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Home My WebLink AboutBLD2006-00709 • . 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 #: BLD06-00709 Received Date 12/21/2006 SITE ADDRESS: 83 FIR CIRCLE Issue Date 12/21/2006 PORT HADLOCK, 98339 APPLICANT: JUSTIN J BENTO PHONE: 379-5396 ANNIKA S BENTO PO BOX 1424 PORT HADLOCK WA 98339 36 SUBDIVISION: BISHOP ACRES Block: Lot: PARCEL NUMBER: 932300036 Section: 2 Township: 29N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTP198306 Expires 9/26/2008 OWNER, JUSTIN J BENTO PHONE: 379-5396 if different: ANNIKA S BENTO PO BOX 1424 PORT HADLOCK WA 98339 PROJECT DESCRIPTION: NO MLA REQ'D INSTALLING 120 GAL PROPANE TANK AND GAS 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 12/21/2007. REQUIRED INSPECTIONS: Tank/Line/Appliance:-7t r !n-7-,6-Kr �,NE)(_)e--0J FinalApproval: (0--g--0 7 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 WILDING PERMIT APPLICA•N BLD06-00709 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00709 Received Date: 12/21/2006 SITE ADDRESS: 83 FIR CIRCLE PORT HADLOCK, 98339 OWNER: JUSTIN J BENTO PHONE: 379-5396 ANNIKA S BENTO PO BOX 1424 PORT HADLOCK WA 98339 BISHOP ACRES SUBDIVISION: Block: Lot: 36 PARCEL NUMBER: 932300036 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTP198306 Expires 9/26/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NO MLA REQ'D INSTALLING 120 GAL PROPANE TANK AND GAS 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: SETBACK: DECK: 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 12/21/06 87054 Total: $51.00 ( -Do 6-�a� 4��¢5oN c�� JEFFERS OUNTY S1ECEIVE11) } DEPARTMENT OF COMMUNITY DEVELOPMENT on `"4 621 Sheridan Street• Port Townsend •Washington 98368 DEC 212006 360/3.79-4450 • 360/379-4451 Fax �,gS..._. � www.co.jefferson.wa.us/commdevelopment i��N+,�IIINIVIIC Master Permit Application MLA: 1 Ij Project Description(include separate sheets as necessary): .4.LJ- f, o I. Pr-ar-v^� • -,4,k (12-c .) S�vve . Tax Parcel q 3 23 0003// Prope Number: / c, Size: , /ST Q. -3 (acres/square feet) Site Address and/or Directions to Property: 8.3 %r- •Y`CJQ f ( 3.3 Property O er(s)of Record:_LhAS 7L7 1 eti-� Telephone: 3 co 3 - Fax: C�email: Mailing Address: O of /�y , PA: l - - o wq !U 331 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: hat kind of Permit?(Check each box that applies) uilding i Variance(Minor, Major or Reasonable Economic Use) [j Demolition Permit ❑Conditional Use[C(a),C(d),or C]** 110 Single Family Discretionary"D"or Unnamed Use Classification DB Garage Attached/Detached Special Use(Essential Public Facilities)** ❑Manufactured Home ❑Boundary Line Adjustment In Modular ❑Short Plat*" Commercial* ❑Binding Site Plan** Q Change of Use ❑Long Plat** ❑Address Road Approach °Planned Rural Residential Development(PRRD)/Amendments*" NI Propane ❑Plat Vacation/Alteration** DAllowed"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 ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment OForest 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 i• pp tion for permit(s). OWNER SIG -�11l1:a�4..�� / / L�� dll�� _ i�L1 -�� orso By signing thi ... c � the .fr/.i. • ;•- hat the intliP n pr-- ,and Mr nts,is trr correct to the best of his,her or it's knowle• . Any material falsehood or any omission of a material fact made by the o =agent with respect to this application packet may result in this permi 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 an required later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the app cation that h he wants rior notice. Signature: Date: /Z —2-0 —OG The action •r- ions Applicant will un ake as a result of the issuance of this permit may negatively impact upon one or more threatened or endanger.. s•ecies and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endanger.d •pecies 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 y u are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer le responsi ' for adh ing to and mplying wi a ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: /2—7—c) „p' D:\PerrnitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • BUILDER STATEMENT • I IF/I I�-I( \\( ��-+ II I) The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that theytre'n l \e`nsed contractor§and`thrft they will be assuming the responsibility of the General Contractor for the proposed project. 1 Rc Signature: Date: C E C 2 2006 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: ,��,{�(��• UltIN I i(�tli MAILING ADDRESS: 2t c �N 104 Q{'10Lk EMAIL: CONTRACTOR'S LICENSE �O e'1slc3 WAINS NUMBER: V\Ou�-c- cli1 c V'/O(40 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 ❑Community System ❑ Alteration/Remodel 0 Concrete Total: Height: Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: 0 Private well ❑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 apply: j5 Underground Tank aAbove ground Tank Size of Propane Tank: /2CJ j a.uay.3 ,Heat Stove ❑Cook Stove ❑Woodstove ❑Fireplace Insert 0 Hot Water Tank 0 Pellet Stove j]Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / E 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: 2na Floor Heated Consistency Review: n 5 5O Other Heated Base fee: p( 5I , ob 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: $ -7 lP• 50 Receipt Number: Q .1 bS 1 Cash/Check Number: 'l c 1 ESTIMATED COST(REQUIRED) Date: �,�r^' b� .Fair market value of all labor and materials foundation to finish i11 Initials: y:: ` ` D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc U a • � REC1 lAI )) DE 2 � JEEEEHS NaMP liV 6&INS 7 3 2 ::do03 7 1 13 23ov 036 1 2.30o034 c S°k i I Pr" Q I w - d'1 .- .�� . ) � ► i I. r 1 ® '.�- ' 4 - (C. k t,20 mil, �0-y-L (l,^c. > 3 S k4 •i-,,5‘,.-. to-ph"c t. re.ur,,-.- 8 3 Fir Ct rc.12