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Home My WebLink AboutBLD2006-00419 • IP 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 #: BLD06-00419 Received Date 7/19/2006 SITE ADDRESS: 271 CAMERON DR Issue Date 7/19/2006 PORT LUDLOW, 98365 APPLICANT: MARK R GARRISON PHONE: 360-437-1133 PENNY J GARRISON 271 CAMERON DR PORT LUDLOW WA 983659713 16 SUBDIVISION: SOUTH BAY#2 Block: Lot: PARCEL NUMBER: 995600016 Section: 21 Township: 28N Range: 01 E CONTRACTOR: PORT ORCHARD HEATING PHONE: 437-8222 824 BYWATER WAY PORT LUDLOW WA 98365 Contractor's License PORTOHA084OB Expires 9/1/2006 OWNER, MARK R GARRISON PHONE: 360-437-1133 if different: PENNY J GARRISON 271 CAMERON DR PORT LUDLOW WA 983659713 PROJECT DESCRIPTION: A/G 100 GAL PROP TANK, COOK STOVE & PIPE 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 7/19/2007. REQUIRED INSPECTIONS: Tank/Line/Appliance:I—maw Le, Olt A* lirr&voR._ Liues cX 8/6/4iv �-'e..,oK Stosi a O K S f ic4k,,AL FinalApproval: d k. 4),na,/ ghc/x, itfr 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 06-00419 BUILDING PERMIT APPLICATION BL Review Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00419 Received Date: 7/19/2006 SITE ADDRESS: 271 CAMERON DR PORT LUDLOW, 98365 OWNER: MARK R GARRISON PHONE: 360-437-1133 PENNY J GARRISON 271 CAMERON DR PORT LUDLOW WA 983659713 SOUTH BAY#2 SUBDIVISION: Block: Lot: 16 PARCEL NUMBER: 995600016 Section: 21 Township: 28 N Range: 01 E CONTRACTOR: PORT ORCHARD HEATING PHONE: 437-8222 824 BYWATER WAY PORT LUDLOW WA 98365 Contractor's License PORTOHA084OB Expires 9/1/2006 REPRESENTATIVE: MIKE JORDAN PHONE: 425-328-7190 13306 27TH DR SE BOTHELL WA 98012 PROJECT DESCRIPTIOr A/G 100 GAL PROP TANK, COOK STOVE & PIPE 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: SEW WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routi Date: Cie Type Amo i Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $51.00 LYK 07/19/06 83842 Total: $51.00 " t♦QG JEFFERSON COUNTY � r ic ` ,; DEPARTMENT OF COMMUNITY DEVELENT '-' '.:> rC 621 Sheridan Street• Port Townsend • Washington 98368 . + 360/379 4450 • 360/379-4451 Fax J .01s IN ,,p www.co.jefferson.wa.us/commdevelopment t f .� , Master Permit Application JEFFERSON COUN4Y C[1 d_, `-'` _ (X Projecje n(inktoclude separate2. sheets ssa ) �€kop TA-OK ( 6- z Tax Parcelr: (�( � /�r 000/6 Property Size: (acres/square feet) Site Address and/or Directions to Property: `2- I (kwn_f'Oy+ DrZ 1PereT L ..B Lester 9 g-3 6r Property Owner(s)of Record: Plkii•N ( kii ,10.1 SOv-- Telephone: .3(O0 42 -1 t 33 Fax: email: Mailing Address: Z.4-1 C#-w&ro-v` rbK. 4.10ftT LA....bcal".) ti. 4' 3il f" Applicant/Agent� (if different from owner): /4/ �?1cj AA) Telephone: if 32 . 190, Fax: email: w►.)eav"c't ut e he 7t*LJ,CN. Mailing Address: %23oL L7 ` 17x- �� j -U 1 �[r'O)9- What kind of Permit?(Check each box that applies) ❑Building i Variance(Minor, Major or Reasonable Economic Use) d 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 El Modular °Short Plat** ❑Commercial* °Binding Site Plan** ❑Change of Use °Long Plat** ❑Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** JR Propane T .1k.,K q tu 0 p//Ot ❑Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development** O Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment :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: �. GNAOFAGENT I hereby designat= /� 0� ta.qct as my agent in matters relating to his a plication for permit(s). OWNER SIGNATURE • `% /f • �j-C � Date: ��j� 0 Co By signing this application form,the er/ e attest that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any ma ial fal e d or ny omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and- I further agree to save,i nify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which i in any wa accrue agai, - erson Cou • .s a result of or in consequence of the granting of this permit. I further agree provide access nd right/entry t•J;-rs. unty and its employees,representatives or ents for the sole purpose of application review and an required lat r in pections. Staffs c s . • right of entry will be assumed unless the applicant forms the County in writing at the time of the ap ation tha r she wa t .nor . •-� Signature: 1!j / •` Date: ` The action or actions Applicant ill .nd- a =s a r:sult of the issuance of this permit may negatively impact upon one or more threatened or endangered species and co . -.d to . .;0ntial"-ke"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"o ESA." sevs. .unty makes no assurances to the applicant that the actions that will be undertaken because this permit has b--r sued I,gat, .at- e, :••. Any ins a ual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)e -- if youra-ie f compli•• -with e J;•erg.• County development code.The-Qpplicant acknowledges that he,she or it holds individual and non-tr. sferable r-s,onsibit for-.h. in. . -• . complyinftvith the ESA. The Applicant has read this disci i er a signs and dates it below. Signature: ' — ��`� �� ,C Date: 6 (5 /-4110 D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • BUILDER STATEMENT y ` -1' ik 'L ,' l .. ii�;r The signer o is statem:nt does ereb ce ify j.-t they are the Owners of the parcel referen d h ein,that they�� t licensed contractors and that they will b :ssumin. t resp. sibility,f e y n/eral Contractor for the proposed project. Signature. `aro k _ Z Date: 1 5 0J GENERAL CONTRACT.- "R ' nee'UREDHOM�E,IN,/ST�ALL/ER::f PHONE: FAX: MAILING ADDRESS: EMAIL: ,� �Fir1 4 Nie ! CONTRACTOR'S LIC 7SE , �N A y�� ^ WAINS NUMBER: 9 ,/�, O�IT SVJ .,!)1 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: ❑Sewer ❑ Addition 0 Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition Bedrooms: Water Supply: ❑ Other: pp Y: Existing: Setback: ❑ Private well 0 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 applv:� r]Underground Tank Above ground Tank Size of Propane Tank: ( CI(� ❑Heat Stove jErbook Stove 0 Woodstove ❑Fireplace Insert 0 Hot Water Tank 0 Pellet Stove []Other Is this appliance being installed in a Manufactured/Mobile Home? Yes 40 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2n6 Floor Heated Consistency Review: Other Heated Base fee: -I pU Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL fix)5 - Decks 911/Rd Approach fee: Other TOTAL: $ !(Q C Receipt Number: ( Cash/Check Number: 0 I ESTIMATED COST(REQUIRED) Date: ',Fair market value of all labor and materials foundation to finish Initials: D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-3(1-05-2.doc 1 . : . • r‘;;,, 'f. 4 lu I.-\., 9k-Kf.tSr 2 i 0 POYLTLA rt) 601/3 u-A- , ir, t- 9c Fo ol, (_ i0 $ , J 4 ,I '''-. ' e i 14! , I. -' i (t. ' ___) , , ''F.I.J , 1 V j • C e6 V (Al rail e__ - �a ��kII - (%!C halLei-' �r • .I I _1 RECEIVED ;` ` l % JUL 1 9 2006 JEFFERSON COUNTY IC00 colc , 1-1.-ct- l ) .-�ror7) al&u ,� 01''a.t‘_S l_ / I 3f)(LC� -TANK ',l t-,. I . 1,-,ft-Lv-t 1(A Vt \ -\-----,)C- C` \aYM ‘ ' v..,),