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Home My WebLink AboutBLD2009-00033 Illt UILDING PERMIT APPLICASN B RD09-00eview 0e33 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00033 Received Date: 2/9/2009 SITE ADDRESS: 23 CREEK VIEW LANE PORT TOWNSEND, 98368 OWNER: RICHARD B FENLEY PHONE: 360-385-7270 SUSAN I FENLEY 23 CREEKVIEW LN PORT TOWNSEND WA 98368-2536 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001342005 Section: 34 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 DESCRIPTIOI` SWAP OUT 120 GAL PROP TANK - SAME SIZE & LOCATION 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: 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 Bv: Date: Receipt: Approved/Date Propane Tanks/Stoves $55.00 LYK 02/09/09 105362 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 #: BLD09-00033 Received Date 2/9/2009 SITE ADDRESS: 23 CREEK VIEW LANE Issue Date 2/9/2009 PORT TOWNSEND, 98368 APPLICANT: RICHARD B FENLEY PHONE: 360-385-7270 SUSAN I FENLEY 23 CREEKVIEW LN PORT TOWNSEND WA 98368-2536 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001342005 Section: 34 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 pp)) 338g5 Contractor's License SUNSHP*077QP Expires 11/167/2 010-5875 OWNER, RICHARD B FENLEY PHONE: 360-385-7270 if different: SUSAN I FENLEY 23 CREEKVIEW LN PORT TOWNSEND WA 98368-2536 PROJECT DESCRIPTION: SWAP OUT 120 GAL PROP TANK -SAME SIZE & LOCATION Directions SEE DIRECTIONS& MAP 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 2/9/2010. REQUIRED INSPECTIONS: an Line/Appliance: Fin alApprova' 2,)il psi 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 1 • eek vvv.2-ivf / PAik C 0 V kill. (4;:-Alirmd.L °1V c° JEFFERSOWOUNTY 1110 DEPARTMENT OF COMMUNITY DEVELOPMENT `-'r v - ` ''`4 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax gs�N ,�O� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: [Y1 A. ( ' N Project Description (include separate sheets as necessary): fi C--3? //1-7`-€ V 4(_ _ ) — f J/24 O( 6c12 Tax Parcel O 0 / !/� Property ` Number: ! 7` 00 s Size: (acres/square feet) Site Address and/oCire�tiorls to Property: P _ ti Property Owner(s)of Record: ( C.0 Telephone: 3�� - �� 7 Fax: mail: T Mailing Address: Applicant/Agent(if different from owner): S NS pi I NE P R.o PA N E Telephone: 3a5-571 7 Fax: 3BS- 587E email: INFOeSUALSHNE proff4'7c, Mailing Address: I D853 RHOpy D 2. FE. N19O L_Ock LJ R- 9 833'7 coal What kind of Permit? (Check each box tfiat applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use [C(a), C(d),or C]** ❑ Singie Family ❑ Garage Attached/Detached L7 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular ❑ Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business El Cottagelndustry 0 Long Plat** Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management El Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑ 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: 4\ ( c DESIGNATION OF AGENT I hereby designate Su t•1S F) I NE Pt°p A-4-1 to act as my agent in matters relating to this application for permit(s). `OWNER SIGNATURE ("--15ateD /r By signing this application form,the owner/agent attests that t e 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 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. Sf 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 i spections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the a plicati t r s for •dice. ignature: % 1 Date: The action or actions Applicant will undertake as 'result of the issuance of this permit may negatively impact upo 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 S, 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 c pliance with the Jeffers n County development code. The Applicant acknowledges that he,she or it holds individual and nonAransfera ,po s' ility f a ring to an c lyingyvith the ESA. The Applicant has read this discim r n si ns and dates it below. Signature: Date: it 7 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc IBUILDER 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: SIANEH NE Pleo pace (360) 335- 5797 ( 36o) 3Bs-5877 MAILING ADDRESS: )0853 4-00 Y n of U e— P. i-i. EMAIL: 1 n-Eb�sUhsthve Pro Pvn e 6 cool CONTRACTORS LICENSE WAINS NUMBER: 1,(y1s(4 P+ e /�/q q P NUMBER ARCHITECT/ENGINEER: PHONE( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: 0 Sewer 11 Addition ❑ Steel Proposed: Bank ❑ Community System LI Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System 0 Repair ❑ MasonrySEP Permit# Li Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Type of Heat: Proposed: ❑ Private well ❑ Two Party 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 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: Underground Tank I Above ground Tank Size of Propane Tank: 1/4'1-0 6/ - I 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 / 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 Fort Officer Use;Only ,�,,;u , `,=Y.. ,�,,, 4 e.1`o d 1,?' Y ;fit ,o 0Y Main Floor Heated EH Bld App Review: 2nd Floor Heated . Consistency Review: , Other Heated :. Base fee: a3 ' .- Mezzanine A "'i Additional Section: 4 Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Car po,t SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ 5, ` Receipt Number: I CY: CPZ- Cash/Check Number: ESTIMATED COST(REQUIRED) Date: �5 23 •Fair market value of all labor and materials foundation to finish - j Initials: ------(---"2------'D G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc