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Home My WebLink AboutBLD2008-00191 • • 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 #: BLD08-00191 Received Date 5/8/2008 SITE ADDRESS: 2261 OLD GARDINER RD 23 Issue Date 5/8/2008 APPLICANT: Ret-S Yl1ae 11, ._ _ PHONE: 2261 OLD GARDINER RD7WD.3 SEQUIM WA 983828718 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002353003 Section: 35 Township: 30N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 o Contractor's License SUNSHP*077QP Expires 1 1/67/2gg5 008 5875 OWNER, DISCOVERY BAY LSEHLDRS ASSOC PHONE: if different: 2261 OLD GARDINER RD SEQUIM WA 983828718 PROJECT DESCRIPTION: NEW A/G 120 GAL PROP TANK Directions SEE MAP AND 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 5/8/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: ;Ue 4 J/u,ES l/K 5/.�1/o FinalApproval: OK -}oar rut,( 0-04 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 MILDING PERMIT APPLICATI BLD08-00191 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00191 Received Date: 5/8/2008 SITE ADDRESS: 2261 OLD GARDINER RD 23 OWNER: DISCOVERY BAY LSEHLDRS ASSOC PHONE: 2261 OLD GARDINER RD SEQUIM WA 983828718 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002353003 Section: 35 Township: 30 N Range: 02 W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 REPRESENTATIVE: TRUDY ROSENBERG PHONE: 360-797-7265 2261 OLD GARDINER RD#23 SEQUIM WA 98382 PROJECT DESCRIPTIOP NEW A/G 120 GAL PROP TANK TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC 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: an 5 O I & Type Amount Paid Bv: Date: Receipt: Approved/Date Propane Tanks/Stoves $105.00 AMS 05/07/08 97447 Total: $105.00 SON RECEIVED �ti4` or, JEFFERSOOUNTY • ', ' L `." DEPARTMENT OF COMMUNITY DEVELOPMENT f 'Y 0 7 9" '' '4 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 3.60/.379-4451 Fax �, r r i �rQS` gip$ www.co.jefferson.wa.us/commdevelopment i i',....ulilti 4ti,)�'li QCD kIN Master Permit Application MLA: Y\O r \. L� r-(C( Project Description(include separate sheets as necessary): l •1Fi'it< • l& (3t FLI`�C(.Dc�tn i"i^ d-3 ( 6ee c ;4-e l�(.c7-A): neuo (cC�GC4tCv1 Tax Parcel Property I ( Number: r;[7 a 3 5 •3 0 0 D.. Size: 4n n K t (acres/square feet) Site Address and/or Directions to Property:r r aa& / d� 6ard,,ier RCL 4 .� 3 (rav cj/vieY Property Owner(s)of Record: pi S 0/73E J . 1/4! SAY RV 015:SO.1 , r Telephone: 7e1'1- '7.2, y 3 6 D Fax: email: Mailing Address: 0202(g 1 Ot (?Q red/heP' i 'd 5to c ilj WA' 9r.3 2- Applicant/Agent(if different from owner): Tf IA f1 Ro.Se rl Gi- / 1 5 Fri 5/' Telephone:(36a> '/4 I. 7 26, ' Fax:J �e , email: -Fri sre,See\. atiro •Com Mailing Address: ,.2..3C,1 a Gel &G v--cl i 'l er g t a/r4 t W/4f 9 g3 g - What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) • ❑ Demolition Permit ❑Conditional Use[C(a),C(d),or C]** ❑Single Family ❑Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular ❑Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat*"' ❑ Address ❑Road Approach ❑Binding Site Plan** ❑Home Business ❑Cottagelndustry ❑Long Plat*" SI Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑ Plat Vacation/Alteration** El Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management 0 Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑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 ❑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: ��A pESIGNATION OF AGENT I hereby designate %., L r /„/c / pa.€/yt, .Q�( to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE n_ _II.{/ Ate-- ,. /'f',e /71 4,,, r A. Date: Y/7 —eu> By signing this application form the owner/agent attests that the information providedherein,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 attomey'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 review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli tion t t or she wants prior notice. Signature: ' ' A e .,�e- , Date: "'—/ ? -LGIr The action or actions Ap cant 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-tran erable sppnsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ../ > / vC "17 Date: Y/') -or (::\Documents and Settings\carat\Local Settings\•Temporary Internet Bilks\OI.1(8Wlaster Permit Application 12-19-2006.doc • • • -•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 licensedijprilj"rarsiang they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FtFERSOAI COUNTY OCD 'yilshlt✓l e Ptrvi cine• 3t,0 3?•' 5797 MAILING ADDRESS: 10:5 3 ir\/IQ j l_. 7vrL. JJ / EMAIL: CONTRACTOR'S LICENSE v Fi/ 7 Q R/C[_G WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: 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 rConcrete Total: Height: Individual System Repair 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 Tan)and/or Appliance Installation permit,mark all items below that apply: ❑Underground Tank gAbove ground Tank Size of Propane Tank: %.0 p a((6 a❑Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water TO k 0 Pellet the 0 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /tO 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2na Floor Heated Consistency Review. Other Heated Base fee: 10( Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: 61 1 LI LI —) Cash/Check Number: ea5,Y-\ ESTIMATED COST(REQUIRED) Date: Fair market value of all labor and materials foundation to finish 5 I-1 )06 Initials: 61-0 C:\Documents and Settings\caral\I,ocal Settings\Temporary Internet Files\Ol.K86\Master Permit Application 12-19-2006.doc • 0 Q oc ILI Z N 0 IX W 4 U � � VO J W 0. J W aR 0 u >_ } a 1� W 0 rt Ii._ 0 0 a I- rn C� N 0z p W o 0 z0 U Wz a W O -J Z w H X (1Z ~ f 1 W O U p 0 CO O. V z W , ,, Y Z O LJ W J c L . L a st z Q z > F- - O co z0 0 Wz Z O Y J J N U.