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HomeMy WebLinkAboutBLD2009-00157 ! • 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 #: BLD09-00157 Received Date 6/1/2009 SITE ADDRESS: 70 LAUREL ST Issue Date 6/2/2009 PORT HADLOCK, 98339 APPLICANT: PATRICK D WAIT PHONE: 360-379-4990 MARY L WAIT 70 LAUREL ST PORT HADLOCK WA 98339-9720 25 SUBDIVISION: PORTAGE BAY PARK Block: Lot: PARCEL NUMBER: 989100019 Section: 6 Township: 29N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 p) 3g5 Contractor's License SUNSHP"077QP Expires 11/((33 67/2010-5875 OWNER, PATRICK D WAIT PHONE: 360-379-4990 if different: MARY L WAIT 70 LAUREL ST PORT HADLOCK WA 98339-9720 PROJECT DESCRIPTION: A/G 250 GAL PROP TANK& GAS LINE 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 6/2/2010. REQUIRED INSPECTIONS: (Tank/Line/Appliance: _ FinalApproval: Lo 3 � BUILDING INSPECTION HOT-LINE 379-4455. 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 •UILDING PERMIT APPLICASN B RDO9NOOp157 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00157 Received Date: 6/1/2009 SITE ADDRESS: 70 LAUREL ST PORT HADLOCK, 98339 OWNER: PATRICK D WAIT PHONE: 360-379-4990 MARY L WAIT 70 LAUREL ST PORT HADLOCK WA 98339-9720 PORTAGE BAY PARK SUBDIVISION: Block: Lot: 25 PARCEL NUMBER: 989100019 Section: 6 Township: 29 N Range: 01 E 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 DESCRIPTIOP A/G 250 GAL PROP TANK & GAS LINE 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 By: Date: Receipt: �prove ate Propane Tanks/Stoves $142.00 LYK 06/01/09 108525 A P ®v E r Total: $142.00 JUN cR ( 'Jefferson County Planner & Building De]artm, 1 r . 110 fil • ..•.. • SITE VISIT REPORT . .,,. , (PLOT PLAN) DATE , .- e-r(L‘c,i< --, 1Y\P Q-'••? U3A ir : /,.; //0/ft;5/ . , CONTACT: SS 7 LS\ )1Q.E;(— ''r, 74-, 0140 L c)(A PHONE #: . TIONS FAX Email PLANNER: '5) --- ( 8c) IP i ----------> (r : 0 0 I1 t cc LI., . "- a... : '1( , r\Q 'Th• , , 1 . v.e'a." v . , 4° itiN -- 1 2009 \o" V rillk46; ocO JEFFERSO COUNTY 4 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax O www.co.jefferson.wa.us/commdevelopment TNQtr, Master Perr it Application MLA: I�� 4 Project Description(include separate sheets as necessary): SD , c_ s Tax Parcel Property Number: 9 / 00 o / Size: (r. es/square feet) Site Address and/or Directions to Property: 7 D L a-u,r-e S , , lar • {1 �� f(F33 - Property Owner(s)of Record: 47724 Lie— s MAC' 1; Telephone: I _ C4,6 -2 e - if 9O Fax: email: Mailing Address: /5 — Applicant/Agent(if different from owner): S U_MS II IN E P f .o PA N E Telephone: 395-579 7 Fax: 3BS-5-S7S email: INFcgSuAisHnJEProem-2e. Mailing Address: 10853 SHOpy D 2• / PE. 1-160 LOCk , 1�7 R- 9 833`j .0'"` What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor,Major or Reasonable Economic .:se) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** 1 .......... S• ingle Family 0 Gatage -AtFached[Detached 0 Discretionary AD-*or Unnamed-Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use El Short Plat** ❑ Address ❑ Road Approach 0 Binding Site Plan** ❑ Home Business ❑ Cottagelndustry 0 Long Plat** Propane 0 Planned Rural Residential Development(PRRD)/A6endments** 0 Sign 0 Plat Vacation/Alteration** 1 ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revjeions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 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_praposal, if known: )t 0 DESIGNATION OF AGENT \�I hereby designattee\014&IS E P�P A4'1t to act as my agent in matters relating to/this application fear permit(s). 1�WNER SIGNATURE i C GiGG� (�('4�� (Date di' -- 1- ci By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correc 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 liabilities,judgments,court costs,reasonable attorney';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 I U review and any required ldo' .ections. Staffs,accesss and right of entry will be assumed unless the applicant informs the County in writing at the time of the a plication thhe wants prior etire. ignature: �[— G C/ Date: 6, —.l— )-(1):)(I 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 +s the I\t "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 pli nce with the Jefferson County development code.The Applicant acknowledges that he,she or it hold.individual and non- ansferable re ns' - y for adh erin to a complying with the ESA. The Applicant has read this disclaimer and signs and dales it below. ignature: _ Date: l 2-i' �f G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc `t,i 40, BUILDER STATEMENT The signer of I's statement does hereby j.ertify that they are the Owners of the parcel referenced herein,that they are not licens: contractors and that they will be a3'uming the responsibility of the General Contractor for the proposed project. Signature:_ Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: SO Q H jNl:, P20 pa� (O) 3�35- 5797 ( 360 3B5-5875 MAILING ADDRESS: Y n�i v e_ P. L. CONTRACTOR'S LICENSE 1 � 11 r �� n �SU✓1s}11v►t p�'o pc 6 p(11 n WAINS NUMBER: u hs14 Pf DIN l Q P NUMBER ARCHITECT/ENGI:JEER' PHONE( ) FAX: ( ) MAILING ADORE:, : EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sew-:ge Disposal: 0 New 0 Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Communit; System ❑ Alterationrr._model ❑ Concrete Total: Height: ❑ Individual system ❑ Repair ❑ Masonry SEP Permit ❑ Demolition ❑ Other: Bedrooms: Water Supp; Existing: Setback: Type of Heat: Proposed: ❑ Private w ❑ Two Party Total: ❑ Public Name of Sys n: 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 Prop 4:ie Tank and/or Appliance Installation permit,mark all items below that apply: j Underground T;:nk I Above ground Tank Size of Propane Tank: -.S' 0 ce-- Z1 _ I Heat Stove t nook 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 applyins tar a permit to install a propane tank you must also submit a site plan showing all of the buildi' :is,all property lines, tank loca:-on and size, distances from the propane tank to all property lines,buildings and septic systed;.components, including the rrse,ve area. ritaVilM:I,.W..:V!.•64"7411WD7Z'11:' '!cl.7 S•uare Footav Current Proposed :''©4p ,��.. k r1 2 , o IsarFrZiCMN,, . }u. ,I a*,,74 1^ G Main Floor Heated U aR } ''.� a �rst~ �i EH Bld A Review: " PP 2 Floor Heated kYr":�' ." Consistency Review: aelIt.f Other Heated ., t".:F,. ^' 1.� Base fee: rMIN Mezzanine ,� F0:' ,i; Additional Section: IIIk,:" Heated Basemen( s: F � �4•"' •v Plan Check fee: 84 Unheated Basemel't ! * e, A. State Surcharge fee: Other Unheated ,.r , l' Pot Water Review fee: Mi Garage/Carport "1 M kz SUBTOTAL ,�,:., ire ,•,' 6'Tw ,T.r- Decks _ 5 911/Rd Approach fee: Other , Y, 3 �� y ,•;�x � TOTAL: u'a7 i74.6.1 `��• ' f �, Receipt Number: OF k t tr r,1 Cash/Check Number: ESTIMATED COST(REQUIRED) Date: NI•Fair market value of all labor and materials foundation to finish 0 Initials: _ G:\PermitCenter\###FOI,'IS###\DRD FORMS\Master Permit Application 12-19-2006.doc I