HomeMy WebLinkAboutBLD2006-00230 •
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 #: BLD06-00230 Received Date 5/3/2006
SITE ADDRESS: 621 GRIFFITHS POINT RD Issue Date 5/3/2006
NORDLAND, 98358
APPLICANT: ARTHUR I PRICE PHONE: (206) 283-7205
MARGARET B PRICE
2201 EASTMONT WAY W
SEATTLE WA 98199-3805 TX 2+
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 021324002 Section: 32 Township: 30N Range: 01 E
CONTRACTOR: QCO MAINTENANCE INC PHONE: (360) 876-4876
PO BOX 370
PORT ORCHARD WA 98366-0370
Contractor's License QCOMAI*993NS Expires 08/10/2007
OWNER, ARTHUR I PRICE PHONE: (206)283-7205
if different: MARGARET B PRICE
2201 EASTMONT WAY W
SEATTLE WA 98199-3805
(206) 284-0993
PROJECT DESCRIPTION: WOODBURNING FIREPLACE INSERT REPLACEMENT
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 05/03/2007.
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
I:\F_BLD_Permit_Propane.rpt 10/29/19£
RILDING PERMIT APPLICATS BLD06-00230
Review
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00230 Received Date: 5/3/2006
SITE ADDRESS: 621 GRIFFITHS POINT RD
NORDLAND, 98358
OWNER: ARTHUR I PRICE PHONE: (206)283-7205
MARGARET B PRICE
2201 EASTMONT WAY W
SEATTLE WA 98199-3805
SUBDIVISION: Block: Lot: TX 2+
PARCEL NUMBER: 021324002 Section: 32 Township: 30 N Range: 01 E
CONTRACTOR: QCO MAINTENANCE INC PHONE: (360) 876-4876
PO BOX 370
PORT ORCHARD WA 98366-0370
Contractor's License QCOMAI`993NS Expires 08/10/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION WOODBURNING FIREPLACE INSERT REPLACEMENT
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: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
Type Amount Paid Bv: Date: Receipt: Approved/Date
Propane Tanks/Stoves $51.00 KAS 05/03/06 81160
Total: $51.00
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¢go C JEFFERSO•OUNTY • _,
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368 f_` --
360/379-4450 •• 360/379-4451 Fax
�gS. ,e0 www.co.jefferson.wa.us/commdevelopment MAY * 3 2006 Li
Master Permit Application p MLA: — �--�--
Project Description (include separate sheets as necessary): ,.1� :IT t;, VEt.GpMF"_"f
WC Cct j� /
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Propert'
Tax Parcel Number: 0 21 3 241.. O 2 Size: Il, 2 S A c ,e S } (acres/square feet)
Site Address and/or Directions to Property: G .-\c ,-{"k., pi- i k - ( (c ra l ? ,,.1 , L{.,,1
Property Owner(s)of Record: A- *1.0 v- 1 93- M 2i^4Prel 6 priL .
Telephone:206- 7 Fj A - 726 C Fax: 2 b 6 - 224 -0993 email: --
Mailing Address: 22.0 I East wv..),-I i l tJ2..y •1-de,f1-E S e t4 I e /44, 9 3 /99-38('V
Applicant/Agent(if different from owner): —
Telephone: — Fax: email:
ividiiing Address: --
What kind of Permit?(Check each box that applies)
L 1 Building ❑ 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 ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
Modular ❑ Short Plat**
❑ Commercial* ❑ Binding Site Plan**
Li Change of Use ❑ Long Plat**
❑ Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
LI Propane ❑ Plat Vacation/Alteration**
❑ Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance
❑ Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
11 Wireless Telecommunication* ❑ Jefferson County Shoreline Master Program Amendment
Forest Practices Act/Release of Six-Year Moratorium
*May require a Pre-Application Conference **Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate — to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE '--1"
Date:
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 it's 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.
I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's 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 require later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours.
Signature: �/ � A
Date: "t/12 9706
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 action(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-
transferable respon ' . ty for ering plying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: (j� (vJ/,/La,.e_e Date: 4 / 27/Q6
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc