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HomeMy WebLinkAboutBLD2009-00130 • ! 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 #: BLD09-00130 Received Date 4/28/2009 SITE ADDRESS: 102 DENA LN Issue Date 4/28/2009 CHIMACUM, 98325 APPLICANT: WILLIAM TOLF PHONE: 360-732-0993 LINDA TOLF 102 DENA LN CHIMACUM WA 98325-7710 12 SUBDIVISION: BISHOP HEIGHTS DIV II Block: Lot: PARCEL NUMBER: 933500012 Section: 35 Township: 29N Range: 01W CONTRACTOR: EVERWARM INC PHONE: (360) 452-3366 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 8/17/2010 OWNER, WILLIAM TOLF PHONE: 360-732-0993 if different: LINDA TOLF 102 DENA LN CHIMACUM WA 98325-7710 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 4/28/2010. REQUIRED INSPECTIONS: Tank/Lin e/Appliance:_ C FinalApproval: C-SM0c1 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 BLD09-00130 itUILDING PERMIT APPLICA N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00130 Received Date: 4/28/2009 SITE ADDRESS: 102 DENA LN CHIMACUM, 98325 OWNER: WILLIAM TOLF PHONE: 360-732-0993 LINDA TOLF 102 DENA LN CHIMACUM WA 98325-7710 BISHOP HEIGHTS DIV II SUBDIVISION: Block: Lot: 12 PARCEL NUMBER: 933500012 Section: 35 Township: 29 N Range: 01 W CONTRACTOR: EVERWARM INC PHONE: (360) 452-3366 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 8/17/2010 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW WOODSTOVE TYPE OF WORK STV SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 C—TE34:11 �---D� Routing Dat Type Amount Paid By: Date: Receipt: t Permit $142.00 LYK 04/28/09 108353 p Ov EE Total: $142.00 ." Jefferson County Planning &Building Department 04/27/2009 15:29 3E0379111 JEFF CO PERMITC4WR PAGE 01/02 190© JEFFERSON COUNTY 11k% DEPARTMENT OF COMMUNITY DEVELOPMENT 0 621 Sheridan Street• Port Townsend•Washington 98368 � y A, 360/379 445O. 360/379-4451 Fax •coje rson.wa.us/commdeveiopment Master Permit Application MLA: k_( I 1 it_/1 t 1`` Project Descriptionjj (include separate sheets as necessary): 4/,STY_/kt k r+ -�1„es Tax Parcel Number. /33,E7jC1D /Z Property Size: .,5- C/c re s (ecres/square feet) Site Address and/or fractions to Property:. 102 LA--) a ,h $ . Property Owner(s)of Record f 4 Telophone:(71,C) '1_7,1-C'J%.'S Fax: email: Mailing Address: IC 2. j)•r',-Lei L p Yl e ( J ,J116_L4vr.-',, CO 4 l '3.,�-j Applicant/Agent(If different from owner) Telephone: Fax: email: , Mailing Address: . . : - What kind of Permit?(Chet*each•boic that applies El Lot or Road Segregation - JBuilding 0 Critical Areas Stewardship Plan /1I Detholition Permit 0 Variance(Minor,Major or Reasonable Economic Use) 0 Single Family 0 Garage Attached.!Detached U Conditional Use[CO),C(d).,or C]""" �p 2 a 2009 ❑ Manufactured Home, , :_0Modular 0 Discretionary"D"or•Unnamed Use Cias�ril c ion O Commercial" ❑Special Lite(Essential Public Facilities)'" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address , O Road Approach 0 Short Plat'" ❑Home Business 0 Cottage Industry Ci Binding Site Plan"* la Propane I0 Long Plat** ❑Sign - ' • • 0 Planned Rural Residential Developrnent(PRRDy/Amendments" ' ❑Allowed'Yes"Use Consistency Anaiysls CI Plat Vacation/Alteration"** O Storhawater Management ❑Shoreline Master Program.Exernption/Permit Revisions"* D Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial bevelopment*" C1 Temporary Use 0 Shoreline Management Valiance ❑Wireless Telecommunication" 0 Comprehensive Plan/UDC/Larid Use District Map Amendment E1 Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County,Shoreline Master Program Amendment May require a Pre-A pplleatlon Conference 0 Tree Vegetation,Bequest "RequrresaP.ra-Applldatiorf 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 appllcctlon 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 rasped 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 atterney's fees and eicpenses which may in any way accrue against Jefferson County as a result of orin consequence of the granting of this permit. I further agree to provide atxess and right of entry to Jefferson County and.Its employees,representatives or agents for the sole purpose of application review and any required ter Ins •ctions. :Staffs and right of entry will be assumed unless the applicant Informs he County i writing at the time of the appffCatioit(b he he Wa prior riot i� �� -- Signature: �- % late: The action•or actions Applicant will undertake as'a result of the I Suanee.of.this permit,may negatively inhpact upon'onB,or mo threatened or endangered species and could lead to a potential."take"of an endangered species as those terms'ate 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 becauaethis permit has been Issued will not violate the ESA. Any.Individual,group orragency can tile a lawsuit on behalf of art endangered species regarding your action(s)even if ye are In compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-t sfe responsl•ilIty fora and camplyih th the'•SA. The Applicant has read this disci ' snot signs rid dates it beiow. C�' _ � / ' T— Signature: � � )---�--� --__ Date: � 2-4)/ 2 UYi 04/27/2009 15:29 360379.1 JEFF CD PERMITC•R PAGE 02/02 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 win be asuming the responsibility of the General Contractor for the proposed project. Signature: . Date! . GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: e e wc.�r wi , .i_rl C' • L (340 z/S�-33 ( ) MAILING ADDRESS: a,j-7/.S 1 y i d I 1 T a i 3 EMAIL: CONmACton'S LICENSE �"(� n / _ p^! J �,v,„,,WAINS NUMBER: L CJ r1�r.(,�i. Q R 0/ f— / NUMBEq ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL • Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New ❑ Wood Existing: o Sewer C Addition ❑ Steel Proposed: Bank. LI Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 0 individual System ❑ Repair ❑ Masonry SEP Permit.' ❑ Demolition oother; , Bedreomst Water Supply: Existing: Setback 0 Private Well ❑ Two Party Typeof Heat: Proposed: 0 Public Total: _ Name ofSystem:- yells-is a Commercial erolactyou must answer the following Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(include9 owners,tenants,employees,etc) Current. Proposed - • IBC Occupancy: • IBC Type of construction: Will you have Foodtervice? leas / No _ if this Is a Propane Tank andlorAppliance installation Permit,mark all items-beltwv that aoolir; I Underground Tank t Above( Size of Propane Tank: I Heat Stove I cook Stove I Woodstove 1 Fireplace Insert I Hot Water Tank I Pellet stove. I Other Ls_t is_appliance helot'.fnstailed_in a Manufacturred/Mobile Horne? Yes / No ' When applying for a pahrit'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. ` ,Vr ^, t, rt i�i1 iSf'1�'h'�I`�V 7�i r y} i ,I��'i�yr,r Yht' 1 ,�, *� qy'7 A^,t4 f,�4 �,K'^T`,,y �,r?,rr '�, 1 �tk rr i�`��,a4 1 lt, ��'' �F,Lrr 1 qi�}5,;I:MIN 1,71 N} S•uarm FObta:a Current PrO•osbd '� ' F' nk�, Nt: i� rtr 1 iiVeliW�,k r,'fd,.�`�1�'� I `i it li ' `ft ,rrt9tlri' ai of n I 4 ..�,.... �...}.,l/M I W.v.'1.15 N ku�rn�Yl^rt 1 . r r ..1111i.,�w{ .1.1.A'41N�)iHw u[�1n.�1 Main.Fleur Heated k')4- , .EH Bid App Review: r 2'i Floor Heated t�i'; °'r'` ` Consistency Review APR 8 Other Heated 4u" iiN t4� rt} 4, Base fee: Mezzanine -4"' o "�°'� Additional Sectiond. : Heated Basement W ;i:, 1. '�' Plan Check fee: 4(,1%,,rai` 'j'.r' Unheated Basement i n?q,,Drn 5 ;t,...: State Surcharge fee; ' Ogler l)rifyeate5 "` Pot Water Review fee: Garage/Carport P���t• '• t;;,•,,-' t SUBTOTAL "— Decks ;,F1n. t kYs r" 911/Rd Approach fee: Other ^IR ";,V:4; TOTAL $' 4' b �LI 2••— [ lI"�hi"lip`ti' f� ,,,,,of rP `,. v Receipt Number: 1 ,1C �� fi iF , d�r,t�, `Cash/Check NumibOn t t,1JC�. rit ti,$,•,4"'AMA ,h'L v I ti� . ESTIMATED COST(REQUIRED) T Date: . «Fair morkot value of nil ld;borand meterfals follOckdon to frhlsh A-Z8-0� Initials: � GAPermitCcnteA#f#VORMS#N4ADRI)POWS1Cucrcnt i]RD Porm\Meow'Prr/nir Anrd:'..1:—e_m_no ,. y ---___.. ...... 4,„.... .0.4. 1! I 1 1 \\ I i I' — __,___ . , .. 1 1 i . 1 — 1 I , ... _____ . _ (2) 3 I 1 . Cs..1 CL_ -cz i I 11 _ -- _ I _ 11 ....,—.__ 1 i 1 , ,