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Home My WebLink AboutBLD2009-00025 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 #: BLD09-00025 Received Date 2/2/2009 SITE ADDRESS: 152 HUCKLEBERRY PL Issue Date 2/2/2009 PORT TOWNSEND, 98368 APPLICANT: KAREN C KRUG PHONE: (360) 379-2570 CHARLES S JAMES 152 HUCKLEBERRY PL PORT TOWNSEND WA 98368 7 SUBDIVISION: CAPE GEORGE VILLAGE DIV 6 Block: Lot: PARCEL NUMBER: 941400006 Section: 13 Township: 30N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 p Contractor's License SUNSHP*077QP Expires 11/((33 67/23g5 010-5875 OWNER, KAREN C KRUG PHONE: (360) 379-2570 if different: CHARLES S JAMES 152 HUCKLEBERRY PL PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: ADD GAS LINE FOR NEW GAS DRYER -ALSO FIREPLACE INSERT Directions EXISTING A/G 250 GAL PROPANE TANK 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 2/2/2010. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: ( CC -(-0-= T 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 BLD09-00025 43UILDING PERMIT APPLICAWN Review Type: Jefferson County Department of Community Developm nt 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00025 Received Da e: 2/2/2009 SITE ADDRESS: 152 HUCKLEBERRY PL PORT TOWNSEND, 98368 OWNER: KAREN C KRUG PHONE: (360) 379-2570 CHARLES S JAMES 152 HUCKLEBERRY PL PORT TOWNSEND WA 98368 CAPE GEORGE VILLAGE DIV 6 SUBDIVISION: Block: Lot: 7 PARCEL NUMBER: 941400006 Section: 13 Township: 30 N Range: 02 W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/201 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' ADD GAS LINE FOR NEW GAS DRYER - ALSO FIRE LACE INSERT EXISTING A/G 250 GAL PROPANE TANK 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 STORI S: OTHER: CONST TYPE: GARAGE: SHORELINE' CONST TYPE: 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 Propane Tanks/Stoves $110.00 KAS 02/02/09 '105294 Total: $110.00 ��.¢ oNo c &� JEFFERS0 0UNTY • DEPARTMENT OF COMMUNITY DEVELOPMENT f-' . ' ` '`4 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax .gs N c$ www.co.jefferson.wa.us/commdevCI elopment Master Permit Application MLA: �--- Proje. Description (include separate sheeeets/as necess ,). ,/ >/n5' �l(/� �'O/" L-'��.5 "� fr */l- � 4f sP ,_— Tax Parcel r ,,II Property Number: 'I4 l `t OD OD 6 _ Size: 2 3 (acres/square feet) Site Address and/or Directions to Prooertv: .`i��sco � , tc2 ,4(C..1 Z 7 G e _/5)-7 .s 11/9 /Pric)s� � , ti e AZ -6 / 1 p 1�� Property Owner(s)of Record: , G/Wc'CAS S rJ�jpos• It/- ,&d,i--✓� / .etf, v Telephone: (,.cCQ 3 Z.S-- Fax: email: 4eze•,.Z �'oi Mailing Address: / 2 / l /(�Ij` ,I-k-- -,F 71 �Dl�.r c� Gt) 454—r 77 Applicant/Agent(if different from owner):�S(I-MS 1-1 I p KO pA Li Telephone: 395-5717 Fax: 3 BS- SO 7.6- email: lNFOg SurJSN/NE ProPmri(,, Mailing Address: I D4353 SHODy p e- / 1�. NFfo LOCk LJ R- 9 &33cj �m 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 CI*" Single Family 0 Garage Attached/Detached a Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** 0 Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance ❑ Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ 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: DESIGNATION OF AGENT \�I hereby designate 614i�S ) I NE" I O P to act as my agent in matters relating to this application for permit(s). 1WNER SIGNATURE &es "e7 _ Date: f By signing this application form,the owner/anfif 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 iiabiiities,judgments,court cosis, 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 UUU review and any required later inspections. Staff ccess and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicatio he o she w pr.' tice. 1 ignature: Date ') The action or actions Applicant will ur i�rfake 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 nontransferable p sibilit for ad ng d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc • BUILDER STATEMENT III The sigPer 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: I GENERAL CONTRACTOR OR MANUFACTURED HOME ( 36O) 385-58 INSTALLER: SO tS�i� I N L" P08,53 8 an� (360) 3 5- 57PHONE: FAX: MAILING ADDRESS: P 1 �3 -7 75 , S CONTRACTOR'S LICENSE 3oY �j U P.j� f1• EMAIL: I nSU'1s�tvI� p('r7 p 6 Cola NUMBER: L(V1s,NF P`,, DI7Q p WAINS � NUMBER MAILING ADDRESS: PHONE`( ) FAX: ( ) EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: L; New ❑ Wood Existing: Addition 0 Steel Proposed: ❑ Sewer ❑ 0 Alteration/Remodel ❑ Concrete Bank ❑ Community System Total: Height:❑ Repair 0 Masonry ❑ Individual System 0 Demolition ❑ Other: Bedrooms: SEP Permit# Water Supply: Existing: Type of Heat: Setback: ❑ Private well ID Two Party Proposed: Total: 0 Public Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of occupants(includes owners,tenants, employees.etc) Current Number of ADA swing Spaces: IBC Occupancy: IBC Type of construction: Proposed you have Food If this is a Propane Tank and/or A fiance Installation ermit mark all items elow that apply Service? Yes / No i Underground Tank Above ground Tank S1ze of opan Tank: 9 ,`/ I Heat Stove I Cook Stove Woodstove (replace Insert I HotrWaterTank Peet stove I Other �_D/� 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 Usb.'On1 �,: t ',, ii;if �`=;r Main Floor Heated y � - . a >�,�. . Qrtount : k ,Rlevftfi , EH Bid App Review: - 2n0 Floor Heated =' Consistency Review: Other Heated '`` Base fee: _ Mezzanine d p' ..- I,]p,ODAdditionalal S Suction:ion: - Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Carat'^,,/Carps SUBTOTAL Decks t L O. 00 911/Rd Approach fee: Other ' TOTAL: $ llo.cp Receipt Number: l bal Cash/Check Number: �j ESTIMATED COST(REQUIRED) "t aa Date: •Fair market value of all labor and materials foundation to finish a 1a IL109 Initials: `� ,;\PermitCcnter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc e Nc��lelehe,-� PL— 1