HomeMy WebLinkAboutBLD2008-00433 • •
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 #: BLD08-00433 Received Date 10/1/2008
SITE ADDRESS: 6221 CAPE GEORGE RD Issue Date 10/1/2008
PORT TOWNSEND, 98368
APPLICANT: JAMES E ENGLE PHONE: 360-385-3139
JOYCE E ENGLE
6221 CAPE GEORGE RD
PORT TOWNSEND WA 983689040
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001301004 Section: 30 Township: 30N Range: 01W
CONTRACTOR: THURMAN SUPPLY PHONE: 360-457-8591
1807 E FRONT ST
PORT ANGELES WA 98362
Contractor's License THURMS*954JA Expires 11/26/2008
OWNER, JAMES E ENGLE PHONE: 360-385-3139
if different: JOYCE E ENGLE
6221 CAPE GEORGE RD
PORT TOWNSEND WA 983689040
PROJECT DESCRIPTION; NEW WOODSTOVE INSERT - 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 10/1/2009.
REQUIRED INSPECTIONS:
Tank/Line/Appliance:
FinalApproval` rr- pW►.PEr-R SSS 1 0-
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
IlibILDING PERMIT APPLICAAN BLD08-00433
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00433 Received Date: 10/1/2008
SITE ADDRESS: 6221 CAPE GEORGE RD
PORT TOWNSEND, 98368
OWNER: JAMES E ENGLE PHONE: 360-385-3139
JOYCE E ENGLE
6221 CAPE GEORGE RD
PORT TOWNSEND WA 983689040
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 001301004 Section: 30 Township: 30 N Range: 01 W
CONTRACTOR: THURMAN SUPPLY PHONE: 360-457-8591
1807 E FRONT ST
PORT ANGELES WA 98362
Contractor's License THURMS*954JA Expires 11/26/2008
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI' NEW WOODSTOVE INSERT - NO MLA REQ'D
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION ADD'L: HEAT TYPE:
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
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: ..3 I ,� a
Type Amount Paid By: Date: Receipt: Approved/Date
Propane Tanks/Stoves $105.00 AMS 10/01/08 102682
Total: $105.00
L.,.
410 . .
- - ___ � 1
CD �� � —
( I t-------T---- -.
;kc, 41 - 7 - 7 ..____ —
_ mo o y -
0
“' r - . J' i
'NC I' 1
I 1
I i
C\ --(‘)
U ,
\ .i-- ?-a-
‘ _,, --,-, ----- , 9/ , 0
- - --- ----- - _, r -} ,.,, ,....,
crix
( ( ) 9 v
, ,
___. _ .._ ./ I \-."
, .,,
1.. ,_ c.---,, . .,-', ' 0 c-,-) i))\---,
._._:, ,
: i 4,-:-. 0 C
, C----• 4: c:Z t
1 7
E C6
(1°47,aiiiit°1‘res.,,,e4
k L. 'i_,;1_.,ii
JEFFERSO UNTY • It y t ,
DEPARTMEN COMMUNITY DEVELOPMENT
�' 621 Sheridan Street • Port Townsend •Washington 98368 OCT 0 x 201R
ji
360/379-4450 • 360/379-4451 Fax
4:4 )1'' 0*0� www.co.jefferson.wa.us/commdevelopment ;}
ffERSON COUNTY BIT
Master Permit Application MLA: h() Gk. nq\CS-
Project Description I clu arate sheets as necessary):
GUi __ oej,y• o c/ / S-P1. 7 /z114, a ,;1/lt%lCoz-i' ,
Tax Parcel ��
Property
Number: c7Ci! 3.-i c CJ Size:
(acres/square feet)
Site Address and/or Directions to Property:
K' -`-,2 / (I,,, �'C'_o ra - �n
/
-e i
`u/
Property Owner(s)of Record: � ,j/4,yi
Telephone: ) 6 ` :;CS-- 5i Fax: email:
Mailing Address: (2„.2,/ C ,i. t� ejL,
Applicant/Agent(if different from owner):
Telephone: `f j]_ C I ' " 7--z (c 0 Fax: email:
Mailing Address: i) "�, i y(2/
What kind of Permit?(Check each box that applies
❑Building 0 Variance(Minor, Major or Reasonable Economic Use)
0 Demolition Permit 0 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)**
0 Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
❑ Address 0 Road Approach ❑ Binding Site Plan**
❑ Home Business 0 Cottagelndustry 0 Long Plat**
❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑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
0 Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetation 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 / j to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE ( P __)Q Date:/2j/1 /a,
By signing this applica n 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 ap.'�.. re that he or she ants prior notice.
Signature: /
,� 77., ✓ �7�.�0 Date: �/J/O /cJ
The action or actions Applicant will underta9Ce as a result of the issuance of this permit may negatively impact upon one or more threatened 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-tran. er�:e responsibilit for adhering o and complying with the ESA. The Applicant has read this disclaimer and sins and dates it below.
Signature: a-yyJ�Q
� � �� Date: /���/��3
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
•
0
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:
/Al-1 Y1,-'70 fr (54v) 5':5''7— 3'S47 / ( )
MAILING ADDRESS: /gG 7 .G f 7`,, - EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: /6:GI,1"'PM * l J f!may'7¢- NUMBER
ARCHITECT/ENGINEER: 7v4 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: ❑ 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 grow nk Size of Propane Tank:
i Heat Stove i Cook Stove li Fireplace Insep i Hot Water Tay I Pellet Stove i Other
Is this appliance being installed in a anufacture 1:51iile Home? Yes /(hd
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 EH Bld App Review:
•
2na Floor Heated Consistency Review:
Other Heated Base fee:
Luc(TOCVQ . lG5.G�'
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL
1 G5. cc
Decks 911/Rd Approach fee:
Other TOTAL: $ 1 C 5,
l i•>'''.t, /-,.I.S (.I�. -/. >�X 1 Receipt Number: l •-) lj -5-4
Cash/Check Number: e t ' gt�
ESTIMATED COST(REQUIRED) Date: r'`—t
•Fair market value of all labor and materials foundation to finish l
Initials: V.)
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc