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HomeMy WebLinkAboutBLD2008-00399 0 • 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 #: BLD08-00399 Received Date 9/8/2008 SITE ADDRESS: 142 BRIDLE WAY Issue Date 9/8/2008 PORT TOWNSEND, 98368 APPLICANT: JAMES C ANGLE PHONE: 360-301-9449 1240 W. SIMS WAY#61 PORT TOWNSEND WA 98368 2 SUBDIVISION: CAPE GEORGE VILLAGE DIV 5 Block: Lot: PARCEL NUMBER: 941100002 Section: 18 Township: 30N Range: 01W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2008 OWNER, JAMES C ANGLE PHONE: 360-301-9449 if different: 1240 W. SIMS WAY#61 PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: INSTAL NEW��500 GAL U/G PROP TANK & FUTURE Directions SEE MAP AND DI PCIITppIWPF1NNn MLA REQ'D 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 9/8/2009. REQUIRED INSPECTIONS: Tank/Line/Appliance:i/(ciVK-- (-t(Iw( (fc1,4'a.crt�F,41--l0-c- Y FinalApproval: 8-Z( -07 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 tILDING PERMIT APPLICA1N BLD08-00399 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00399 Received Date: 9/8/2008 SITE ADDRESS: 142 BRIDLE WAY PORT TOWNSEND, 98368 OWNER: JAMES C ANGLE PHONE: 360-301-9449 1240 W. SIMS WAY#61 PORT TOWNSEND WA 98368 CAPE GEORGE VILLAGE DIV 5 SUBDIVISION: Block: PARCEL NUMBER: 941100002 Section: 18 Township: 30 N Range: 01 WLot. 2 CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI98306 Expires 9/26/2008 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt INSTAL NEW 500 GAL U/G PROP TANK & FUTURE APPLIANCES-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: 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 $157.00 AMS 09/08/08 102652 Total: $157.00 riv goN JEFFERSON OIJNTY • RECEIVED rz3 DEPARTMENT OF COMMUNITY DEVELOPMENT o' N4 "4 621 Sheridan Street• Port Townsend •Washington 98368 SEP 0 8 360/379-4450 • 360/379-4451 Fax 2Q�� vv ww.co.jefferson.wa.us/commdevelopment ww.co.jefferson.wa.us/commdevelopment I-IINO JEFFf8Sri' =uNif i ''l , Master Permit Application MLA: l( C) ►'Y. CV Yam- d Project Description(include separate sheets as necessary): /n15r/ds-u- [1N'/16-7Lo (iA42 ,P4ePi - /-A- J Tax Parcel Number: q`7l/ - /00 - 00 L. Property Size: S r / �% � 3 (acres/square feet) Site Address and/or Directions to Property: � .-A-p q�;r- /9� Oki b t-E (/,� G0,Jy �tlt ) o©0,2- - rOMVSc , wry 91 to Property Owner(s)of Record: �/AA 675 2 : 6 -- Telephone: .� *2/—ei f itil Fax: 3 L�)/3 7 J'- fr'o/U email: a/r/u wry_f/fie9d/t' xjJ1. c1 Mailing Address: /y 7 © W. r5•//VJS tt/ f ;1 6 / Q1jKr p-i /A/Cr'7VL3 1,t/ Applicant/Agent(if different from owner): I Telephone: Fax: email: Mailing Address: 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 ❑ 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 0 Address ❑ 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** ❑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 ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑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 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 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 prov'•e access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any qtf ed later inspections. taffs acces and right of entry will be assumed unless the applicant inform the County in writing at the time of the appl t t• tit he or wa prior notic Signature: Date: 9 v The action or a.i.ns Applicant will undertake as a suit of the issuance of this permit may negatively impact upon one or more threatened or endangered lsp cies and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangere. pecies Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issue9 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 2(r in complian with the Jefferson Co my development code.The Applicant acknowledges that he,she or it holds individual and non-transfe ab r s o sibilit a ing to and co ying with the ESA. The Applicant has read this disclaimer d si s a dates it below. Signature: Date: 9 ? t/ G:\PennitCenter\'q###FORMS###\DRD FORMS\Master P rmit Application 5-29-08.doc • BUILDER STATEMENT • The signer of th" s tement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be as u respo ility he Gener Contractor for the proposed 9 project. nature: � Date: GENERAL CiATRACTOR OR MANUFACTURED OME INSTALLER: PHONE: FAx: 11/41101)ArrA—I/til ilIV/4-1kr ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL Project Type: Type:T e: Bathrooms: Shoreline: Type of Sewage Disposal:❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System Total: Height: CI Individual System ❑ Alteration/Remodel CI Concrete SEP Permit# ❑ Repair ❑ Masonry ❑ Other: Bedrooms: Water Supply: CI Demolition Existing: Setback: ❑ Private well ❑ 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: `/OO 7Heat Stove/Cook Stove i Woodstove i Fireplace Insert i✓Hot Water Tank i Pellet Stove i Other 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. Square Footage I Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bid App Review: 2nd Floor Heated Consistency Review: Other Heated Base fee: 5�.n!1 WO LY1Z- ` DO Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: -Garage/Carport SUBTOTAL 5`1 Decks 911/Rd Approach fee: 1. Other TOTAL: $ 1 51. cO Receipt Number: 16 a C05 Cash/Check Number: i a i ESTIMATED COST(REQUIRED) Date: 9 a cyc .Fair market value of all labor and materials foundation to finish ! I Initials: J, G:\Permitcenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc R� S K) T rnI I -Ir— rn WIi 0i 71 c. Y Y � 0 ' 0. z r C 2 O Z v 2 W � �i 00 a Av a Aµ �O m� �m ti a mz p AO A no�22�Omr+A�O ¢Y�L •( nplA Tpn2 D'nDOYImnA,1pA 22 =� q