknowledges that he,she or It hands hdividual
\` one bl Iblll r pbho whh tie ESA. The Aopewnt has road this dliktinmsV end rigge➢IM dabs it below.
y X s - u.. onto )G C/rigger
-
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G:\PeantC DSI)FORMS\Mum Pemtit Applicrdon 7-604-4.1o‘
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• III ,
FT OWNER BUILDER STATEMENT
The signer of this statement does hereby certify that they 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.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
,S6"-4---P-, ->✓,-.- �--4.� ( ) 3 -s 7�7 ( )
MAILING ADDRESS: /U' j ) Nl EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: CC-4617 Stile,Z Q77 /-n NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX: ( )
, MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New 0 Wood Existing: 0 Sewer
❑ Addition 0 Steel Proposed: _ _ Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: 0 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: "0 (9,41‘..tchttlik
❑ Underground Tank 0 Above ground Tank Size of Propane Tank: ('
❑ Heat Stove 0 Cook Stove ❑ Woodstove 0 Fireplace Insert 17 Hot Water Tank [1 Pellet Stove 1KOther /972..
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:
ry� 4
2NU Floor Base fee:
3t°Floor Additional Section:
Mezzanine: Plan Check fee: _ s - =,
Heated Basement State Surcharge fee:
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee:
Garage/Carport TOTAL: $
Decks
Receipt Number —-` tpt+� 4 34t;g'
Other Cash/Check Number:
c w I..
ESTIMATED COST(REQUIRED) Date: ` 1 ; .
•Fair market value of al/labor and materials foundation to finish -'�� 41 ,
Initials: "
w:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc