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Home My WebLink AboutBLD2008-00280 • • 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 #: BLD08-00280 Received Date 6/25/2008 SITE ADDRESS: 304292 HWY 101 Issue Date 6/25/2008 APPLICANT: JAMES D WINTERBOURNE PHONE: 425-836-5193 8507 250TH AVE NE REDMOND WA 980535813 SUBDIVISION: Block: Lot: PARCEL NUMBER: 602261012 Section: 26 Township: 26N Range: 02W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2008 OWNER, JAMES D WINTERBOURNE PHONE: 425-836-5193 if different: 8507 250TH AVE NE REDMOND WA 980535813 PROJECT DESCRIPTION: NEW A/G 120 GAL PROP TANK& FIREPLACE - NO MLA REQ'D 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 6/25/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: aOK Q� /v/A, AOW✓aZ L OK 0...5. -Ave f,c 4-7-"pg)E f P or_ S'sh,?fr, FinalApproval: /ij -iC1 r ,r,,z/ 0-5/44:9 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_Perm it_Propane.rpt 10/29/19 *BUILDING PERMIT APPLICAS Review ON 00280 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Pori Townsend, WA 98368 PERMIT #: BLD08-00280 Received Date: 6/25/2008 SITE ADDRESS: 304292 HWY 101 OWNER: JAMES D WINTERBOURNE PHONE: 425-836-5193 8507 250TH AVE NE REDMOND WA 980535813 SUBDIVISION: Block: Lot: PARCEL NUMBER: 602261012 Section: 26 Township: 26 N Range: 02 W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTP►983O6 Expires 9/26/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW A/G 120 GAL PROP TANK & FIREPLACE - 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: 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 Bv: Date: Receipt: Approved/Date Propane Tanks/Stoves $157.00 AMS 06/25/08 100437 Total: $157.00 ON cam �' JEFFERal COUNTY ''tt � DEPARTMENT OF COMMUNITY DEVELOPMENT JUi� 2 5 2008 '4 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax as p'. www.co.jefferson.wa.us/commdevelopment JFJJJPS�N r i' 'r rn Master Permit Application MLA: 100 1"{ L re_ t Project Description(include separate sheets as necessary): _1/1.�:->- I l �n�p�� F►re_10la . Tax Parcel Property -t- Number: 1 04 1i DO OOl- c* 60 <3 a(0I a1 a— Size: 6.yes (acres/square feet) Site Address and/or Directions to Property: 3'-a-CO— 1\) U S F� 10 I -- &I 1 td Property Owner(s)of Record: 0.-VYLC•, 5 \/ i (�7n_t t r k Telephone: LO-c.� g-,30 J5 11-3 Fax: " `J - 7Li email:..JIY J i� 4/{l l/,!cWnc.k Mailing Address: �0 7 / I RedtM 6Y-) • ci :3 • c"- '', Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d), or C]** ❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** O Commercial* 0 Boundary Line Adjustment O Change of Use 0 Short Plat** O Address 0 Road Approach 0 Binding Site Plan** 0 Home Business 0 Cottagelndustry 0 Long Plat** let Propane 0 Planned Rural Residential Development(PRRD)/Amendments** 0 Sign 0 Plat Vacation/Alteration** 0 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: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any emission 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 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 th ap ation that he or hew nts pr or notice. /_'(/ Signature:'. • ( Date: l/i l!/� The action o_.ions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered s.- ies 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 no ran erable respons'bili for ad ering o and complying with the ESA. The Applicant has read this disclaimer and signs and d�tgs it below. a'Signatur cry,. 4.T 0 Date: (' CI —��i'1C C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc / D al LA ii) _3r-,L 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 b: a,s • ing the responsibilty oft e Ge eral Contractor for the proposed project. Signature aNYU.3 (N `JLt . Date: (.0—, L'(--0Ej GENERAL. •N 4-) •CTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ilY)MAY - 1 f t 473'10a�-ram (30 3ff.S. to,a3 (3 0 S - (o9 i it MAILING ADDRESS: a(0s Cviim`cc<.r.► 12d EMAIL:wuJ .) enzyw lfL Ai # , c''yr1 c CONTRACTORS LICENSE WAINS ��"/CQVL. NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: j 75 Shoreline: Type of Sewage Disposal: ❑ New Wood Existing: 1 Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System IC Alteration/Remodel ❑ Concrete Total: e3V Height: Individual System ❑ Repair Masonry i - 7 S SEP Permit# ❑ Demolition I Other: Bedrooms: Water Supply: Existing: \.._3 Setback: Y5(Private well I Two Party Type of Heat: Proposed: I 1 Public Total: 3(o G-('Y ice- 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 Installation permit, mark all items below that apply: ❑Underground Tank XAbove ground Tank Size of Propane Tank: Ic. J.3 ❑Heat Stove ❑Cook Stove ee e 0 Fireplace Insert ❑Hot Water Tank 0 Pellet Stove ther pfirpr.vt-0.- Is this appliance being installed in a Manufactured/Mobile Home? Yes /e) {t+r-e-Q I«-R- 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 �,I EH Bld App Review: 2"tl Floor Heated D Consistency Review:45 Other Heated Base fee: !��- �- Mezzanine Additional Section: - Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport _ -__ SUBTOTAL Decks a 911/Rd Approach fee: • pod. 3 or-O TOTAL: $ 4l V-C..p in_c_e_ Receipt Number: 1O(Y- 5 Cash/Check Number: l L ESTIMATED COST(REQUIRED) Date: 6 Ian v6 .Fair market value of all labor and materials foundation to finish Initials: /„ /\ C:\Doc ,,a d Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc A t 1 1 nSillf C'U'(iN'y " • . Sri „ 0 .- T ..,,, 'c- i ' . / L . / v(i)\ LI / '_\\ Sl �, �` s + ii 2. j -Pj - . •- 8- 1 i -) /-) \\, '67 __,_._. , .. Le,: 0,,, ,r_ . ..e. ) \ t'—,; \ —. (\ 7— \ ii, — 7) c , T.—, 1'k Ls.), \ .„ 0 \t________7ir, 4- -r , 11 ,,.____r--7,-3 , ''T- l - 7 .- \j 1_ r 3. t 3 - . . RECEIVE-6 L-I- j41 t----1- 1 g -(i- o JUN2520Q8 JEFF ERSON COUNTY OCO