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Home My WebLink AboutBLD2008-00227 • 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 #: BLD08-00227 Received Date 5/30/2008 SITE ADDRESS: 2861 E MARROWSTONE RD Issue Date 5/30/2008 NORDLAND, 98358 APPLICANT: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 T23+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 021332013 Section: 33 Township: 30N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 p) 3g5 Contractor's License SUNSHP*077QP Expires 1 1/67/2008-5875 OWNER, STANLEY E BOKLAND PHONE: (360) 385-0589 if different: DOROTHY M WOODSIDE 2861 E MARROWSTONE RD NORDLAND WA 98358-9521 PROJECT DESCRIPTION: INSTALLP�I� (2)A/G 120 GAL PROPANE TANKS AND INSTALL GAS Directions SEE GOOGLE MAP i 9)IRECTIONS 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 5/30/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: (c -(q j FinalApproval: (D- 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 lb ILDING PERMIT APPLICA•N BLD08-00227 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00227 Received Date: 5/30/2008 SITE ADDRESS: 2861 E MARROWSTONE RD NORDLAND, 98358 OWNER: STANLEY E BOKLAND PHONE: (360) 385-0589 DOROTHY M WOODSIDE 2861 E MARROWSTONE RD NORDLAND WA 98358-9521 SUBDIVISION: Block: Lot: T23+ PARCEL NUMBER: 021332013 Section: 33 Township: 30 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: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR (360) 385-5875 PORT HADLOCK WA 98339 PROJECT DESCRIPTION INSTALL (2) A/G 120 GAL PROPANE TANKS AND INSTALL GAS PIPING 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. SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $157.00 KAS 05/30/08 100224 Total: $157.00 . , - i SITE VISIT REPORT (PLOT PLAN) JOB ( TI±` Ujoosl De. DATE : qZ q/6r CONTACT: . ADDRESS PHONE #: . DIRECTIONS FAX #: Email . PLANNER: . l'\211; -.-. iH I1 'O>. a_iau I I / I i ID ? uJ / \--0\afv\ -- \ti L r RECEIVED MAY3 ° 36 w JE`rF ► C`�Di11: DCD 8 EA ci4 Rd, . g o c • 1', -�CEIYED 'O JEFFERSO OUNTY . rik '�` DEPARTMENT OF COMMUNITY DEVELOPMENT •.. ►4 621 Sheridan Street • Port Townsend •Washington 98368 Y O 2008 360/379-4450 • 360/379-4451 Fax O� www.co.jefferson.wa.us/commdevelopment JEFFERSA COMA' acD Master Perr l;it Application MLA: Project De ription(include separate sheets as necessary): Tax Parcel Number: (_)p� n / ,3 3Ga— Oy 3 Property I Size: 0„.res/square feet) Site Address and/or Directions to Property: a 86 / _E. ate,-CrQ 1/41.7a ,O . - ` 2 61)^ . 1 C.,__ Property Owner(s)of Record: .46 6�^07h-r7 /...)O o O.J1 D AL e, Telephone: 3a� O SP9 - Fax: email: • Mailing Address: <fzZ . Applicant/Agent(if different from owner): S u-MS H I N E P RZo PA N ' Telephone: 395-5717 Fax: 3BS'SO7S email: fNFOeSUn1314/;.1EPI-o(391-7C• Mailing Address: I OS53 SHOpy D 2• / P. N1-0 Lock, l�R- 9 B33cf con-t 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 -Att ched/Detached CI DTsoretionary AD'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** me Business 0 Cottagelndustry 0 Long Plat** pane 0 Planned Rural Residential Development(PRRD)/Anendments** ❑ Sign 0 Plat Vacation/Alteration** 1 ❑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...federe1.permits required for this proposal, if known:. pe , , ., I, Plo DESIGNATION OF AGENT N.I herebydesi nate u i" g N P�e to act as my agent in matters relating to this application for permit(s). WNER SIGNATUR� � 14 C��r' ` (Date: `_D 7— J By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and corre'c. 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 appiic tion 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 UU review and any require'd later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicatio that he or she wants prior notice, ignature: L P�� --- E �D Date: j U 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-13 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 holc,z individual and non- ansferabl snsibility for for adhering to and com lying with the ESA. The Applicant has read this disclaimer and signs and daes it below. Signature � i f l l i�_,rel 1 te S-- .4. ' . '' Da ; G:\PermitCenter\###FORMS###\DAD FORMS\Master Permit Application 12-19-2006.doc • BUILDER STATEMENT III A 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: SOr3-C'H NE Pt opan (360) 385- 57T7 ( 360) 385-5875 MAILING ADDRESS: f 0 853 .4}-0 1 ' el & P. H. EMAIL: I n CONTRACTOR'S LICENSE ,SUhS{l1i1t Pro Pan e 6 0�1 NUMBER: �7 WAINS SU hSN P+ Ul7( Q P NUMBER ARCHITECT/ENQiNEER: PHONE ( ) FAX: ( ) MAILING ADDRESS:. EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: 0 Sewer 0 Addition 0 Steel Proposed: Bank ❑ Community system 0 Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System ❑ Repair 0 Masonry SEP Permit# 0 Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: Type of Heat: Proposed: ❑ Private well ❑ Two Party Total: 0 Public Name of System: If this is a Commercial Protect you must answer the following: Numb r 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 pbove ground Tank Size of Propane Tankr� /off O • t Heat Stove ) Cook Stove I Woodstove Fireplace Insert I Hot Water Tank I Pellet Stove I h0f er /g2-1p—sz-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 buildin;s,all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, includin• the reserve area. I °Squ �. '�C 7 �i 'Ir (,P' q rl 'h, ',' 4 tr. 6,,,,, t a ' " '' r7 are Footage Current Proposed ® ®IqU °. A,;, • ' ,„,,) ifk>,;? k .' 'a. r`.Main Floor Heated ;r4 ,3i% EH Bld App Review: M1 �1 2"°Floor Heated . 4�: nr «t f-.1??k� . Consistency Review: • Other Heated I - i` , '�*,`• M il x 'i `^,„ Base fee: i �.,ll Mezzanine gel , "fa r0 ►tL 15-1- MAN1 (' L � b Additional Secti : ' WNti Heated Basement f '0444 Plan Check fee: ,4j� Unheated Basement } State Surcharge fee: Other Unheated f Pot Water Review fee: Garage/Carport • ,cmo- �_._:_: rt1,.,1; 'PI,: SUBTOTAL Decks s ' . , 151 . LO `' 911/Rd,, rLy Approach fee: Other ;Iw J TOTAL: $ I Si.W ij t, Y -,,, Receipt Number: /bOaT ) . Cash/Check Number: ' ' '�k. t--1 14(o ESTIMATED COST(REQUIRED) , : : Date: c/ •Fair market value of all labor and materials foundation to finish 5 t O b Initials: 1 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc