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Home My WebLink AboutBLD2006-00508 • • 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 #: BLD06-00508 Received Date 9/1/2006 SITE ADDRESS: 60 VANCOUVER DR Issue Date 9/1/2006 PORT TOWNSEND, 98368 APPLICANT: SUSAN M HAZARD PHONE: 360-379-0859 60 VANCOUVER LN PORT TOWNSEND WA 983689675 29+ SUBDIVISION: DISCOVERY BAY HEIGHTS DIV 1 Block: Lot: PARCEL NUMBER: 947300029 Section: 32 Township: 30N Range: 01W CONTRACTOR: SUBURBAN PROPANE PHONE: (360) 377-7647 351 CHICO WAY NW BREMERTON WA 98312 3 Contractor's License SUBURPL044DA Expires 3(/1gp)2/2007 6756 OWNER, SUSAN M HAZARD PHONE: 360-379-0859 if different: 60 VANCOUVER LN PORT TOWNSEND WA 983689675 PROJECT DESCRIPTION: A/G 50 GAL PROP 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 9/1/2007. REQUIRED INSPECTIONS: Tank/Line/Appliance: 41 u K /-a2 _,5r,aAli,hu‘ .lnavc DL V25/46 FinalApproval: ae—Othe glzv�/OLJ� 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 APPLICATN BLD06-00508 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00508 Received Date: 9/1/2006 SITE ADDRESS: 60 VANCOUVER pR--- PORT TOWNSEND, 983 8 OWNER: SUSAN M HAZARD PHONE: 360-379-0859 60 VANCOUVER LN PORT TOWNSEND WA 983689675 DISCOVERY BAY HEIGHTS DIV 1 SUBDIVISION: Block: Lot: 29+ PARCEL NUMBER: 947300029 Section: 32 Township: 30 N Range: 01 W CONTRACTOR: SUBURBAN PROPANE PHONE: (360) 377-7647 351 CHICO WAY NW BREMERTON WA 98312 Contractor's License SUBURPL041DA Expires 3/12/2007 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI A/G 50 GAL PROP TANK TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE CODE EDITION. 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: 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: q - 1 -06 Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $51.00 LYK 09/01/06 84815 Total: $51.00 II III R Ec f4:4 iv ifi.„-' 1[..',,! 40s Na°N % JEFFERSON COUNTY ' \s A DEPARTMENT OF COMMUNITY DEVELOPMENT SEP 0 1 2006 III 1.4 621 Sheridan Street• Port Townsend • Washington 98368 360/379-4450• 360/379-4451 Fax �q www.co.jefferson.wa.us/commdevelopment FFERSON COUNTY OCI S 'i'� Master Permit Application MLA: ' Project Desc iption(include separ to sheets as necessary): & , t(t ROO TaAl-L t&W— Tax Parcel Q 7 3 Property Li Number: 1 l 60021 � 1 Size: 2 2 i 2 87 • -Pt• (acres/square feet) Site Address and/or Directions to Property: �O Vain 91AN-€r kakuL Poy Tow S€ d, u}Q Property Owner(s)of Recgrd: St taiY1 M . H a�cyY GL) Telephone: C3(pp) 39r —O 85G1 Fax: email: Mailing Address: (DO Vafrl e iW 01/4)14,1. fed To W h Wid, C 6.3562.Ut pnd , Q CM.) Applicant/Agent(if different from owner): Ltj . q 836)la A 09-5 "�"""� Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) ❑Building ❑Variance(Minor, Major or Reasonable Economic Use) d Demolition Permit ❑Conditional Use[C(a),C(d),or C]** d Single Family ODiscretionary"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** El Change of Use 0 Long Plat** Q Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** .Propane ❑Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** OStormwater Management ❑Shoreline Management Substantial Development** OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑Temporary Use OComprehensive 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: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE 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 required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior notice. Signature: fll1/,,,BSI $1 Date: 9 CULS . 2000 The action or actions Applicant will und-•:ke 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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: 'Z'j to "5 . 2 GO(P D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc 0 I 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. •(?-fliV LeV Signature: Date: 29 aul• 2-C%,, ( )q 3/- 04 GENERAL CONTRACTOR OR MANUFACTURED ME INSTALLER: PHONE: 311 -5 4 oft FAX: (.1.b Ur bui, ere Pt. T'0wnsorW (3(QO ( ) MAILING ADDRESS: 19 ` LJ. F) 189 CI a 308 EMAIL: CONTRACTOR'S LICENSE ' WAINS NUMBER:C�p��C/_ ,CCOi SUB1RI'I� Ot+ PA NUMBER 'J li z f PHONE ( Q)y 3 9- 11 6L4Ax:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New IA.Wood Existing: ❑Sewer ❑ Addition 0 Steel Proposed: Bank ❑Community System CEr Alteration/Remodel 0 Concrete Total: Height: .Individual System ❑ Repair 0 Masonry SEP Permit# 5Er' S Q-j'f5 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: X,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 Underground Tank %Above ground Tank Size of Propane Tank: Q_ craiLayt, O Heat Stove ❑Cook Stove ❑Woodstove ❑Fireplace Insert 0 Hot Water Tnk 0 Pellet Stove p 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: �5. 50 Other Heated Base fee: D O 51 Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL r(o. 5b Decks 911/Rd Approach fee: ..---- Other TOTAL: $ "7(, 3b Receipt Number: 34an Cash/Check Number: r7 I ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish Initials: _ C D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc O T r, tit -o N • 0 o '`fuI, O A CD Cb -n 1.--alt O r+ ,= Q sa CD (./) CD i 0' CD ,C.n-r. 130.0' Cl.)CD SD ym CD cn m a CO n'8= x m a( O o. �.CT) s, v co co U. — ° a o C'b O co m CD oc, -a(0m - ® ® .4 m v x C'b II _ = CD— s �= N G) CO on N 0) a Q Q N =.p x al co CD 0 n o 6- �Cco ,, -0Qm 15.-;1 _, r— --V=0 < 0 �. 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