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Home My WebLink AboutBLD2009-00036 �UILDING PERMIT APPLICaON B RDO9-00eview 0e36 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00036 Received Date: 2/10/2009 SITE ADDRESS: 175 JOLIE WAY PORT TOWNSEND, 98368 OWNER: LANCE RENNIE PHONE: 360-385-5356 TRACY RENNIE 175 JOLIE WAY PORT TOWNSEND WA 98368-9009 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001071012 Section: 7 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: PHONE: PROJECT DESCRIPTIOI NEW HEAT STOVE & GAS PIPE TYPE OF WORK NON SQUARE FOOTAGE TYPE OF IMP NEW MAIN: VALUATION CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORI•S: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIG T: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid Bv: Date: Receipt: ifs ved/Date Propane Tanks/Stoves $110.00 LYK 02/10/09 105370 AtOVErR Total: $110.00 EB le 2009 Jeffer on County Plannin1 &B ilding Department . 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 #: BLD09-00036 Received Date 2/10/2009 SITE ADDRESS: 175 JOLIE WAY Issue Date 2/10/2009 PORT TOWNSEND, 98368 APPLICANT: LANCE RENNIE PHONE: 360-385-5356 TRACY RENNIE 175 JOLIE WAY PORT TOWNSEND WA 98368-9009 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001071012 Section: 7 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 1/17 201 0 5875 Contractor's License SUNSHP"`077QP Expires 1 / OWNER, LANCE RENNIE PHONE: 360-385-5356 if different: TRACY RENNIE 175 JOLIE WAY PORT TOWNSEND WA 98368-9009 PROJECT DESCRIPTION: NEW HEAT STOVE& GAS PIPE 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 2/10/2010. REQUIRED INSPECTIONS: Tank/ ine/Applianc (Ei1O9 FinalApproval:, L- '3 1 3\OcA 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 SITE VISIT REPORT (PLOT PLAN) JOB Z-A•O C mF- 7 �u/V/E DATE : / 4/ I CONTACT: ADDRESS PHONE #: DIRECTIONS FAX #: Email _ PLANNER: �\ n 19 °I 4, I �x►sT+�t i VIDE 4 IOb V l00/L00 3NHd0 d 3NIHSNfS c 89;8E03E XVJ E9:9L 600VOL/C0 ��¢soN cow JEFFERSONOUNTY • ti \,� DEPARTMENT OF COMMUNITY DEVELOPMENT �`� = `'`'' 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax IS p5 www.co.jefferson.wa.us/commdevelopment ZIING Master Permit Application MLA: jQ f 11LA. 'Cc L, ' ) Project Description (include separate sheets as necessary): _ Tax Parcel 0a ( D 7 / D l Property Number: Size, (acres/square feet) Site Address and/or Directions to Property: /7 o L/ e_, G( io/ c c-Dwru fi . ��a Property Owner(s) /`�of Record: L ''t C-Q ` / / 6./7,7/-e Telephone: . V,7-S3.3'67 - Fax: _ email: Mailing Address: LcZQ, Applicant/Agent(if different from owner): S u-/VS N I N E P RiD ', A N E Telephone: 395-5717 Fax: 33S' SO'7S _ email: (NFoe$uNSN/NE ProeAve• Mailing Address: I OS53 RRoDy A e- / P i. NF}D►--oc% F9- 9 p 33� �►,-, 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 Cj** ❑ Singie Family ❑ Garage Attached/Detached L_I Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular ❑ Special Use (Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business El Cottagelndustry ❑ Long Plat** Propane El Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** 0 Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance 0 Temporary Use ❑ ComprehenE.ive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment 0 Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *May require a Pre-Application Conference **Requires a Pre-A..lication Conference Please identify any other local, state or federal permits required for this proposal, if known: oe DESIGNATION OF AGENT \ S I hereby designate L(N IS I-) I N PR-0 EP An�- -to act as my agent in matters relating to this application for permit(s). `�WNER SIGNATURE S4E-''k - --t `'' _ / Date: , -- I 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 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 snit 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 U 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 pligation that he or she wants prior notice. ignature 1-4, 0,—.._,,,..,. - `f • -•---- (� ' Date:> , (`�c-1 The action or actions Applicant will,ndertake 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 nonLansferrable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature.__) `— Date: 2 6 G:APenotCenter\###FORMS###\DRD FORMS\Master Permit Application 1 2-19-2006.doc • BUILDER STATEMENT • The sig,er of this statement does hereby^ertify that they are the Owners of the parcel refe enced 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: SOIS2H INk: P20 pan , (B60) 385- 571 ( 360) 385-5875 MAILING ADDRESS: 1 O 85J .4}co y I U e- at.L. EMAIl.: 0 n-Fp(�sL '1sHIV1e Pro Paine 6 can CONTRACTOR'S LICENSE t WAINS NUMBER: 5UhS 4 P+ 077 E7 Q fJ NUMEIER ARCHITECT/ENGINEER: PHONE ( ) FAx: ( ) MAILING ADDRESS: EMAIL Oroject Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New ❑ Wood Existing: _ II Sewer O Addition ❑ Steel Proposed: - Bank ❑ Community System ❑ Alteration/Remodel LI Concrete Total: - Height: i I Individual System n Repair n Masonry SEP Permit# O Demolition ❑ Other: Bedrooms: Water Supply: Existing: _ Setback: Li Private well 0 Two Party Proposed: _ Li Public Type of Heat: Total: _ Name of System: f this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: `umber of occupants(includes owners,tenants,employees etc) Current Proposed BC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No f 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 Heat Stove I Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other 0 p lance 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, lincluding the reserve area. Square Footage Current Proposed .For Office;Use.Only ,' . Amount , Reyiel~ .1 , Main Floor Heated EH Bld App Review: 2n°Floor Heated Consistency Review: Other Heated Base fee: I �. l Mezzanine Additional SectiDn• Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carpoi i SUBTOTAL H0 Decks 911/Rd Approach fee: Other TOTAL: $ l O Receipt Number: I 6 .3-10 Cash/Check Number: CO ESTIMATED COST(REQUIRED) Date: h .Fair market value of all labor and materials foundation to finish C�(.'-t Initials: h G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc