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Home My WebLink AboutBLD2007-00022 • • 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 #: BLD07-00022 Received Date 1/30/2007 SITE ADDRESS: 91 QUINAULT LOOP Issue Date 1/30/2007 PORT TOWNSEND, 98368 APPLICANT: BONNIE D WHYTE PHONE: 379-2821 91 QUINAULT LOOP PORT TOWNSEND WA 983689464 16 SUBDIVISION: CAPE GEORGE COLONY DIV 4 Block: 10 Lot: PARCEL NUMBER: 938701015 Section: 12 Township: 30N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 OWNER, BONNIE D WHYTE PHONE: 379-2821 if different: 91 QUINAULT LOOP PORT TOWNSEND WA 983689464 PROJECT DESCRIPTION: NO MLA REQ'D GAS PIPING TO NEW RANGE 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 1/30/2008. REQUIRED INSPECTIONS: Tank/Line/Appliance: PUT 61,5 (mil �� O E� ,_5' 7 ! Lt/e1 FinalApproval: 312—,10-7 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 OICILDING PERMIT APPLICA BLD07-00022 �N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00022 Received Date: 1/30/2007 SITE ADDRESS: 91 QUINAULT LOOP PORT TOWNSEND, 98368 OWNER: BONNIE D WHYTE PHONE: 379-2821 91 QUINAULT LOOP PORT TOWNSEND WA 983689464 CAPE GEORGE COLONY DIV 4 SUBDIVISION: Block: 10 Lot: 16 PARCEL NUMBER: 938701015 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: SUNSHINE PROPANE 10853 RHODY DR PHONE: 385-5797 PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NO MLA REQ'D GAS PIPING TO NEW RANGE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 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 Permit $102.00 DJK 01/30/07 87203 Total: $102.00 ft..! • • , 6 'cti Itt^/ RECEIVED ' ' JAN3020 „r 0 ( ctirittvO Cr4 fffialos111I Y+IN e?cist - r-. s . t •wgsoN % JEFFERSONO,UNTY �q (( ` �3L� a - ��' iiiirtik.��' DEPARTMENT OF COMMUNITY DEVELOPMEI Ilv tl4 V �� 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 44.0 J 0 2007 gszirNe,1p www.co.jefferson.wa.us/commdevelopment ttaMaster Permit Application �Hffl11J� ��1 aO Lt YL U n Project Description(include separate sheets as necessary): C7i f /a/P/N6 i o alcW 2 I- ir--e Tax Parcel (� Property Number: _ 7 C) Size: (acres/square feet) Site Address and/or Directions to Property: 7/ U'(t/vl 4 Gfr Property Owner(s)of Record: 6or>/7i.e t<.)I,�e-- / Telephone: 27 5 " d' / Fax: email: • Mailing Address: s Applicant/Agent(if different from owner): _ s2f h SJ`f/n/ e iv QP4--1V 2 Telephone: 3(f5:S '7c! 7 , Fax: ,? g,S'-se `7S email: /A/FO�-5741/97//7�1c)/��NQ . Mailing Address: / O P.c_p fenv o Y OR, Pi /V nl,LO c/c 64)4-. 9 . ) y' c°� What kind of Permit?(Check each box that applies) ❑ Building ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** 0 Single Family ❑Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached 0 Special Use(Essential Public Facilities)** ❑Manufactured Home ❑ Boundary Line Adjustment ❑Modular ❑Short Plat** ❑Commercial* ❑ Binding Site Plan** ❑Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** g Propane 0 Plat Vacation/Alteration** ❑Mowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** 0 Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless 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: � • SIGNATIO► . GENT I heraby c)('= at: /'/ ,/ -gent i att- . - a i • . i is - •w�ion i •- (s). . , ♦w - ,•T lirr .ate: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,isAnie 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 attomey'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.Access and ' t of entry to this property shall be requested and shall occur only during regular business hours. r Signature: 1. 4 /-._, Date: 1 ' t' 7 L 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 been9sued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your • \J action(s)everIWYyou are in compliance with the Jefferson Cou ty development code.The Applicant acknowledges that he,she or it holds individual and non-tran ble responsibility for adh�g to and complyi wi the ESA. The Applicant has read this disclaimer and signs and dates it below. ;C I �7 Signature: /�'—" --< `Z A____...% Date: I J/ � /U 7 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc its • OWNER BUILDER STATEMENT • N 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: SunSht/,Jt p2ap4/J (360) .38S5S797 (36a) 38S- 5?7S MAILING ADDRESS: / D Q S ? // �-v o y 0 it EMAIL: t n Fo 5 r-f.//h e PR co py-ne . co/t1 CONTRACTOR'S LICENSE WAINS NUMBER: E(,f N S 100 7K 017 76Z IQ NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System O Alteration/Remodel 0 Concrete Total: Height: 0 Individual System ❑ Repair u Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 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 and/or Appliance Installation permit,mark all items below that apply: ❑ Underground Tank 0 Above ground Tank Size of Propane Tank: , ❑ Heat Stove ,Ez Cook Stove ❑ Woodstove 0 Fireplace Insert ❑ Hot Water Tank 0 Pellet Stove Other -d p `r-e. Is this appliance being installed in a Manufactured/Mobile Home? Yes / No �f 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 For`O :cUse Only , Current Proposed Amount' 4. �n Main Floor Consistency Review: 4 Y 2"u Floor BaSgfpe: C G `" ��"5�?�� s 3iO Floor itiona!Section: y W .L f. 0, t Mezzanine: }: 1!� h - ' Plan Check fee � � �i�wv�. �1 ,. F ,,pii,, 4 e%,-1sti '2L Oka Heated Basement 's` S State Surcharge , !-, Unheated Basement t'2 ` Pot Water Review fee „, Other Unheated 911/Rd Approach fee s;,,� Garage/Carport TOTAL:, $ I - Decks • - ReceiptJ- ,,..-SAet.'rt. �. Z �4 'FP, �YyJ x,t ,"i'° ,,, ,k �.:;,,-.,y Other Cash/Gh 'Ni�l1 0,''�F36 N.' y x,:- '4 37 r w �i�,.qy� ESTIMATED COST(REQUIRED) Date: - �tVi ,, >i �i ra �r.Fair market value of all labor and materials foundation to finish „, a "�_0 �r,5 'Initials, !. ,�' , y ' ' ,; :.+ `f , r . •. � .. ... `"�. '�� .Fay G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc