The URL can be used to link to this page

Home My WebLink AboutBLD2007-00556 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 #: BLD07-00556 Received Date 10/25/2007 SITE ADDRESS: 133 TIMBER HEIGHTS DR Issue Date 10/25/2007 PORT LUDLOW, 98365 APPLICANT: WILLIAM J CENTOBENE TRSTE PHONE: W J CENTOBENE LIV TRUST PO BOX 65368 PORT LUDLOW WA 98365 67 SUBDIVISION: TIMBERTON VILLAGE PHASE III Block: Lot: PARCEL NUMBER: 998500067 Section: 17 Township: 28N Range: 01 E CONTRACTOR SUNSHINE PROPANE PHONE: 385-5797 (,kCjC(I} 10853 RHODY DR Gr115 PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 OWNER, WILLIAM J CENTOBENE TRSTE PHONE: if different: W J CENTOBENE LIV TRUST PO BOX 65368 PORT LUDLOW WA 98365 PROJECT DESCRIPTION: EXISTING 120MM GAL PROP TANK TO NEW GENERATOR & GAS Directions SEE MAP& DIREd NI'M FM REQ'D To Site: 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 10/25/2008. REQUIRED INSPECTIONS: Tank/Line/Appliance: £ rE2,oz ,L/uE %D GkNE,e4TLl DL SA7�� & RAra/ GW 17P7, L / FinalApproval: D� PEP �16 11 OOP /l 4; 4 441 0/07 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 Review BUILDING PERMIT APPLICAT!N B T0556 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00556 Received Date: 10/25/2007 SITE ADDRESS: 133 TIMBER HEIGHTS DR PORT LUDLOW, 98365 OWNER: WILLIAM J CENTOBENE TRSTE PHONE: W J CENTOBENE LIV TRUST PO BOX 65368 PORT LUDLOW WA 98365 TIMBERTON VILLAGE PHASE III SUBDIVISION: Block: Lot: 67 PARCEL NUMBER: 998500067 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077 QP Expires 11/17/2008 REPRESENTATIVE: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR (360) 385-5875 PORT HADLOCK WA 98339 PROJECT DESCRIPTION EXISTING 120 GAL PROP TANK TO NEW GENERATOR & GAS LINES-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: '.) t9`5)(91 C(.6 Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $102.00 AMS 10/25/07 9:3435 Total: $102.00 • • • SITE VISIT REPORT (PLOT PLAN) JOB oi,`/lm Cew-TD,r3&73E DAIE'1 DLL to / 3/07 CONTACT: ADDRESS PHONE #: DIRECTIONS FAX #: Email PLANNER: n l.1 5 �EXIS i 1 - - - - - -1 3T - i � I I D�4- Lg14.M VEN eaivQ.. /03 f �.¢gt9N CO JEFFERSON•COUNTY • RECEJIV -E D '�' , \� ' - DEPARTMENT OF COMMUNITY DEVELOPMENT ,_ "� = `d 621 Sheridan Street • Port Townsend • Washington 98368 O C T 2 5 2007 360/379-4450 • 360/379-4451 Fax gSNo(c4 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: JE,,YfERSOk. %CDU� DCD Project Description (include separate sheets as � necessary): Si r (11 Grp...--�C - v 11- - ,- �'"� Tax ParceY' q c� 50 0 , D C-. Property Number: / Size: (acres/square feet) Site Address and/or Directions to Property: /3 3 /i/32er /V e 4° Zr. /7 .L/A--i-. J Property Owner(s)of Record: /Ji//ia-. Telephone: -V37 //) cF Fax: email: Mailing Address: Applicant/Agent(if different from owner): $U..NS F11 I N E P KO PA N E Telephone: 3a5--5717 Fax: 3BS'S07S email: fNF0@SUni3N/NEProPeW7C. Mailing Address: I D4,S3 Si-101)y A 2. / Pr. 1-119-0 Lock W A- ct 8,33.7 �1,1 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 C]** ❑ Single Family 0 Garage Attached[Detached 0 Discretionary MD"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach ❑ Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** (0-Sign 0 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 ❑ Temporary Use ❑ 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 S 4 I N PRo P1 to act as my agent in matters relating to this application for permit(s). WNER SIGNATURE (Date: !0 Q3 O7 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 U\ review and any req I d r inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the \ ` time of the appf or sh is prior notice. ignaure: Date: !0/2 V0 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 u are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-,_trans "r sibir y r adhering to and complying with the ESA. The Applicant has read this disclaim and signs and dates it below. Signature: Date: io/a?/07 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 assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: S14c 1li0E P2opaid. (360) 395- 5797 ( 36O) 385-5875 MAILING ADDRESS: 10853 1-00 Y 11 i v e_ P. I-1. EMAIL: (fl-FW54A$i.liVI Pro Pane 6 Cot►'. CONTRACTOR'S LICENSE WAINS NUMBER: '5U U Y's-N P+ OT7ft 11 P NUMBER ARCHITECT/ENGINEER: �C PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project 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 ❑ Repair ❑ 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: I Underground Tank I Above ground Tank Size of Propane Tank: -a�i.1 f i /L o i I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove Other - Is this appliance being installed in a Manufactured/Mobile Home? Yes / No �740 1:'"1- -" - 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. ,... 4 s � -, t W � fs e" a 6 u� � Square Footage Current Proposed uffie UeOnly� , � . �r . ��_4A`�Q �1�s�xRlo4 r Main Floor Heated , 'V w . EH Bid App Review: t� -„ ', Kr 2"°Floor Heated ,`1t' � Consistency Review: Other Heated 4 t . Base fee: p O Mezzanine i x' , Additional Section: i ' t z ti Heated Basement '�'} f Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated °' Pot Water Review fee: r: Garage/Carport SUBTOTAL Decks J 911/Rd Approach fee: Other TOTAL: $ ao° ;: Receipt Number: (,� 3 C ' I' � �' -I 35P:r : �' Cash/Check Number: 73C1 ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish l 01 dJ/0-7 Initials: a\PennitCcnter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc