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Home My WebLink AboutBLD2009-00077 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 #: BLD09-00077 Received Date 3/17/2009 SITE ADDRESS: 301 TALA SHORE DR Issue Date 3/17/2009 PORT LUDLOW, 98365 APPLICANT: MARVIN J OWEN JR TRSTEE PHONE: 360-437-1999 JOAN E OWEN TRUSTEE PO BOX 65301 PORT LUDLOW WA 98365-0301 56 SUBDIVISION: TALA SHORES#3 Block: Lot: PARCEL NUMBER: 998200353 Section: 15 Township: 28N Range: 01 E CONTRACTOR: DAVIS & WINSLOW CONST INC PHONE: 360-434-0422 PO BOX 2709 BREMERTON WA 98310 Contractor's License DAVISWC937DE Expires 3/10/2011 OWNER, MARVIN J OWEN JR TRSTEE PHONE: 360-437-1999 if different: JOAN E OWEN TRUSTEE PO BOX 65301 PORT LUDLOW WA 98365-0301 PROJECT DESCRIPTION: NEW WOODSTOVE 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 3/17/2010. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: � � 3I1 10(1 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 ILDING PERMIT APPLICASN B RDO9-00eview 0e77 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00077 Received Date: 3/17/2009 SITE ADDRESS: 301 TALA SHORE DR PORT LUDLOW, 98365 OWNER: MARVIN J OWEN JR TRSTEE PHONE: 360-437-1999 JOAN E OWEN TRUSTEE PO BOX 65301 PORT LUDLOW WA 98365-0301 TALA SHORES#3 SUBDIVISION: Block: Lot: 56 PARCEL NUMBER: 998200353 Section: 15 Township: 28 N Range: 01 E CONTRACTOR: DAVIS &WINSLOW CONST INC PHONE: 360-434-0422 PO BOX 2709 BREMERTON WA 98310 Contractor's License DAVISWC937DE Expires 3/10/2011 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW WOODSTOVE 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 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 $142.00 KAS 03/17/09 10573 Total: $142.00 • 0 [Jl! 1 ��,SoN O6� JEFFERSCWOUNTY • , \g DEPARTMENT OF COMMUNITY DEVELOPMENT '' 4 P4 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • kgS, G p� www.co.jefferson.wa.us/commdevelopment360/379-4451Fax Master Permit Application MLA: l\t) (14A EEG '_N Project Description(include separate sheets as necessary): ;,s 7`r 1 wvoc( .do VC_ tN 4/s4,- f./eztK,c. AeAAcl way sl,or Tax Parcel Number: ClezV$ 2 by - Property Size: (acres/square feet) Site Address and/or Directions to Property: Sot 711414 S ‘c�( .0,r RJrt1-tid/v Property Owner(s)of Record: / .A...t,Al 1-.t-"43.-_, t-J o a..+ €I ic.4 0-,'f--•'Tir4-+s"t' Telephone: 3 L D tf 3 7 —M e7 Fax: email: Mailing Address: 00 3 oX 6 S 3o I to tr L_.-1140W , J„4 A- /834S-63r, I Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ,Building ❑ Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) 0 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** it<_ ❑ Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities).** ❑ Change of Use 0 Boundary Line Adjustment j' ';i', 1 7 2C_ J,; ❑ Address 0 Road Approach 0 Short Plat** ❑ Home Business ❑ Cottage Industry 0 Binding Site Plan** ❑ Propane ❑ Long Plat** I frrpslP}0 ['nul,,•� ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** LI Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Forest Practices Act/Release of Six-Year Moratorium 0 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 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 accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and rig try to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspec' ns. Sta ccess and ' ht of entry will be assumed unless the applicant informs the County in writing at the time of the ap at he or sh ants pri noti . Signature: ,...„,„____ ,.6J4_ Date: kl'''Ait A.,1 C1 The action or actio Applicant w I�iU ndertake as a result of 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 th&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 complian with itte4efferson my development code.The Applicant acknowledges that he,she or it holds individual and non-transf: 1,.:'- !.4.nsibility or dheri tr:i d co p ing with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ^--.i 42 44, Date: Z / ��dt�A, )t, �U c) / 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 MANUFACTURED HOME INSTALLER: PHONE: FAX: / 641-';5 4 l },( :kis/ax. t�04sir —Tl/c-I,a, c- (36 ) 6Z 3SL o- � ( ) MAILING ADDRESS: z 43‘ L c c C{, Po,-} vrc 4c,✓ i EMAIL: CONTRACTOR'S LICENSE tit/G( �l'l 3- ' WAINS NUMBER: D4vi IA'C ,370E NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition LI Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ 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 r 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 Is this appliance being instal e a anufactured/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 BId App Review: 2"tl Floor Heated Consistency Review: Other Heated Base fee: 1�Y ,W�h tUQb L-� v L. `t Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 14a.c) Decks 911/Rd Approach fee: Other TOTAL: $ z4-a£0 Receipt Number: I Ct5-13 Cash/Check Number: 1 pI ESTIMATED COST(REQUIRED) Date: �MI ' •Fair market value of all labor and materials foundation to finish I Initials: /---'^ - ___' G:\PemvtCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc O m 0 r z 3 rn x a °0 m N � r *� • W �J m T— v m v � Q ccn cn c a O rn v i 0 1/4 Cb rn cn cn 9 O co rn O m rn c O 1 -o a v