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Home My WebLink AboutBLD2009-00029 03UILDING PERMIT APPLICAOON BLD09-000e29 view Typ Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00029 Received Date: 2/3/2009 SITE ADDRESS: 31 WORKMAN ST PORT TOWNSEND, 98368 OWNER: 31 WORKMAN LLC PHONE: (360) 385-5606 2009 4TH ST PORT TOWNSEND WA 98368-2201 EASTVIEW INDUSTRIAL PLAT SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 947800001 Section: 10 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 11/17/2010 REPRESENTATIVE: SUNSHINE PROPANE PHONE: (360) 385-5797 10853 RHODY DR (360) 385-5875 PORT HADLOCK WA 98339 PROJECT DESCRIPTIOr INSTALL INTERIOR AND EXTERIOR GAS PIPING 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 $55.00 KAS 02/03/09 105300 Total: $55.00 • I • 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 #: BLD09-00029 Received Date 2/3/2009 SITE ADDRESS: 31 WORKMAN ST Issue Date 2/3/2009 PORT TOWNSEND, 98368 APPLICANT: 31 WORKMAN LLC PHONE: (360) 385-5606 2009 4TH ST PORT TOWNSEND WA 98368-2201 1 SUBDIVISION: EASTVIEW INDUSTRIAL PLAT Block: Lot: PARCEL NUMBER: 947800001 Section: 10 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP"077QP Expires 1'i��OB-5875/ OWNER, 31 WORKMAN LLC PHONE: (360) 385-5606 if different: 2009 4TH ST PORT TOWNSEND WA 98368-2201 PROJECT DESCRIPTION: INSTALL INTERIOR AND EXTERIOR GAS PIPING Directions 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 2/3/2010. REQUIRED INSPECTIONS: Tank/Line/Appliance ) ) 1 I IIt}y FinalApprovalcd lI) DQ 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 7 • _ SITE VISIT REPORT (PLOT PLAN) JOB 1-:,+T 1 L-'. 4-- L21 IE Co Sr, DATE : 1130 I o 1 CONTACT: ADDRESS U.D:pg-KVnF+P s4- _ PHONE DIRECTIONS FAX Email PLANNER: re' en n E tSrIIL wI • N .-a n:2 k�4S C°� JEFFERSOI,OUNTY • ' DEPARTMENT OF COMMUNITY DEVELOPMENT I-, ` 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax � pco. www.co.jefferson.wa.us/commdevelopment 1,9 Master Permit Application MLA: Project Description(include separate sheets as necessary): A Cam- I,- 5 i c; P. d 1 n Tax Parcel Number: 7 y'7 goo col Property Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: 3( Gv O(-14 yr\ct r\ A L. C_ Telephone: 3 $ S- S Co 0 Cr Fax: email: Mailing Address: 3 I (.J O C ‘- Ivy ct Y\ S E' Applicant/Agent(if different from owner): Su,n S k► r\< ern pc, " c Telephone: 3(.O 38 S - S'l 9 ') Fax: email:I 11 @Su R S k i r,e,pr 0 p cL r✓e , "`'` Mailing Address: /CF'S3 l ock fir- 0)+ b}a.cl lock, Wlj g183 3 What kind of Permit?(Check each box that applies ❑Building ❑ Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family El Garage Attached/Detached ❑ Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑ Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach ❑Short Plat** 0 Home Business_ ❑ Cottage Industry 0 Binding Site Plan** 2-Propane - Pt p i '^) ❑ Long Plat** ❑ Sign 0 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)* ❑ Shoreline Management Substantial Development** ❑Temporary Use 0 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 ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local, state or federal perypits required for this proposal, if known: SuasKt (kC Co) DESIGNATION OF AGENT I hereby designate Su Ti sh I to act as my agent in matters relating to this application for permit(s). OWNER SIGNATU Date: 02(03 (471 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 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 a lieation th t or she ants r or notice. , Signature Date: o 2e/Io3/0 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 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-transfe resp n •bility for hen to and complying with the ESA. The Applicant has read this disclaime and si ns and dates it below. Signatur� G Date: 01/�Qj�4 G:\PermitCenter\###FORMS###\DRD 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 MA FACTURED HOME INSTALLER: PHONE: FAX: Sumstrc tro (1Zn,e (3O)3Ss -5797 ( ) MAILING ADDRESS: EMAIL: 10$S3 �odi Or "�� Nl,cp(or,�� / 33q In OL6)Cuhskthepro0an&. co44- CONTRACTORS LICENSE WAINS NUMBER: SLMS k. . d7-1 CO NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: u New i_1 Wood Existing: H Sewer ❑ Addition 111 Steel Proposed: Bank f, Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: L Individual System Cl Repair n Masonry SEP Permit# Water Supply: ❑ Demolition L Other: Bedrooms: pp y: Existing: Setback: 0 Private well ❑ Two Party Type of Heat: Proposed: 1 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: i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other tn-k h&Al(pe_ 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2fa 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: $ Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc