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HomeMy WebLinkAboutBLD2006-00719 • • 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 #: BLD06-00719 Received Date 12/26/2006 SITE ADDRESS: 343 BISHOP HILL CIRCLE Issue Date 12/26/2006 CHIMACUM, 98325 APPLICANT: SCOTT A BARCLAY PHONE: 732-0527 FRANCES L BARCLAY 343 BISHOP HILL CIR CHIMACUM WA 983258797 1 SUBDIVISION: BISHOP RIDGE DIV II LONG SUB Block: Lot: PARCEL NUMBER: 933400001 Section: 35 Township: 29N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI98306 Expires 9/26/2008 OWNER, SCOTT A BARCLAY PHONE: 732-0527 if different: FRANCES L BARCLAY 343 BISHOP HILL CIR CHIMACUM WA 983258797 PROJECT DESCRIPTION: NO MLA REQ'D INSTALLING A/G 120 GAL PROPANE TANK TO SERVICE GENERATOR 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 12/26/2007. REQUIRED INSPECTIONS: Tank/Line/Appliance.I 2--2-9-ch, FinalApproval. 12 Z`f—E'g- 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 ItILDING PERMIT APPLICATION BLD06-00719 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00719 Received Date: 12/26/2006 SITE ADDRESS: 343 BISHOP HILL CIRCLE CHIMACUM, 98325 OWNER: SCOTT A BARCLAY PHONE: 732-0527 FRANCES L BARCLAY 343 BISHOP HILL CIR CHIMACUM WA 983258797 BISHOP RIDGE DIV II LONG SUB SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 933400001 Section: 35 Township: 29 N Range: 01 W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NO MLA REQ'D INSTALLING A/G 120 GAL PROPANE TANK TO SERVICE GENERATOR 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 12/26/06 87062 Total: $51.00 12/27/2006 10:26 360-733528 FRAN'S OFFICE Sail PAGE 02 + E v.., O - .- w 2 0r` ,� _• 4 e c � ,-, o CO CA = d a" o �° "� E UU . 0 - 1 U ILi + 1. ot. O irzl 4., .. /1/ (� w C.., 5,1 I 4.1 z Al ct ,,.,;1 % c„.5 „a ›...= co . ,, ,,› > t,i) . la � t O ca on v) 0 1 ECEW AI ) DEC27 AT. _. iitRtISIINIAIUNI 01,11 ��i�$0N Cod,. JEFFERSOIPOUNTY ffL� b�-��� W r\N DEPARTMENT OF COMMUNITY DO 12MENT ' '� 4y J '' 4 `� 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 4,,1� p www.co.jefferson.wa.us/commdeveloprnent , . - H'I'N� EFFIJIItIN[[ppll i'1 ��ll rr���� ��nn ���� Master Permit Application i11 iA&: K 0 ( V Yt (�-�(\ 0 Project Description (include separate sheets as necessary): --n-a\,�� n /Gr\ ') ogok\ icc PaVVe- ko \C `vc StfViCP -e.nerakoY_ Tax Parcel ((JJ Property U Number: -1 3 La ©0 00 \ Size: r . P-1 acres/ quare feet) Site Address and/or Directions to Property: 3t- 'J'S o A\\\ C2rc,\t, C-�1�rvxac u rh Property Owner(s)of Record: SGo Telephone: --nra- ( S 2.-7 Fax: email: Mailing Address: `lt{'1 ‘i2 �Stin) WIN\ C V-C\2. C-Vv‘x w\c1, u ry- 4. s Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) 1 Building 1 Variance(Minor, Major or Reasonable Economic Use) i Demolition Permit 1 Conditional Use[C(a), C(d), or C]** 1 Single Family 1 Discretionary"D"or Unnamed Use Classification 1 Garage Attached/Detached 1 Special Use(Essential Public Facilities)** 1 Manufactured Home 1 Boundary Line Adjustment 1 Modular 1 Short Plat** i Commercial* 1 Binding Site Plan** 1 Change of Use 1 Long Plat** i Address 1 Road Approach 1 Planned Rural Residential Development(PRRD)/Amendments** N."r'Propane 1 Plat Vacation/Alteration** I Allowed"Yes"Use Consistency Analysis 1 Shoreline Master Program Exemption/Permit Revisions** 1 Stormwater Management 1 Shoreline Management Substantial Development** 1 Site Plan Approval Advance Determination (SPAAD)* 1 Shoreline Management Variance 1 Temporary Use 1 Comprehensive Plan/UDC/Land Use District Map Amendment 1 Wireless Telecommunication* 1 Jefferson County Shoreline Master Program Amendment 1 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 orovided 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 appli ation that he or she wan�/prio. tice. Signature: G, dei„ Date: Z' V � 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-tra rable responsibility for dheri to and corn ,lying with the ESA. The Applicant has read this disclaimer and signs and dates it elow. Signature: AV.V\Wl C✓`- Date: l v a C - V �_.e G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.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: W\btavN\ tag Y\ V f c (ayne (360) IS S- - 6 &83 ( ) d1` MAILING ADDRESS: �S P `t EMAIL: CONTRACTOR'S LICENSE � et 933 ci WAINS NUMBER: \\ 1 OUYAT Q \ a 30(0 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL P ject Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System O Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ! i 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 Tapk and/or Appliance Installation permit,mark all items below that apply: i Underground Tank` i Above ground Tank Size of Propane Tank: ,)L A i Heat Stove I Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove I 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 asite 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: 2f°Floor Heated Consistency Review: s`I 'J SO Other Heated Base fee: c SI . OG Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL —) G .SO Decks 911/Rd Approach fee: Other TOTAL: $ -7 6 .S v Receipt Number: $'-)b6 2 Cash/Check Number: 1--1 1 ESTIMATED COST(REQUIRED) Date: 1 vZl��f •Fair market value of all labor and materials foundation to finish Initials: y...... G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc