HomeMy WebLinkAboutBLD2008-00445 • •
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 #: BLD08-00445 Received Date 10/13/2008
SITE ADDRESS: 204 KALA POINT DR Issue Date 10/13/2008
PORT TOWNSEND, 98368
APPLICANT: PATRICK T O'MEARA PHONE: 360-385-3659
204 KALA POINT DR
PORT TOWNSEND WA 983689530
SUBDIVISION: IRONDALE Block: Lot:
PARCEL NUMBER: 962113413 Section: 35 Township: 30N Range: 01W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI983O6 Expires 9/26/2010
OWNER, PATRICK T O'MEARA PHONE: 360-385-3659
if different: 204 KALA POINT DR
PORT TOWNSEND WA 983689530
PROJECT DESCRIPTION: INSTALL PROPANE TANK, LINES, AND APPLIANCE
Directions 204 Kala Point Dr, 2tnd"ppholuse o R9 Rt before Kala Point Community Gate
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 10/13/2009.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: I D-2--2-0I'
FinalApproval: {1--1G'---2,2 zv'V
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.rn. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
I.\F_BLD_Permit_Propane.rpt 10/29/19
WILDING PERMIT APPLICA•N BLD08 00445
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00445 Received Date: 10/13/2008
SITE ADDRESS: 204 KALA POINT DR
PORT TOWNSEND, 98368
OWNER: PATRICK T O'MEARA PHONE: 360-385-3659
204 KALA POINT DR
PORT TOWNSEND WA 983689530
IRONDALE
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 962113413 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883
265 CHIMACUM RD
PORT HADLOCK WA 98339
Contractor's License MOUNTPI98306 Expires 9/26/2010
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOF INSTALL PROPANE TANK, LINES, AND APPLIANCE
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:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
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 RAR 10/13/08 102827
Total: $157.00
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1308 Alexander Avenue East,Buildin B,Fife, WA 98424 Office: (253) 926-6330,Fax: '
$ a . (253)926-8515
Pricing is for base models.Some upgrades have been added to drawings that are not included in the base price.Prices and features are subject to change.
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(,,- ;ONor,, JEFFERSON JNTY
WIy ,a DEPARTMENT OF COMMUNITY DEVELOPMENT
1-' .\„= 'C 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
&.gSN��p� www.co.jefferson.wa.us/commdevelopment
i-rIMaster Permit Application MLA:
Project Description (include separate sheets as necessary):
-,r/17'kA // /:cno,4,ve. //E4-F S/nv'E/ 7 4m/G
Tax Parcel Number: Qf trp 2- / 3 v /3 Property Size: 7,L /(7, 5Ov (acres/square feet)
Site Address and/or Directions to Property: ,ZO / A 4/4 /2o,,�7- and vE , . ,,,A Hz,vs E c,^,
A iftiT 106co,eE *H/q "',01 00.ynv.,,ivy CrATE.
Property Owner(s)of Record: y''9T/{it/ 7- !!)%E/1.e/P
Telephone: 364 385--36 5-9 Fax: email:
Mailing Address: ,2 p y ,I_,.�y/4_ /,‘"i,v 1 D,Q,vG_ /44_j j 30,,vs-E,-.n , h'A 4 68 3 6 8
Applicant/Agent(if different from owner):
Telephone: Fax: email: ,D
Mailing Address:
What kind of Permit?(Check each box that applies ^;1
❑Building ❑ Critical Areas Stewardship Plan -
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family 0 Garage Attached/Detached ❑ Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed Use Classification Noll U60
CI Commercial* 0 Special Use(Essential Public Facilities)** It um
❑ Change of Use 0 Boundary Line Adjustment
O Address ❑ Road Approach 0 Short Plat**
❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan**
Jropane ❑ Long Plat**
❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration**
❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
0 Temporary Use El Shoreline Management Variance
❑Wireless Telecommunication* ❑ 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 Cl 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 ccrue against Jeff County as a result of or in consequence of the granting of this permit.
I further agree to provide acc and right of ent o effe on County and its employees,representatives or agents for the sole purpose of application
review and any required I in ecti s. St s acces and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application 2�': ants p or ce
Signature: / Date: 1 v --/J-D-
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 n endangered species as those terms are defined in the federal law known as the
"Endangered Species Act" "ESA."Jefferson County es no assurances to the applicant that the actions that will be undertaken because this
permit has been issued not violate the ES_ Any• idual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you compli with 'J n County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfera o fo ri 'th the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: 'Z. Date: /U _ (3 _v 7
j, G
G:\PermitCenter\###FORMS###\DAD FORMS\Master Permit Application 5-29-08.doc
• 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:
inav/ /i /CV-2-oP 6 (360)385'-6gF3 ( )
MAILING ADDRESS: 2k c C?g' i*-c c-fri /2,44.,Q EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: 1- Shoreline: Type of Sewage Disposal:
❑ New X Wood Existing: 2- 1-- ❑ Sewer
,g Addition is Steel Proposed: 0 Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: 2--_ Height: X Individual System
Li Repair ❑ Masonry SEP Permit# 0/ -00;LS7
Li Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 3 Setback: Ll Private well ❑ Two Party
Type of Heat: Proposed: Public
1`v, Z.v Total: -3 Name of System: P J n
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 Under round Tanker Above ground Tan) Size of Propane Tank: / £ Ua/,
Heat Stove i 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 KID
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 /0 .7 7 EH Bld App Review:
o
2nd Floor Heated 7 ys. Consistency Review:
Other Heated ease fee:
Mezzanine Additi na�Son:
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: $ ' -'1—
Receipt Number: i 0Z&2:7
Cash/Check Number: 2D4-4v
ESTIMATED COST(REQUIRED) Date:•Fair market value of all labor and materials foundation to finish lb i I O (-')
it p00 OJ Initials: ( v
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G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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