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Home My WebLink AboutBLD2008-00018 • 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 #: BLD08-00018 Received Date 1/17/2008 SITE ADDRESS: 312 WOODRIDGE DR Issue Date 1/17/2008 PORT LUDLOW, 98365 APPLICANT: RONALD E THOMPSON PHONE: 360-437-5076 LINDA A THOMPSON 312 WOODRIDGE DR PORT LUDLOW WA 983658743 35 SUBDIVISION: WOODRIDGE VILLAGE DIV 1 Block: Lot: PARCEL NUMBER: 999700035 Section: 21 Township: 28N Range: 01E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3B01 385-5875 Contractor's License SUNSHP*077QP Expires 11/17/2008 OWNER, RONALD E THOMPSON PHONE: 360-437-5076 if different: LINDA A THOMPSON 312 WOODRIDGE DR PORT LUDLOW WA 983658743 PROJECT DESCRIPTION: 2 x 120 GAL A/G PROP TANK& GENERATOR -NO MLA REQ'D Directions SEE MAP& DIRECTIONS IN FILE 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 1/17/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: 'hate- 42/e /Gti I-2 S--o 12-3 3 w1 u-ra,sc - L 2, - FinalApproval: �Z 22 OF 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 ItILDING PERMIIT APPLICA•N BLD08-00018 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00018 Received Date: 1/17/2008 SITE ADDRESS: 312 WOODRIDGE DR PORT LUDLOW, 98365 OWNER: RONALD E THOMPSON PHONE: 360-437-5076 LINDA A THOMPSON 312 WOODRIDGE DR PORT LUDLOW WA 983658743 WOODRIDGE VILLAGE DIV 1 SUBDIVISION: Block: Lot: 35 PARCEL NUMBER: 999700035 Section: 21 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 DESCRIPTIOI 2 x 120 GAL A/G PROP TANK & GENERATOR -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: I 1 � �J 108 Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $157.00 AMS 01/17/08 S'5864 Total: $157.00 • SITE VISIT REPORT (PLOT PLAN) '!JOB � a SUIT-� 6S 1P DATE : > • CONTACT: ADDRESS ZloL L. --)0Z,VCJ(.0l-� P x L-•Il ) PHONE #: • DIRECTIONS FAX #: Email • PLANNER: a° C \03) ""\\ 2.61 >. ,0 a C 0 pAYNVvAsY max` ,i- � v« //bM L • • • • • • • �`5QN oa JEFFERSOUNTY 4," ' �" DEPARTMENT OF COMMUNITY DEVELOPMENT _ JAN 1 7 20Q6 ''`4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 40 N ,.O www.co.jefferson.wa.us/commdevelopment JEFFERSON COUNTY DO ztrMaster Permit Application MLA: no m t q, arc '0 Project Descriptio�q(include separate sheet`as necessary): � � � Tax Parcel roperty Number: / 99 - 7 2Q- Q` _ Size: (acres/square feet) Site Address and/or Directions to Property: - 3/. -- Vi200 0 2 / D _L f ri . Property Owner(s)of Record: J OA f L/ 4/04 atop-) /'JoA) Telephone: `I 3 -7 - ,5 c3 7 C - Fax: email: Mailing Address: -S L - Applicant/Agent(if different from owner): S u-NS I-I I N E P Ro PA N E Telephone: 395-579 7 Fax: 38S' 5.87S email: (NFQSUN3rt/NE proPfw,e• Mailing Address: 10S53 RHODy D 2• / P i. N19O Lock Lc)R- q 833. `.,01,1 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]** ❑ Singie 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 ❑ Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** Propane 0 Planned Rural Residential Development(PRRD)/Amendments** / 0 Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ 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 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: 6e, c `-� ESIGNATION OF AGENT I hereby designate cl(( PRO Peri to act as my agent in matters relating to this application for permit(s). WNER SIGNATURE �• 4111h._ ate D I " 16-ZOQ By signing this application form,t owner/a ent 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 whic ay• any way .- rue against Jefferson County as a result of or in consequence of the granting of this permit. ( I further agree or provi.- acce . right of entry to fferson County and its employees,representatives or agents for the sole purpose of application U review and an require, I ter .=ctions. Staffs :cces and right of entry will be assumed unless the applicant informs the County in writing at the time of the a p ation ha h- ;4. e wants prior n• ice. f ignature: r'. AI' Date: 1 45 — 2(d The action or actions Applic•nt will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered sp: -s and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the U "Endangered peci. Act"or •A."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this ) permit has .-en iss - will • olate the ESA. • ividual,group or agency can file a lawsuit on behalf of an endangered species regarding your /y� action(s)ev: if you a i •. liance with the J fferso County development code.The Applicant acknowledges that he,she or it holds individual and non-trans -rabl- r p.'i`dity for adhering t and c plying with the ESA. The Applicant has read this disclaimer and signs and ates it below. Signature: Date: I I5" '41G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc BUILDER STATEMENT • The signer of this statement does hereby^ertify 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: St4 iot P2opane II (360) 3�35- 5797 ( 360) 385-587.5 MAILING ADDRESS: 0 853 .}}-00 Y J u e_ f. '.I_ EMAIL: n' PS(,(eAcnit 1e pro pane a C of►1 CONTRACTORS LICENSE WAINS NUMBER: SUV S-14 P7` a I (n�7 Q P NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition El Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: El Individual System ❑ Repair ❑ Masonry SEP Permit# El Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: 0 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 tallation permit,mark all items below that apply: I Underground Tank Above ground Tank Size of Propane Tank: 02 (-) Heat Stove I Cook Stove I Woodstove �I Irep ace 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. v Square Footage Current Proposed For Office Use Only , M ' Main Floor Heated EH BId App Review: 2nd Floor Heated Consistency Review: Other Heated Base fee: ;x ) 1 Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carpoi t SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ CS") O 3 Receipt Number: "1 5t Coq Cash/Check Number: ESTIMATED COST(REQUIRED) Date: j ( I- I J� 'Fair market value of all labor and materials foundation to finish Initials: C,3 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc