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Home My WebLink AboutBLD2007-00589 • • 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 #: BLD07-00589 Received Date 11/27/2007 SITE ADDRESS: 133 TIMBER HEIGHTS DR Issue Date 11/27/2007 PORT LUDLOW, 98365 APPLICANT: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 SUBDIVISION: TIMBERTON VILLAGE PHASE III 67+ Block: Lot PARCEL NUMBER: 998500067 Section: 17 Township: 28N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*017QP Expires 11/17/2008 OWNER, WILLIAM J CENTOBENE TRSTE PHONE: (360)437-9128 if different: W J CENTOBENE LIV TRUST PO BOX 65368 PORT LUDLOW WA 98365 PROJECT DESCRIPTION: ADD AN A/G 120 GAL PROPANE TANK NEXT TO EXISTING 120 Directions PROPANE TANK 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 11/27/2008. REQUIRED INSPECTIONS: Tank/Line/Appliance: 0Ai✓ 1A / 4/6 7, FinalApproval: Q,'-Pp- —f / /2/G 47 /1 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 �ILDING PERMIT APPLICATION BLD07-00589 Jefferson County Department of Community Development Review Type: l 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00589 Received Date: 11/27/2007 SITE ADDRESS: 133 TIMBER HEIGHTS DR PORT LUDLOW, 98365 OWNER: WILLIAM J CENTOBENE TRETE PHONE: (360)437-9128 W J CENTOBENE LIV TRUST PO BOX 65368 PORT LUDLOW WA 98365 TIMBERTON VILLAGE PHASE HI SUBDIVISION: PARCEL NUMBER: 998500067 Section: 17 Township: 28 Block: Range: 01 E Lot. 67+ 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 DESCRIPTIOP ADD AN A/G 120 GAL PROPANE TANK NEXT TO EXISTING 120 PROPANE TANK 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: CONST TYPE: OTHER: CONST TYPE: GARAGE: SHORELINE: DECK: SETBACK: SEWAGE DISPOSAL: BANK HEIGHT: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $102.00 KAS 11/27/07 95483 Total: $102.00 • • SITE VISIT REPORT (PLOT PLAN) JOB 0/ l/44') C&w7D,z3t-7-)E DATE : / l 3 D7 ADDRESS CONTACT: DIRECTIONS PHONE #: FAX #: Email PLANNER: 71) P9 Lj EX'�DPq 1 I I RECEWE D N O V 2 7 2007 (�ENEQATCQ. JEFFERSON COUNTY BCD ,c�." SON C�� JEFFERSON�NTY • RECEIVED / 3 DEPARTMENT OF COMMUNITY DEVELOPMENT kko � 621 Sheridan Street • Port Townsend • Washington 98368 NOV 2 7 ? 360/379-4450 • 360/379-4451 Fax .;0. 1o.;0. t. www.co.jefferson.wa.us/commdevelopment q Master Permit Application JEFFERSON COUNTY BCD MLA: Project Description(include separate sheets as necessary): /' ez-- ,C/L/./) /4-1,/.c. (/(l - J/i,21- J Tax Parcel Number: 99T -Soo - D 6_7 Property Size: (acres/square feet) Site Address and/or Directions to Property: /3_3 / %h2.QL—�-- 7</[:l6'774T7 / Pi- LC-ra6_0 ki Property Owner(s)of Record: Telephone: / 37•-99/ _ Fax: email: Mailing Address: ,__i' . Applicant/Agent(if different from owner): S U..NS H I N E p R,o ?A N E Telephone: 3a5-57`9 '7 Fax: 33S' SOTS email: fnf Fo@$UnJs,-//l.]E Prof/WC. Mailing Address: IDS53 RHoD p 2- / , uric Lock to A_ 9 8339 �r.,,t 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 Cj** ❑ Single Family ❑ Garage Attached i 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 ❑ Road Approach ❑ Binding Site Plan** 2❑ ome Business 0 Cottagelndustry ❑ Long Plat** ropane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑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 ❑ 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: ,,,,,) I herebydesignateDESIGNATION OF AGENT 3u E PRO A-►-1 to act as my agent in matters relating to this application for permit(s). (OWNER SIGNATURE f 2'-,,, ('Date: /J/Zy '7 By signing this application fo ,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 requi later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the a pli ati a t nor notice. ignature: Date: // /0.7 The action or acti r,,s- pplicant 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-ransf I 'bility r hering to and complying with the ESA. The Applicant has read this disclaimer nd si ns and dates it below. ignature: I Date: ///Z'//c G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc ,�`(CJ//�"� /� 10O I. • 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: Si4I214 i0E: PR2o pane (860) 335- 579.7 ( 36O) 365-587; MAILING ADDRESS: 1 085J •1`}}UO y n ell) e- P. f H• EMAIL: ((1 tO J3,(v‘sf Itie_ pro Pale 6 C c '\ CONTRACTOR'S LICENSE WAINS NUMBER: c3u1,\374 P+ UN P NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ 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 TariJc_andinr ADDTianseJnstallation ermit,mark all items below that apply: 1 Underground Tan I Above ground Tank' Size of Propane Tank: /c I Heat Stove I Cook ove oodstove I Fireplace Insert I Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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. is r ::-, "`' n s. '' ''' c SqY( • �+Kota.ts `"Square Footage Current Proposed �"F,or' fice�Use<Only �.�in'::f`r. Y'' *,�. .A1 tom . ' .F . . °i -' ..e." Main Floor Heated i:.. ` ' : EH Bld App Review: Y`S: <S 17 ' 2n0 Floor Heated ` „x{ Consistency Review: Other Heated ' 't - Base fee: Mezzanine 'RECEV • Xr Additional Sectidn: Heated Basement r, , '3 Plan Check fee: NOV 272Q0 � FF J, z {�n f„.,.. Unheated Basement . ray L Rt^ `'. State Surcharge fee: Other Unheated t"',:'4 ', ; Pot Water Review fee: � EfFF ,S �1N11 i � tai,.:_ __ __ ..-- SUBTOTAL Garage/Carport I to.0 0 t�.b J Decks : 1dna' . 911/Rd Approach fee: Other Xa ai, _. ' TOTAL: $ 1 D, Ia ,c)c) i , Receipt Number: vl 5`I %3 3,* ' `` Cash/Check Number: q s - ESTIMATED COST(REQUIRED) Date: 1 a 7la .Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc