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Home My WebLink AboutBLD2007-00467 • • 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 #: BLD07-00467 Received Date 8/23/2007 SITE ADDRESS: 31 MARINER PL Issue Date 8/23/2007 PORT LUDLOW, 98365 APPLICANT: ROBERT R RETKE PHONE: 360-437-0470 MARY K RETKE 31 MARINER PL PORT LUDLOW WA 983659765 17 SUBDIVISION: BAYVIEW VILLAGE DIV 2 Block: Lot: PARCEL NUMBER: 931900017 Section: 16 Township: 28N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 OWNER, ROBERT R RETKE PHONE: 360-437-0470 if different: MARY K RETKE 31 MARINER PL PORT LUDLOW WA 983659765 PROJECT DESCRIPTION: REPLACING GAS (HEAT STOVE) INSERT- NO MLA REQ'D 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 8/23/2008. REQUIRED INSPECTIONS: Tank/Line/Appliance: q S c-c zEPLAI elk 4/7,67 FinalApproval: Ok - or -(11hgJ 9/9/67 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 eview !UILDING PERMIT APPLICATTN R00467 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00467 Received Date: 8/23/2007 SITE ADDRESS: 31 MARINER PL PORT LUDLOW, 98365 OWNER: ROBERT R RETKE PHONE: 360-437-0470 MARY K RETKE 31 MARINER PL PORT LUDLOW WA 983659765 BAYVIEW VILLAGE DIV 2 SUBDIVISION: Block: Lot: 17 PARCEL NUMBER: 931900017 Section: 16 Township: 28 N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REPLACING GAS (HEAT STOVE) INSERT - NO MLA REQ'D TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: 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: WD I icy—) Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $51.00 AMS 08/23/07 93086 Total: $51.00 • . SITE VISIT REPORT (PLOT PLAN) JOB �°A1 DATE : $)9 )o- CONTACT: ADDRESS PHONE #: DIRECTIONS FAI) #: Email PLANNER: ,)vot- I if\ \? jF 3 � ,z Qt. Act 4.1 \k— lur (f V REcIIvED 5 AU6 2 3 21187 JtfffRSUN BCD �yL)L L, \\ ,;,. .: rid ��4) o�� JEFFERSON COW( • t',...L., y'il��i 44 DEPARTMENT OF MMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 ,,;, ?, c 360/379-4450 • 360/379-4451 Fax3 ' p� www.co.jefferson.wa.us/commdevelopment i'l Master Permit Application MLA: HH N C1UN i Cf Project Description(include separate sheets �, as necessary): C7 J TALI' ( (/D ,1-¢ J/ -r--e,_ C,--._,1-1 Z e,ro C ,-4-,/cQ r l Tax Parcel /� 2/- 900 — / �I ' i J D//�j� Property Number: / Size: (acres/square feet) Site Address and/or Directions to Property: .3I in/9 /A.) Pt R,RT J_.uDL C to) Property Owner(s)of Record: 6m AO--; i-,6 T V E Telephone: '3 7 L'i 7C Fax: email: Mailing Address: 31 /Pre 12_11Cc2 (L Rr Li)0Lott; (4_,,- q 8-3 . - Applicant/Agent(if different from owner): 5.44-n S rr-0 h L ,O2.13cf r,e__ Telephone: .36.O 3 es- S"7 i -1 Fax: 3 $S S 8 75 email: Mailing Address: /O P)5 R h o d cj dr. PT • tl1�Lo ice+ fad f=) 5 83 3 S ( What kind of Permit?(Check each box that applies) [i Building ❑Valiance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a),C(d),or C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification 0 Garage Attached/Detached 0 Special Use(Essential Public Facilities)** ❑ Manufactured Home 0 Boundary Line Adjustment 0 Modular ❑ Short Plat** ❑Commercial* ❑ Binding Site Plan** 0 Change of Use ❑ Long Plat** 0 Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** ropane ❑ Plat Vacation/Alteration** Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance 0 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 *Ma -•uire a Pre—A•.licatiion 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 here de ' net ,-r-a'>,rny age ,. : s :latir'g to lion for permit(s). OWNtGNATURE ( x Tr tl By signing this application form,the owner/agent attests that the information provided herein,and In any atta invents,is true and correct to the best of his,her or Ws knowledge. Any material faisehood 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 attorneys 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. n 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 right of entry to this property shall be requested and shall occur only during regular business hours. ,,,111,/ �� ignature: ?Z ' / Date: c5 / �" / 1 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 v) 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-transf e n lbLitsfor adf in�nd complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. ignature: / , (��C� �) Date: ,/r"1 e 7, ,;:\PermaCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc /' e ,The signer of this statement does hereby certify IdRBUILDERSTATEMENT hey are the Owners of the they will be assuming the responsibility of the General Contractor for the proposed parcel proja.referenced herein,that they are not licensed contractors and that Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: (hsh,frt 6'1O7 1 (,360 ) .3 8SS7? 7 ( ) MAILING ADDRESS: L OU 53 o d/.rj v/)f EMAIL: CONTRACTORS LICENSE -7'�7 WAINS NUMBER: Str nsH/'n x d< ! Q r NUMBER ARCHRECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Typo: Bathrooms: Shoreline: ❑ Type of Sewage Disposal: New ❑ Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System ❑ Atteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# i] Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Type of Heat: Proposed: ❑ Private well ❑ Two Party Total: ❑ Public 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 ❑ Above ground Tank Size of Propane Tank: K Heat tove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove cr tther _this appliance being installed in a Manufactured/Mobile Home? Yes / No 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 For Office Use Only . ,* ' " "? ws , .Current Proposed �lifJq 4 x. ��r �r4Main Floor 'Consistency,Review: `,i ar„ ` r 11 r '' ;.', ' a•,,.• t44 2 Floor Base fee: r f k,. 3`ricer — -- §� Additional Section: '�r ti � 1V J Mezzanine: � , Plan Check:fee: "�" Heated Basement State Surcharge fee: , Unheated Basement ." v," 'y Pot Water ieyiew fee; '', s r� b Ny Other Unheated ----- 7 �` �>•r'�,,0,. 911/R1 Approach fee 4 .,� , JtV a }q1� Garage/Carport rr..434 1.10c' r TOTAL ',' r � {t '' Decks --- i vwl rT� " - Receipt.Number: (g- Si h : r Other -- r Cash/Chock Number: .", ,� ESTIMATED COST(REQUIRED) — j' �' K` Date: r , �� •Fair market value of all labor and materials foundation to finish { ' �,6'9 k ::�V�`4 J Initials: _.,K.E \PenritCenter\FORMS\DRD FORMS Master Pemut ApplKauuti-ts-U:.doc