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Home My WebLink AboutBLD2006-00527 • • 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 #: BLD06-00527 Received Date 9/13/2006 SITE ADDRESS: 74 WINDRIDGE RD Issue Date 9/13/2006 CHIMACUM, 98325 APPLICANT: WALLACE L REISLAND PHONE: 732-4656 BARBARA J REISLAND 74 WINDRIDGE ST CHIMACUM WA 983259767 E SUBDIVISION: SHERWOOD FOREST LARGE LOT Block: Lot: PARCEL NUMBER: 901275005 Section: 27 Township: 29N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, WALLACE L REISLAND PHONE: 732-4656 if different: BARBARA J REISLAND 74 WINDRIDGE ST CHIMACUM WA 983259767 PROJECT DESCRIPTION: NO MLA REQUIRED REMOVE WOODSTOVE - INSTALL PELLET STOVE 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 9/13/2007. REQUIRED INSPECTIONS: Tank/tine/Appliance: 4PPLI14 /KIS-tALLATIG,J dK /I*/O6 FinalApproval: DK -c 4), ytG.( q/4AL le BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a rn. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY I:\F_BLD_Permit_Propane.rpt 10/29/19 BUILDING PERMIT APPLI•TION BL vy527 Reviewiew T Type: Jefferson County Department of Community Development 621 Sheridan Street Porl: Townsend, WA 98368 PERMIT #: BLD06-00527 Received Date: 9/13/2006 SITE ADDRESS: 74 WINDRIDGE RD CHIMACUM, 98325 OWNER: WALLACE L REISLAND PHONE: 732-4656 BARBARA J REISLAND 74 WINDRIDGE ST CHIMACUM WA 983259767 SHERWOOD FOREST LARGE LOT SUBDIVISION: Block: Lot: E PARCEL NUMBER: 901275005 Section: 27 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NO MLA REQUIRED REMOVE WOODSTOVE - INSTALL PELLET STOVE 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: 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 Permit $51.00 DJK 09/13/06 85J05 Total: $51.00 • • °N CO6 JEFFERSON COUNTY kj \ , DEPARTMENT OF COMMUNITY DEVELOPMENT "\.y `4 1 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450• 360/379-445 Fax 4q s } www.co.jefferson.wa.us/commdevelopment ....) Master Permit Application MLA: /j¢- Proj scription(include separate she is as necessary): •flet \s�*)o0&. S-4-0 J ^ - - -4 c V \2�-\l AA- Ste,v.� Tax Parcel Property tl O 1 ��5' 6U Number: 1 Size: (acres/square feet) Site Address and/or Directions to Property: 71e- teLuDie/DG,6 ��. Property Owner(s)of Record: Al /L( --/<-4.A NO Telephone: 7?,9•4‘6- C, Fax: email: Mailing Address: •7 ( 'API)R/p l,c- /2 y.N Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: at kind of Permit?(Check each box that applies) Building ❑Variance(Minor, Major or Reasonable Economic Use) Ej Demolition Permit ❑Conditional Use[C(a),C(d),or C]"* Cj Single Family ODiscretionary"D"or Unnamed Use Classification ❑Garage Attached/Detached DSpecial Use(Essential Public Facilities)** El Manufactured Home °Boundary Line Adjustment El Modular °Short Plat** Q Commercial* °Binding Site Plan** El Change of Use °Long Plat** Xrddress i Rod Approach °Planned Rural Residential Development(PRRD)/Amendments** Popane - 17.2. iv,e_t-5 JL _•NK5. q El Plat Vacation/Alteration** Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development** OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance OTemporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment OWireless 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 tim lication that he or she wants prior nn e. t Signature: �r 1, Date:4 "T- �..'16 1 ne auto or or actions will undertake as a result of the issuance of this permit maynegatively im act upon one or more threatened 9 Y P P dor 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-transferablresponsibility ring tq�j co iplyikig w'th the ES e Applicant has readjhis disclaimer and signs and dates it below. signature: �� C Date: 7-/... — D:\PetmitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • • 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 he aJer_al'C-ontrractor for the proposed project. Signature: ��it�dfiete., , / 4/u12-6'ate: — 3 e7G GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: 0 Sewer ❑ Addition 0 Steel Proposed: Bank ❑Community System ❑ Alteration/Remodel 0 Concrete Total: Height: Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: PP Y: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: 0 Public Total: Name of System: 0 _ 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: in Underground Tank 0 Above ground Tank Size of Propane Tank: O Heat Stove 0 Cook Stove ❑Woodstove ❑Fireplace Insert 0 Hot Water Tank , Rgllet 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: Other Heated Base fee: 5-7 0 a Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 5/ , o° Decks 911/Rd Approach fee: ------ — Other TOTAL: $ 3— ( _o 6 Receipt Number: 8 S CO S— Cas heck Number: ESTIMATED COST(REQUIRED) Date: q .Fair market value of all labor and materials foundation to finish l 13 'L 3 de,m o Initials: t 1 D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc