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Home My WebLink AboutBLD2008-00388 • • 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 #: BLD08-00388 Received Date 8/28/2008 SITE ADDRESS: 351 WINDSHIP DR Issue Date 8/28/2008 PORT TOWNSEND, 98368 APPLICANT: DONNA REGESTER PHONE: 360-385-1385 351 WINDSHIP DR PORT TOWNSEND WA 983682515 57 SUBDIVISION: KALA POINT#1 Block: Lot: PARCEL NUMBER: 964700057 Section: 27 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33Bg0p)) 338g55 5875 Contractor's License SUNSHP*077QP Expires 11/17/2008 OWNER, DONNA REGESTER PHONE: 360-385-1385 if different: 351 WINDSHIP DR PORT TOWNSEND WA 983682515 PROJECT DESCRIPTION: A/G 120GAL PROPANE TANK, GAS LINE AND CONVERT COOK Directions TOP FROM NATURAL GAS TO PROPANE To Site: NO MLA REQ'D 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 8/28/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance:L. `2-1N . -9 V Y/ L Oolc ro/' 5141c7--®ram A-44/c9 -2---a" FinalApproval: a.. C i rlk t (K) (5r—_____,, 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 IRILDING PERMIT APPLICATIN BLD08-00388 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00388 Received Date: 8/28/2008 SITE ADDRESS: 351 WINDSHIP DR PORT TOWNSEND, 98368 OWNER: DONNA REGESTER PHONE: 360-385-1385 351 WINDSHIP DR PORT TOWNSEND WA 983682515 KALA POINT#1 SUBDIVISION: Block: Lot: 57 PARCEL NUMBER: 964700057 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' A/G 120GAL PROPANE TANK, GAS LINE AND CONVERT COOK TOP FROM NATURAL GAS TO PROPANE 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 By: Date: Receipt: Approved/Date Permit $157.00 RAR 08/28/08 102606 Total: $157.00 . ... -. .. ...• . - . ............. ...„ / ( i5 AUG 2 8 2008 --, 1, i _...._ _ JEFFERSUN COLO 1106 1 , • ................ ....., , , --.~S , , 4,.. , • t•-, _ c7, _ _ , • ,..-„, .. , --... .............. ._ _ , _,, _ (a, , --- -- ---1' 1 _.... _ .-7( ......... t \ -c.-- t , , . .. . 4 , 1 ' ' ��.¢,SON co�� JEFFERSO.OUNTY R. �r CET `� F W• \� r3 DEPARTMENT OF COMMUNITY DEVELOPMENT _ "<'\ 4 � 621 Sheridan Street • Port Townsend •Washington 98368 AUG 2 8 200 360/379-4450 • 360/379-4451 Fax �' . 01 www.co.jefferson.wa.us/commdevelopment JEFFEHSoN COUNTY Oct Master Permit Application MLA: Project Description (include se arate sheets as necessary): Prop Gym o Vt`-,-kL — L7 p --e- - //e--cJr CkJ Tax Parcel Number: (�f6 76 \ S 7 — Property Size: (acres/square feet) Site Address and/or Directions to ProQerty: as- wry � / - �..i " , Iic,____ Property Owner(s)of Record: AO/7/2/1 ei � Telephone: 3EFS- /3 63,c Fax: email: Mailing Address: Applicant/Agent(if different from owner): S U-NS 1-0 NE P RO P A N E Telephone: 385'579 7 Fax: 3BS- 5-0 7.5- email: (NFoeSuA13y/NEPr0P4Y7,, Mailing Address: I D853 SHODY J . y f 1. Kfl L CK IO L )R_ 9 533 ' ...Dr,.., 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]** 0 Single Family 0 Garage Attached i Detached U Discretionary"D"or Unnamed Use Classification 0 Manufactured Home 0 Modular ❑ Special Use(Essential Public Facilities)** 0 Commercial* 0 Boundary Line Adjustment 0 Change of Use 0 Short Plat** 0 Address 0 Road Approach 0 Binding Site Plan** 0 Home Business 0 Cottagelndustry 0 Long Plat** Propane 0 Planned Rural Residential Development(PRRD)/Amendments** 0 Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment 0 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: 1)te DESIGNATION OF AGENT NI hereby designate S N I N1E 20 to act as my agent in matters relating to this a licatio for permit(s). WNER SIGNATURE 1 Date: 0 r p By signing this application form,the owner/agen attests that the information provided herein,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 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. (‘G 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 U review and any requir-• .ter inspections. Sta ccess and right of entry will be assumed unless the applicant informs t e County in writing at the time of the applica on that e or she wants pri r tice. 1j� �j ignatu ` re: � .,/I Date: Sc7 °(� 0 The action or actions Applicant will undertake as a sult of the issuance of this permit may negatively impact upon one or more threatene d ed 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 S\ 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 :. : e in compliance wit •e Jefferson County development code.The Applicant acknowledges that he,she or r it holds individual and non_trans'erabl- r-.•onsibility for ad g to - d• omplying with the ESA. The Applicant has read this disclaimer rid si s and dates it below. • Signature: M �r '0 a a , i 4_, Date: G:\PennitCen ter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • BUILDER STATEMENT 40 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: SON.S5H JNII Pceopan.e (360) 305- 5797 ( 36o) 385-5875 MAILING ADDRESS: )0853 o y n�1 U _ f. I-1. EMAIL: I n' A),sUAslIv1e Pro Pan e a ConA CONTRACTOR'S LICENSE WAINS NUMBER: '5uvts'N P+ D f�/n 1Q J NUMBER ARCHITECT/ENGINEER: PHONE'( ) FAx: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 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 Tank and/or Appliance Installation permit,mark all items below that apply: i Underground Tank I Above ground Tank Size of Propane Tank: /off-O G a— i Heat Stove Cook Stove Woodstove I Fireplace Insert i Hot Water Tank t Pellet Stove I Oth .' r �v 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 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. it r Square Footage Current Proposed "Fo Office Use'Only.,' ; `".. Amount Revision G g Py ' , Main Floor Heated EH Bld App Review: 2nd Floor Heated , Consistency Review: 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 911/Rd Approach fee: Other TOTAL: $ t Receipt Number: l�',L0 LLG Cash/Check Number: `A u t n [�V ESTIMATED COST(REQUIRED) Date: (6'� Lc, .Fair market value of all labor and materials foundation to finish �(�Initials: `2— A 12-. G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc