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Home My WebLink AboutBLD2007-00445 • 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 #: BLD07-00445 Received Date 8/9/2007 SITE ADDRESS: 461 PINECREST ST Issue Date 8/9/2007 PORT TOWNSEND, 98368 APPLICANT: HUGH W MUSSER PHONE: (360) 390-4567 NINA K PASCOE 461 PINECREST DR PORT TOWNSEND WA 98368 417 SUBDIVISION: KALA POINT#7 Block: Lot: PARCEL NUMBER: 965000275 Section: 27 Township: 30N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2008 OWNER, HUGH W MUSSER PHONE: (360) 390-4567 if different: NINA K PASCOE 461 PINECREST DR PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: INSTALL A/G 120 GAL PROPANE TANK, LINES AND APPLIANCES 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 8/9/2008. REQUIRED INSPECTIONS: Tannk/Line/Appliance:774\111- [—N-07 -rt tJE --0) AP464A)s'AS F11A)SEi2T) ecee?'ziP 4 /1/0T IUAr. zW /.�/407 FinalApproval: na ! I/07 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 SGILDING PERMIT APPLICAT BLD07-00445 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Fort Townsend, WA 98368 PERMIT #: BLD07-00445 Received Date: 8/9/2007 SITE ADDRESS: 461 PINECREST ST PORT TOWNSEND, 98368 OWNER: HUGH W MUSSER PHONE: (360) 390-4567 NINA K PASCOE 461 PINECREST DR PORT TOWNSEND WA 98368 KALA POINT#7 SUBDIVISION: Block: Lot: 417 PARCEL NUMBER: 965000275 Section: 27 Township: 30 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 DESCRIPTION INSTALL A/G 120 GAL PROPANE TANK, LINES AND APPLIANCES TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2006 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 Bv: Date: Receipt: Approved/Date Propane Tanks/Stoves $153.00 KAS 08/09/07 93104 Total: $153.00 • c A. J C- \t.i. 0. (-- 0 0 ck1 E i 4 I '1/41 i , 1 i Is \rt F1 „_____- ,____ v fi i ,,,....,„ ' ti- ,t 44, k,,,. (._. 1, t , 6 3 t . g N k4��„soI N co&4 JEFFERSONSUNTY • R (�j r \‘ DEPARTMENT OF COMMUNITY DEVELOPMENT Z! j\` - +ii'li IP If '� 621 Sheridan Street • Port Townsend • Washington 98368 & ,fr 360/379-4450 . 360/379-4451 Fax AUG - 9 2007 <4,,,,, p www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: JEN.VII'f,IIIINI lin Project Description (include separate sheets as necessary): _ems rit\u 1 /0l _"wig PE0PI S i& 1-: Tax Parcel ad. Property n Number: `�65000 2�5 Size: .4 �CF =' (acres/square feet) Site Address and/or Directions to Property: 461 ?INECeE T DR . ) PORT TOwNSc-�,o i t,� A ci �,3t_-. Property Owner(s)of Record: 1-IU 614 Iv1 U S�(_-. l IN 1 N f P 1-1 SC L,C= I Telephone: 360 -. 90 -•4`D�'1 Fax: email: hi,:'hYvILISSCv �cohIeseed•C' Mailing Address: SiN M ty !1'S p F V Applicant/Agent(if different from owner): N A Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or Cl** ❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** 0 Home Business 0 Cottagelndustry 0 Long Plat** Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *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 alLt' ' n 'IV 0(001 Date: F-9-07 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 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 wants prior notice.Signature: A__ (, . }��/ q Date: O / " 0 7 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-tran f rable responsibility f r adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: . V V'"k ' R.--3—_-- p c� Date: g—?—re,? G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.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 as uming the responsibility of the General Contractor for the proposed project. Signature: ,t LJ l Y Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: 1MOONTA 1 tJ pap p pr.3� ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer "'t( Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel 0 Concrete Total: Height: ,E Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: %Public FL t!Iale_-w Al-t- Total: Name of System: If this is a Commercial Protect 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 Pro ane Tank and/or A liance Installation ermit,mark all items below that apply: I Underground Tank - Above ground Tank") Size of Propane Tank: I ZU c.12-eir'`- 1 Heat Stove wok Stove rWoodstove 141:eplace Insert Llot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes N) 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: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement iR FICIPIV " State Surcharge fee: Other Unheated ',m Pot Water Review fee: IAt A . Garage/Carport SUBTOTAL `•, �` pp � CEO Decks � a 1 I I I 911/Rd Approach fee: Other TOTAL: $ I J . O Receipt Number: 931 D4 Cash/Check Number: 405 ESTIMATED COST(REQUIRED) Date: t ��•Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc Z 44moi 03 Ep N g Q'pow az O v ' ti 4 of lsi 2;\ .eir :_.4..., J §--2 .-_ L......, ‹ g -..--, t_ 0 c (7 aqc. 41 Coe. 2 oaf �, ,.1e ¢ 4 r LU '7J C) L.125.50DON143 Z. c4 0 %. m w bb I st 9{b z z c' ' Z- / `` a I �`�..— -....- - --I -- , —-----•+) 1QA' ..,,..,,___,} ,1 0 szt.. .. o a �\ z v/ � v td i'''N\'',.\\\\\\.,,,-.\: \\--.\:''''-'''''-"--::' ''(. \' !?!..5-1 o 1 ca it-- w b- d F- F a .4_,. LIV/NG _ w AE� i- Cr. ne ea cp o r Oa 4 g-7 -) �7/d"l l i A"v 48: 0! (121 /36.00Y Qlf d 4. ik ID \A N -J� t atr, , Ai u Ul w 2 z f w _ o