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HomeMy WebLinkAboutBLD2008-00120 • 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 #: BLD08-00120 Received Date 3/31/2008 SITE ADDRESS: 710 JUPITER LOOP Issue Date 3/31/2008 BRINNON, 98320 APPLICANT: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 TX 131 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502094002 Section: 9 Township: 25N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 p 3g5 Contractor's License SUNSHP*077QP Expires 11/((33 67/2008-5875 OWNER, REBECCA L HISSONG PHONE: (360) 796-9962 if different: DOUGLAS R HISSONG 710 JUPITER LOOP RD BRINNON WA 98320-9754 PROJECT DESCRIPTION: SWAP OUT A/G 500 GAL PROPANE TANK FOR A/G 250 GAL Directions SEE GOOGLE MAIS r M i 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 3/31/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: ---7-0)) CK Il 4 f 6/0e ;3) \ FinalApproval: 0.K -Q61- �r;uI _ 1 vfj • BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE is 10 . N '‘'61'\X:16) Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY MI)C))E I:\F_BLD_Permit_Propane.rpt 10/29/19 S UILDING PERMIT APPLICAN BLD08-00120 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00120 Received Date: 3/31/2008 SITE ADDRESS: 710 JUPITER LOOP BRINNON, 98320 OWNER: REBECCA L HISSONG PHONE: (360) 796-9962 DOUGLAS R HISSONG 710 JUPITER LOOP RD BRINNON WA 98320-9754 SUBDIVISION: Block: Lot: TX13- PARCEL NUMBER: 502094002 Section: 9 Township: 25 N Range: 02 W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QQP Expires 11/17/2008 REPRESENTATIVE: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR (360) 385-5875 PORT HADLOCK WA 98339 PROJECT DESCRIPTIOI` SWAP OUT A/G 500 GAL PROPANE TANK FOR A/G 250 GAL PROPANE TANK SAME LOCATION 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: SETBACK: DECK: 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 $52.00 KAS 03/31/08 97040 Total: $52.00 • ! . . SITE VISIT REPORT (PLOT PLAN) 411 . JOB Do° 1-4 tS,S00 C. DATE : 3IA7/be . CONTACT: . ADDRESS 7/O SJ LooP P�, gielt-Ir.�otJ PHONE #: . DIRECTIONS FAX #: . Email . PLANNER: . 1) q' N \\oJ`a� , • v\� --__________'--> RECEIVT D MAR 3 1 2008 �¢SoN c©� JEFFERSO OUNTY • RECEIVED '� `�' DEPARTMENT OF COMMUNITY DEVELOPMENT ' '� 621 Sheridan Street • Port Townsend •Washington 98368R 3 1 2008 360/379-4450 • 360/379-4451 Fax �LIsNoti www.co.jefferson.wa.us/commdevelopment JEf fE r Master Permit Application MLA: Project Description (include separate sheets as necessary): 5 y}rrl i=_ 1-06G,)1- io il �o � A 4-74_ j S m c-1 10 - a. {c Tax Parcel Property 7 iv-cc tz2 lbft.�� Numbtlr: 50 g 0 9 y o 0,;____ Size: bk act' (a.,.es/square feet) Site Address "7 and/or Directions to Property: �(.)0L.k- c " . pfuy t7(0 v p &,,- Lop (�-rst �'0 Sl�E--6, Property Owner(s)of Record: DD / ( 1S S 0 C 'r e ecc 4 • Telephone: .7% 9`7 (o ')-- _ Fax: email: 7 Mailing Address: _ Applicant/Agent(if different from owner): S u-NS H I NE P Ro ?A N E Telephone: 395-579 7 Fax: 3BS S87S email: /JF0e5un1SN/rJE ProPAne. Mailing Address: l 0853 SHODy D 2• / >e 1. HHD I CI< Lc)R_ 9 833 ' `Am What kind of Permit?(Check each box that applies ❑Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** ❑ Single Family 0 Garage Attached i Detached ❑ 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** ❑ Home Business 0 Cottagelndustry 0 Long Plat** /KFropane 0 Planned Rural Residential Development(PRRD)/A<:londments** ❑ Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revii''is** ❑ Stormwater Management 0 Shoreline Management Substantial Development*` ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map/:iendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amenc'ment ❑ 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: r� DESIGNATION OF AGENT )t-0 'I hereby desigpate L(1•1S H I NE P2o P e to act as my agent in matters relating to this application for r:ermit(s). WNER SIGNATU ( Date: o7 By signing this application form,the ests that the information provided herein,and in any attachments,is true and correct;;)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 applic,-.3n 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':`sea 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 - cess and right o ntry to Jefferson County and its employees,representatives or agents for the sole purpose application Cc) review and any requir:d lat:r inspecti.-s. �—ess and *.ht of entry will be assumed unless the applicant informs the County in w.''ing at the time of the applicatio tha - or ,.,•, i pn• •• -. ignaure: Date: �2�dn The action or actions Applicant ' undertake •• a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could ead to a p. tial"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or" •." erson County makes no assurances to the applicant that the actions that will be undertaken because this S� 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 complia e with the Jefferson County development code.The Applicant acknowledges that he,she or it holds ir.lividual � and non-ransfer responsib.ity or adhering to and complying with the ESA. The Applicant has read this disclaime and signs and da -. it below. Signature: Date: _--p- 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: vr�l tS�H I�L- P�,p pa�� PHONE: FAX: MAILING ADDRESS: (360) 3S5- 579�7 ( 36O) 385_5875 0 853o p ei v 1•//�� H. EMAIL: In fQ(Q)SUeAsI-1 I(It p('t)Paine a c on1 CONTRACTOR'S LICENSE NUMBER: WAINS U hst4 P;� �7(7 p NUMBER ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE ( ) FAX: ( ) EMAIL Project Type: Frame Type: Bathrooms: ❑ New ❑ Wood Shoreline: Type of Sewage Disposal: ❑ Addition Existing: 0 Sewer ❑ Steel Proposed: Bank❑ Alteration/Remodel ❑ Concrete Total: ❑ CommualtS stemm ❑ Repair Height: ❑ Individul System o Masonry SEP Permit# 0 Demolition 0 Other: Bedrooms: Water Supply: Existing: Type of Heat: Setback: ❑ Private well ❑ Two Party Proposed: 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: Numbr of occupants(includes owners,tenants,employees.etc) Current IBC Occupancy: IBC Type of constr .n; Proposed If this is a Propane Ta. ._..;_• . • . .!lance I :'f .tion •ermit mark .WoodstoveWill youbelow havethat Foodapply:Service? Yes / No i Underground Tank I Above ground Tan ' 0.� -� s I Heat Stove I Cook Stove i ,� ^`ize� Propane 'ank: 5e C � Ta14� ire• - e7nsert i of +- - ank I Pellet Stove i other � Is this appliance being installed in a Manufactured/ • •• e Ho 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. Square FootageI Current Proposed �s ? '* '�`, p F�or'_pffjcerUse Ow, ,�,, f .4°`E �3 1 Main Floor Heated EH Bld App Review: L �ry - 2n°Floor Heated u�� �� % fry CE 1LJ -1 Consistency Review: Other Heatedi ^� p-� ?7 '' Base fee.--,. 5 �(. 00 Mezzanine 1r� Y� R 32018 f Additional Section: Heated Basement '' `" ' y �;t , Plan Check fee: Unheated Basement 'Y c:: - !s State Surcharge fee: Other Unheated r ,` ��. Pot Water Review fee: Garage/Carport • SUBTOTAL Decks x u 5 0�.0 0 „ , 911/Rd Approach fee: . Other — ;-,,,,,-?...,.; .:-A' TOTAL: $ 5 .co ;4 Receipt Number: Ot1 04O Cash/Check Number: ESTIMATED COST(REQUIRED) 46 1 0c0 Date: .Fair market value of all labor and materials foundation to finish l % Initials: t t`� G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc