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Home My WebLink AboutBLD2008-00239 4 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 #: BLD08-00239 Received Date 6/3/2008 SITE ADDRESS: 11 WARBLER LN Issue Date 6/3/2008 PORT LUDLOW, 98365 APPLICANT: NJ NAYLOR INVESTMENTS ONE LLC PHONE: 360-385-3896 C/O TBPM 412 LOGAN ST PORT TOWNSEND WA 983682225 60 SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot: PARCEL NUMBER: 990500060 Section: 8 Township: 28N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 p 3g Contractor's License SUNSHP*077QP Expires 11/67/�00g-5875 OWNER, NJ NAYLOR INVESTMENTS ONE L_C PHONE: 360-385-3896 if different: C/O TBPM 412 LOGAN ST PORT TOWNSEND WA 983682225 PROJECT DESCRIPTION: A/G 120 GAL PROP TANK, INSERT& GAS LINE Directions 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 6/3/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: `�j`C Z) -t FinalApproval: b -Z -pq 14 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 lik UILDING PERMIT APPLICAPIN BLD08-00239 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00239 Received Date: 6/3/2008 SITE ADDRESS: 11 WARBLER LN PORT LUDLOW, 98365 OWNER: NJ NAYLOR INVESTMENTS ONE LLC PHONE: 360-385-3896 C/O TBPM 412 LOGAN ST PORT TOWNSEND WA 983682225 PORT LUDLOW NO. 4 SUBDIVISION: Block: Lot: 60 PARCEL NUMBER: 990500060 Section: 8 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: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR (360) 385-5875 PORT HADLOCK WA 98339 PROJECT DESCRIPTIOF A/G 120 GAL PROP TANK, INSERT & GAS LINE 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 LYK 06/03/08 100237 Total: $157.00 El) Jut 3 ?We Jefferson County Planning & Building Department -• e SITE VISIT REPORT (PLOT PLAN) JOB -7-6u0JS6.--AD/) Ay 2Rwei_. _l DATE : 62 b3/O K . CONTACT: ADDRESS ii (Ame3LC--1Z LA►0C er 1-.0cIl01.3,- PHONE #: . DIRECTIONS FAX #: . Email . PLANNER: . RECEIVED /10 JUN - 3 2008 n m,-f\k 944;c\ I,- _i �� 3/4 6,55r ___ — — — — - -4 - -7 - - ---ci ---- 3 ),( l' '' w _ 1 'g- J / e� 1) v 5 � 1 ,(,_, l ,ill \, jI, I��l; 77.,0,-riotsi OOP JEFFERSAOUNTY W \;v * DEPARTMENT OF COMMUNITY DEVELOPMENT - "� ` '< ' 621 Sheridan Street • Port Townsend •Washington 98368 _ JUN - 2012 3 ' 360/379-4450 • 360/379-4451 Fax I nl s., ....0.t ,qS, GAO www.co.jefferson.wa.us/commdevelopment JEFfEr3N COUNTY DO Master Permit Application MLA: 3O e l N Project Description(include separate sheets as necessary): /a 1- ByC /._„....,_. (,,,a_t- p,„ ,.._.____ 7,0-.„.7‹ Tax Parcel Property Number: 9 9 0 5O a D I7O Size: (acres/square feet) Site Address and/or Directions to Property: II L.2 - -- 2 Li? ' P i 4. 0 Lo(-L1 �) /7. Property Ow((ner)o of R�e ord: Al Y /./-' : ,/ -- L 1 o�e LLC Telephone:,3LO 31' 3�� - Fax. .) 0 3 V3/7z a email: tQM L°O(yn1 P jU A Mailing Address: /o ( li�'te a-rt4 6 -i • J �1/zl LD �/J J j Applicant/Agent(if different from owner): 3 CL_IVJ H l NE P R PAN P% 7---01 J t,2444'J, („)19 . Telephone: 395'5-79 7 Fax: 3BS- 5-87S email: lrJFo St./AISO,` ,iEProPmne. Mailing Address: I og53 RHoDy D e• P i. -i tI W ck LL)A_ 9 833`7 `Q'"' What kind of Permit? (Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic'.Jse) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family 0 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 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** 2propane 0 Planned Rural Residential Development(PRRD)/Ai:endments** ❑ Sign 0 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 ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendrnent ❑ 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: I DESIGNATION OF AGENT )t c I hereby designat- J L(t•JS 4 I tJ E PRO P ie to act as my agent in matters relating to this a lication for permit(s). `OWNER SIGNATiII 1) / ' f ' a ( ( Date: e I \ By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct;o the best of �J 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 C.CUU review and any re ' later inspections. Staffs access and right of entry ill be assumed unless the applicant informs t County in writing at the time of the a I',a�t' n tha e or she wan r / ignature `\l y Date: ( / OV The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatens,,;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 5\ 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-r.ry z.responsibility for herig to and com with the E A. The Applicant has read this disclai r a sign�.and dates it below. Signature;ear ›�, cl .� Date: f:/ 6 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc It 1 5 '?4 • 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 pan CONTRACTOR, OR MANUFACTURED HOME INSTALLER: PHONE: FAX: SO 1Ilw-H I I V L P R,0 MAILING ADDRESS: (' e, (360) 3�3 5- 5 79�7 ( 36 O) 385-58 75 10853 '4+ooy Diu P. 1.I. EMAIL: 1 n ` (C2)St cthvlC Profane 6 ceo-\ CONTRACTOR'S LICENSE NUMBER: WAINS U viSt4 P+ 077 tn�7 Q P NUMBER ARCHITECT/ENGINEER: PHONE'( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: ❑ New Shoreline: Type of Sewage Disposal: El Wood Existing: ❑ Addition ❑ Steel Proposed: ❑ Sewer ❑ Alteration/Remodel ❑ Concrete Bank ❑ Community System Total: Height: Ill Repair ❑ Masonry g CI Individual System ❑ Demolition ❑ Other: Bedrooms: SEP Permit# Existing: Setback: Water Supply: ❑ Private well ❑ Two Party Type of Heat: Proposed: Total: 111 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: Numb(Ir of occupants(includes owners,tenants,employees:etc) Current IBC Occupancy: IBC Type of construction: Proposed Will If this is a Propane Tank and/or Appliance Installation permit,mark all items o thaty w app you have Service? Yes / No I Underground Tank Above ground Tank ' I Heat Stove I Cook Stove 1 � Size of Propane Tank: /��O • Is this appliance being installed inoasManufac ured/Mobi a Home?Fireplace Insert I t Y/ese/r TNok I Pellet Stove I thers When applying for a permit to install a propane tank you must also submit a site plan showing all of e builds, all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic c systemcomponents, including the reserve area. Square Footage Current Proposed Fpro f*.tlie Og . 2; < 41,4.1"b 's ; I ` Main Floor Heated ` `r EH BId App Review: R. , Lt� 2na Floor Heated Consistency Review: Other Heater( ' ''', " ; Base foe:, Mezzanine '` , Additional Se` -C(D h.t; I 5A .tlon. �_ Heated Basement t;I q? Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 15�. CZ 911/Rd Approach fee: Other "s TOTAL: $ I�'� r,�, W !� 4 .ti Receipt Number: �O � '' Cash/Check Number: ESTIMATED COST(REQUIRED) 4 t 50 Date: .Fair market value of all labor and materials foundation to finish 13fcg Initials: ` G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc