The URL can be used to link to this page

Home My WebLink AboutBLD2009-00333 • • 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 #: BLD09-00333 Received Date 10/1/2009 SITE ADDRESS: 140-4 HIGHLAND GREENS Issue Date PORT LUDLOW, 98365 10/1/2009 APPLICANT: THOMAS J SATRE PATRICIA J GRIFFIN SATRE PHONE: 907 732 3270 PO BOX 35422 JUNEAU AK 99803-5422 SUBDIVISION: HIGHLAND GREEN CONDOMINIUMS Block: Lot: PARCEL NUMBER: 959500016 Section: 21 Township: 28N Range: 01 E CONTRACTOR: EVERWARM INC PHONE: 257151 HWY 101 (360) 452 3366 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 8/17/2010 OWNER, THOMAS J SATRE PHONE 907-732-3270 if different: PATRICIA J GRIFFIN SATRE PO BOX 35422 JUNEAU AK 99803-5422 PROJECT DESCRIPTION: REPLACE WOOD BURNING FIREPLACE W/WOOD BURNING Directions STOVE 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 10/1/2010. REQUIRED INSPECTIONS: Tank/Lin Appliance: / ✓l t p f5::, FinalApproval: /V ' / / 0/ 1(41>'7 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 •UILDING PERMIT APPLICASN BLD09-00333 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00333 Received Date: 10/1/2009 SITE ADDRESS: 140-4 HIGHLAND GREENS PORT LUDLOW, 98365 OWNER: THOMAS J SATRE PHONE: 907-732-3270 PATRICIA J GRIFFIN SATRE PO BOX 35422 JUNEAU AK 99803-5422 HIGHLAND GREEN CONDOMINIUMS SUBDIVISION: Block: Lot PARCEL NUMBER: 959500016 Section: 21 Township: 28 N Range: 01 E 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 DESCRIPTIOt REPLACE WOOD BURNING FIREPLACE W/WOOD BURNING STOVE TYPE OF WORK NON 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: GARAGE: SHORELINE CONST TYPE: SETBACK: DECK: 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 LYK 10/01/09 11'1047 Total: $142.00 C. l I.A 1, s -14 e- -9 [—lJVL O Gee ` O i 5f"-)D 0_ P r I , . 1 2) b-\j\f\ JN"-to s roA a P ' pc V 0 Pi- PA-,--,,ki 0 4\°()\4d\- I i °N Cyr,, JEFFERSONtOUNTY • ' 4;4 DEPARTMENT OF COMMUNITY DEVELOPMENT �. 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax •.487N DSO www.co.jefferson.wa.us/commdevelopment G Master Permit Application MLA: k_, III f t Proj t Description(include separate sheets as necessar y): I p Oe - (r 9Iczc.l` c4 (k,hrAcj-rnE, Tax Parcel Number: q` c C C) i(c' �r� Property Size: i s 6 1-4-(acres/square feet) Site Address and/or Directions to Property: NO --y VA-Iv &'r-'l' G • A,�.,s J9p Property Owner(s)of Record: -6,70IAA 4N Pr AilPA 1Q t ( , A cee} Z Telephone: Ip1-1%)3 ,33)0 Fax: Mailing Address: 'ID—`( l-}tL. O email: , I Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family ❑Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** I ❑ Commercial ❑ Manufactured* Home . 0 Modular - 0 Discretionary"D"or Unnamed Use Classification 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address ❑ Road Approach 0 Short Plat** ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** D Propane ❑Sin 0 Long Plat** y 0 Planned Rural Residential Development(PRRD)/Amendments** ❑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 ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request tion Conference Please identify any other local,state or federal permits required for th s proposlal,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 pro access an ' t of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and an requir d I er ins ctions. taff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the app t r s w t ri r notice. Signature: _...- - I� Date: r 0 1 c! 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 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 non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: G:\PemvtCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • BUILDER STATEMENT The signer of this state t does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be ass ing t r ponsibilitf 't e General Contractor for the proposed project. Signature: \ Date: - 1-6 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: : 4-SOL 3i/_ , MAILING ADDRESS: 9.S 1 IS i Hw'f I 01! f)11 Aft"t -msEma4 P.tAthvJ 04-on e 0 y pvz) ICE WAINS /� 01 J 76 \ (� 1 � CONTRACTOR'S LICENSE 1�/ NUMBER l , NUMBER: E if- 0 `* ( NL PHONE ( ) Fes'( ) ARCHITECT/ENGINEER: EMAIL MAILING ADDRESS: of Sewage Disposal: Frame Type: Bathrooms: Shoreline: Type9 P Project Type: CI Wood Existing: ❑ Sewer 0 New ❑ Steel Proposed: Bank ❑ Community System ❑ Alterati Total: _ Height: ❑ Individual System ❑ Alteration/Remodel ❑ Concrete SEP Permit# ❑ De ❑ MasonryBedrooms: Water Supply: Demolition 0 Other:her: Existing: Setback: ❑ Private well ❑ Two Party Proposed: ❑ Public Type of Heat: Total: Name of System: t \ 1c If this is a Commercial Project you must answer the following: Number of ADA Parking Spaces: Number of Parking Spaces: Current: Proposed: 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 1 Above ground 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 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 For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2"tl Floor Heated Consistency Review: Other Heated Base fee: / Additional Section: Mezzanine Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: SUBTOTAL Garage/Carport 911/Rd Approach fee: Decks Other TOTAL: $ (L Receipt Number: 1 1 \0t_I1 Cash/Check Number: n j ESTIMATED COST(REQUIRED) Date: 11 __` •Fair market value of all labor and materials foundation41000 0 o0 , k finish Initials: G:\Perrnitcenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc