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HomeMy WebLinkAboutBLD2006-00015 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 #: BLD07-00015 Received Date 1/23/2007 SITE ADDRESS: 703 OLD GARDINER HWY Issue Date 1/23/2007 SEQUIM, 98382 APPLICANT: BARBARA C SCHIFFERS PHONE: 360-797-7052 703 OLD GARDINER RD SEQUIM WA 983828701 1 SUBDIVISION: CARYL SHORT PLAT Block: Lot: PARCEL NUMBER: 002331043 Section: 33 Township: 30N Range: 02W CONTRACTOR: ALL ABOUT GAS INC PHONE: 360-681-5474 970 RIVER RD SEQUIM WA 98382 Contractor's License ALLABAG9510T Expires 9/30/2007 OWNER, BARBARA C SCHIFFERS PHONE: 360-797-7052 if different: 703 OLD GARDINER RD SEQUIM WA 983828701 PROJECT DESCRIPTION: NEW 25 GAL PROP TANK& REPLACING EXIST ELECTRIC OVEN W/GAS COOKTOP 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 1/23/2008. REQUIRED INSPECTIONS: Tank/Line/Appliance:'54 6 rade, Luc. b'L4, FinalApproval: 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 BLD07-00015 !UILDING PERMIT APPLICAT!N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00015 Received Date: 1/23/2007 SITE ADDRESS: 703 OLD GARDINER HWY SEQUIM, 98382 OWNER: BARBARA C SCHIFFERS PHONE: 360-797-7052 703 OLD GARDINER RD SEQUIM WA 983828701 CARYL SHORT PLAT SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 002331043 Section: 33 Township: 30 N Range: 02 W CONTRACTOR: ALL ABOUT GAS INC PHONE: 360-681-5474 970 RIVER RD SEQUIM WA 98382 Contractor's License ALLABAG9510T Expires 9/30/2007 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW 25 GAL PROP TANK & REPLACING EXIST ELECTRIC OVEN W/ GAS COOKTOP 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 By: Date: Receipt: Approved/Date Propane Tanks/Stoves $153.00 LYK 01/23/07 87189 Total: $153.00 ,.I N I \ I ' 0 \• \ . 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JEFFERSON•UNTY ��((�� ��((�(� �� `�' DEPARTMENT OF COMMUNITY DEVEL.OPMI IT—A' �A 'w �:k‘q 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax p • www.co.jefferson.wa.us/commdevelo1100 pment ,JAN 2 3 2007 14/%-N6 " I �--- Master Permit Application MLA: I \ ` L& 1 I� Project Description(include separate sheets as necessary): ` AeotiitA�T Re P L+.c,11-3's EtEctz.- c.. DvE11 C.) Cr P S G�aic'f�D-CONt.7> 25 G AL ?Ropsys1C4nUsii Tax Parcel Property t/ Number: d DA. -- '531 ^ b q-3 Size: I (4.#C.2 S (acres/square feet)a Site Address and/or Directions to Pro erty: -4'03 O U Cr Q t h1 e R RD-S Ef v%YVt. 1WA 9$3 p7. Property Owner(s)of Record: A Q.g A{2i jA C LE� �1 C 111 E R o Telephone:C360 mil' — '.t-05-22 Fax: email: Mailing Address: �-Q.., CI t—t Gria RP tt R. PSD —SE.Q V 1o&t of 113n-. Applicant/Agent(if different from owner): Telephone: \ Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) i Building i Variance(Minor, Major or Reasonable Economic Use) i Demolition Permit i Conditional Use[C(a), C(d), or C]** l Single Family i Discretionary"D"or Unnamed Use Classification i Garage Attached/Detached i Special Use(Essential Public Facilities)** i Manufactured Home i Boundary Line Adjustment i Modular i Short Plat** i Commercial* I Binding Site Plan** i Change of Use i Long Plat** i Address i Road Approach i Planned Rural Residential Development(PRRD)/Amendments** 7 Propane i Plat Vacation/Alteration** i�A es"Use Consistency Analysis i Shoreline Master Program Exemption/Permit Revisions** i Stormwater Management i Shoreline Management Substantial Development** i Site Plan Approval Advance Determination (SPAAD)* i Shoreline Management Variance i Temporary Use i Comprehensive Plan/UDC/Land Use District Map Amendment i Wireless Telecommunication* i Jefferson County Shoreline Master Program Amendment i Forest Practices Act/Release of Six-Year Moratorium , *May require a Pre-Application Conference _ **Requires a Pre-Application Conference Please identify any other local, stat federal permitnquiredt this proposal, if known: b ' 3E - 100 Av9.Aem �AGENT Nor—HERS DESIGNATION OF I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATUR &Ak& SC t d Date: -OV1 ) 1Z 1 D I 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. 2 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 it:;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 apVtion that he or s wants r n tic Signature: OJ%& (4tt Date: 0 `S x 2_-o12f- 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 le responsibility f dherin o and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: w-�l'1pwati � `'l`_`>r .L. Date: y1 . IS t 2/1D.- G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc .2' 4 • a • 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 CONTRACTO PI OR MANUFACTURED HOME INSTALLER: PHONE: 5 FAX: All G 1 (� ( ) (S/S`f 7g ( ) /--1/79 MAILING ADDRESS: ey ,p 2 , ere' "�llr � c v.;-. GvY�' EMAIL: CONTRACTOR'44.4 JS�E" 1 � WAINS F�dIA-kitC15 ARCHITECT/ENGINEER: PHONE ( ) FAz:( ) MAILING ADDRESS: - i .r"A c' ^ •' .� EMAIL - ` i,Pt'ble`+ctIjrpe. r.,; r'.. 1 ''' . Ftagle Type'>;' 1 - . Batbr'bgms: ; ' ' ' . Shoreline: Type of Sewage Disposal: ❑ New ❑..,Wilod t_ , ..r ,r r.Existing: f : . • • --tom:'A, 4 •4,` ❑ Sewer 0 Addition Er Steel Proposed: Bank , ❑ Cq muniWSystem ❑ Alteration/Re modgl� �. F 0 Concrete Total: Height'' 6 IndivtduaLSystem Li Repair • . • . 15'41aso11ry'. ' f.. • • , '. r. . e1 :. 1 $EP"POmif# 0 Demolition 0 Other: Bedrooms: Water Supply: Existing: _ Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ 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 andior Appliance Installation permit,mark all items below that apply: I Underground Tank (A.bove ground Tank�5 Size of Propane Tank: .L'S qu`"°'-] I Heat Stove I Cook Stove I Woodstove 1 Fireplace Insert I Hot Water Tank I Pellet Stove)) I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / ©o 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 Bid App Review: 2nd Floor Heated Consistency Review: . ! • / M' •Other Heated •Base fee': " , Mezzanine Additional Section . ' j .• _, w. I , \• r_''. • 1 •. • e l,'..1,11' HeatedBasement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: . Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: ' Other TOTAL: $ Receipt Number: C r/i 3 Q Cash/Check Number: o4 13 C�41 ESTIMATED COST(REQUIRED) Date: •Fair market vahle•of fill labor anti ntat6tip/s foundation to finish : l 1.• .A ' le A..,a i • Initials: . G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-142006.doc C . , '44 ,,-,4,,,r. A, sv.4%,40.4.4., oy,:,,,,;,t,.,• , 4 ,...--.............* . -,... \.,.. , ,.....„ e --e i 1 1 e ' 1 ,I I 1, I I 1 ., t 11, k 5 I j 1 1 I 1 , li I ! i —Nr— t i \N. .,......______1:61 f ' \' CP, ..... ......, f t OA CU:"."4 0 CYD SN4-9 ‘4.1.1•N\ I „:\ , . '''' V"ale? al a S-›-.1 el c4..a21 -- i 1 • 7K 2--4 ITIC2 4! bN 0 .."., • Z • I __S,!:. 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"628 --1 206 S. Lincoln St cuite 201* Port Angeles* Washington 98362 *(206)452-5393 SEOUIM, UJA cf:33£32