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Home My WebLink AboutBLD2006-00550 • • 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 #: BLD06-00550 Received Date 9/27/2006 SITE ADDRESS: 251 OLD SCHOOLHOUSE RD Issue Date 9/27/2006 SEQUIM, 98382 APPLICANT: CHRISTOPHE M RENDER PHONE: 360-797-0000 SUZANNE H REHDER 251 OLD SCHOOLHOUSE RD SEQUIM WA 983828711 T 23 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002331023 Section: 33 Township: 30N Range: 02W CONTRACTOR: EVERWARM INC PHONE: (360)452-3366 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 8/17/2008 OWNER, CHRISTOPHE M RENDER PHONE: 360-797-0000 if different: SUZANNE H REHDER 251 OLD SCHOOLHOUSE RD SEQUIM WA 983828711 PROJECT DESCRIPTION: NO MLA REQ'D REPLACE GAS : °- -DP WITH GAS COOK TOP/ELECTRIC OVEN ALSO ADDING PROPANE FIREPLACE WI BLOWER 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 912712007. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: Ft 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 °BUILDING PERMIT APPLICPION BLD06-00550 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00550 Received Date: 9/27/2006 SITE ADDRESS: 251 OLD SCHOOLHOUSE RD SEQUIM, 98382 OWNER: CHRISTOPHE M REHDER PHONE: 360-797-0000 SUZANNE H REHDER 251 OLD SCHOOLHOUSE RD SEQUIM WA 983828711 SUBDIVISION: Block: Lot: T 23 PARCEL NUMBER: 002331023 Section: 33 Township: 30 N Range: 02 W CONTRACTOR: EVERWARM INC PHONE: (360) 452-3366 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 8/17/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NO MLA REQ'D REPLACE GAS COOK TOP WITH GAS COOK TOP/ELECTRIC OVEN ALSO ADDING PROPANE FIREPLACE W/ BLOWER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW 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: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $51.00 DJK 09/27/06 84947 Total: $51.00 � StO o s5O SON Coo, JEFFERSON COUNTY RECEJIVJTh rIII DEPARTMENT OF COMMUNITY DEVELOPMENT '' ` ' 621 Sheridan Street• Port Townsend •Washington 98368SEP2 7 2 ^R 360/379-4450• 360/379-4451 Fax Lyi$? '$ www.co.jefferson.wa.us/commdevelopment Master Permit Application Ki�I'LA 0 6 Pr ' t Deiscription(include separate sheets as necessary): r i/ I�`� `� L, / (?/2(ere r-('ce3 (t1/L {L,2 Ct�/ tit' , (,:: _, for/C(,.(t i.-e �/l.�-�,)1"f ti_/JICIC </C�l� 4,e,- Tax Parcel) J r Property - J L L';�' / . Number: 0 d Z•33 16 23 Size: Ll , Ct�� (v` �' (acres/tgttare feet) Site Address and/or Directions to Property: �� U' le( cc G�1ie ( a 1i lgef, g �jvr.� ,r,5� S Property Owner(s)of Record: C it 1-I 1 (1'/l ill-r t- .S'k 2 if/l kI C I//J/rL'- Telephone: (. .L ' ( -one 2/2 email:'r e 4 ccC 'C fle"'tit/ire., 7 Mailing Address: G-5 I Fax:(' (a 3 (-/-/(tc ( //ria k /2c ' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) ❑Building DVariance(Minor, Major or Reasonable Economic Use) d Demolition Permit ❑Conditional Use[C(a),C(d),or Cj** d Single Family ❑Discretionary"D"or Unnamed Use Classification 13 Garage Attached/Detached ❑Special Use(Essential Public Facilities)*" ❑Manufactured Home °Boundary Line Adjustment d Modular °Short Plat** Q Commercial* °Binding Site Plan** Q Change of Use ❑Long Plat** ❑Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** Propane OPlat 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)* DShoreline 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: 1 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 ss and right of entry will be assumed unless the applicant informs the County in writing at the time of the application thaf he or e wants prior ti . Signature: ( ''..e„,_U' r/1 L e— --— -- Date: 7 7254:Z.&' 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 respons4ibility for adhering to ancomplying with the ESA. The Applicant has read this disclaims)and sig and dates it below. Signature: ( ?el Lp4 /e.i f- < �_ Date: / .S Ze.' --(- D:\PermitCenter\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 the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ve'w&w• �Ieu ►1.-ilo -c t foe (?&o) q S.Z 3�L 3 ( ) MAILING ADDRESS: 2 () ?/6,1 i/4. /1� , ®kff h L _MAIL: CONTRACTOR'S LICENSE `v / 7 '1NAINS NUMBER: F. 6-I 6-K 14)1 O,68,v, NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: ❑Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: c]Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ❑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 / .o I� If this is a Propane Tank and/or Appliance�nstallation ermit,mark all items below that apply: L. 11-€ it take I /At- in Underground Tank E Above ground Tank Size of Propane Tank: t :..-1-I InU.` t hS 1-t�i( t7 d Heat Stove Gook Stove ❑Woodstove fireplace Insert 0 Hot Water Tank 0 Pellet Stove in Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /610/ 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: I Ci.:, Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ 5100 Receipt Number: qq�� Cash/Check Number: ol.Y"/5 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 _ -0 '�O ,.. ', n 4 -.--..9 r. F m71 , /:\ (-7_ -0 /0 / o w , • ie :// I _$ s, ,N_.3 (..Z_ 6'N „.,,,,,,,. ,c-• s --.... / 4.:. --' 0 1 C3 c 0 c..-A m C \ C.:, C c N F c v- � , • w :-(5 c- . ...::e • '. :._,.. ..i 1 ---- -.-- * .t, Li„.______ (it GI --a--..c.„:„1„, ...1 I rn r rn Co 0 CTh z z rn ^S a 5 T o t H o N m ro g i coII 0 rn ` -o m ' O g; z (f\s 'Qc' > \- . 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