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Home My WebLink AboutBLD2008-00299 • s 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 #: BLD08-00299 Received Date 7/2/2008 SITE ADDRESS: 2261 OLD GARDINER RD#35 Issue Date 7/2/2008 GARDINER, 98382 APPLICANT: JUDY A CATES PHONE: (360) 797-0053 2261 OLD GARDINER RD#35 SEQUIM WA 98382 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002353003 Section: 35 Township: 30N 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, DISCOVERY BAY LSEHLDRS ASSOC PHONE if different: 2261 OLD GARDINER RD SEQUIM WA 98382-8718 PROJECT DESCRIPTION: INSTALL 120 GAL PROPANE TANK AND GAS PIPING Directions To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHFDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 7/2/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance: Ori FinalApproval: I 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 •UILDING PERMIT APPLICAN BLD08-00299 Jefferson County Department of Community Development Review Type: 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00299 Received Date: 7/2/2008 SITE ADDRESS: 2261 OLD GARDINER RD#35 GARDINER, 98382 OWNER: DISCOVERY BAY LSEHLDRS ASSOC PHONE: 2261 OLD GARDINER RD SEQUIM WA 98382-8718 SUBDIVISION: Block: PARCEL NUMBER: 002353003 Section: 35 Township: 30 N Range: 02 W Lot: CONTRACTOR: MOUNTAIN PROPANE 265 CHIMACUM RD PHONE: (360)385-6883 PORT HADLOCK WA 98339 Contractor's License MOUNTPI98306 Expires 9/26/2008 REPRESENTATIVE: JUDY A CATES PHONE: (360) 797-0053 2261 OLD GARDINER RD#35 (360) 797-7223 SEQUIM WA 98382 PROJECT DESCRIPTIOr INSTALL 120 GAL PROPANE TANK AND GAS PIPING TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2006 ADM.: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: CONST TYPE: GARAGE: SHORELINE: DECK: SETBACK: SEWAGE DISPOSAL: BANK HEIGHT: WATER SYSTEM: — BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $105.00 KAS 07/02/08 100554 Total: $105.00 MEM ��gUN cf3�. JEFFERSONWUNTY tECE11�T1R ,-,..N. I-v.1 DEPARTMENT OF COMMUNITY DEVELOPMENT h t *C 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax JUL - 2 20(18 o vvww.cojefferson.wa.us/commdevelopment�`-r17N�� , n, rr�, a nr f? Master Permit Application MLAfs Project Description(include separate sheets as necessary): j/ �'irQ /� Tax Parcel Number: 00 a. c5 S 3 0 Li 3 Property Size: , /3 U (acres/square feet) Site Address and/or Directions to Property: ,t G�/ D /I �s��,,ro///4e ✓ Al /0 / &Jr Property Owner(s)of Record: ,/ Lc cl y X C- 4 f es' , / Telephone: `?h D 7 7 DU S`3 Fax: . >'d U - 77-.7„223 email: C11. 74k,SJ K y 0y�/I0), e OM Mailing Address: .c /9 i= / Applicant/Agent(if different from owner): CI) c/'/ X Telephone: i ' 7 �-- Fax:jj 6 — 7 7- 7,23-3 email:A ra.1 71/0 esi ha✓ 4/4_;b �' c Mailing Address: �_ ;2 ‘,/ / l�'-��t' %_ry l Y ( CoM What kind of Permit?(Check each box that applies ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** Propane 0 Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT he eby cjesignate \1z`' e4L 7 €S to act as my agent in matters relating to this application for permit(s). Ss. ./v/44.-cyc�' Date:- 9WNER•SIGNATURE 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 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 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 ation/ that a or she wants pri n tice ,//��/�` -Sigoatore: . 1.4A /L*� l Date: /� 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 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-transferable rre onsibility for ad / ri to and complying with the ESA. The Applicant has read this disclai er a d signs and dates it below. Sigr +eie ASs�: ! '�t<t K/� �' /V �1 — Date: 1�7 /'�� G:\PemvtCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc MIMI • 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: PHONE: FAX: /moo&4'7/a rt.) .0� (ee- (3�D) ,33-e,i3 ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE 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 ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: PP y Type of Heat: Proposed: ❑ Private well ❑ Two Party 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: Number of occupants(includes owners,tenants, employees,etc) Current Proposed IBC Occupancy: p 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 Above ground Tank Size of Propane Tank: /e�D I Heat Stove (Cook Stove I Woodstove I Fireplace Insert I Hot W Tank I Pellet Stove I Others r4 a Q Is this appliance being installed in a Manufactured/Mobile Home? Yes Yes No hen ying or a permit o install a ne tank you must also submit a site all property lines, tankllo location and size,distances omathe propane tank to all property lines,)an showing all of buildings and septic systee mcomponents including the reserve area. components, - • Square Footage I Current Proposed For Office Use Onl Main Floor Heated Y Amount Revision EH Bld App Review: 2ntl Floor Heated Consistency Review: Other Heated Base fee' Mezzanine I I Ai 105. Cb Additional Sectibn: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated R �� i( r 1l e , ' Pot Water Review fee: Garage/Carport SUBTOTAL Decks JUL - 2 At: ��5 911/Rd Approach fee: Other l+� TOTAL: $ L o5. DO I Receipt Number: 100 554 Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish 7 8 Initials: G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc I 7, o L rn o,, z /X'-.7 9 / 10 I- v\ m / m rm O "\ w " Nao "OD LT.I1 O O Q p oti W w • 23 ..cn • .1\-- - . / ( // //:47,1 VC, 7 I 7-1 co \rn .11 z a (y -1 y., E _.. _. 0...____- \ .._..c> -----.' c. W m I. \ A r 4,i''. ir--- -,,,,,, . 0 z -13 . z e 1 mac. SZ (..'\ \ s • „ N 1 1"A " C V