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Home My WebLink AboutBLD2010-00105 0 • 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 #: BLD10-00105 Received Date 4/8/2010 SITE ADDRESS: 1110 PROSPECT AVE Issue Date 4/8/2010 PORT TOWNSEND, 98368 APPLICANT: LANCE ROSMAIER PHONE: 360-385-2638 DONNA ROSMAIER PO BOX 1197 PORT TOWNSEND WA 98368-0997 1-8+ SUBDIVISION: IRONDALE Block: 140 Lot: PARCEL NUMBER: 962114001 Section: 35 Township: 30N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, LANCE ROSMAIER PHONE: 360-385-2638 if different: DONNA ROSMAIER PO BOX 1197 PORT TOWNSEND WA 98368-0997 PROJECT DESCRIPTION: NEW PELLET STOVE INSTALLATION 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 4/8/2011. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval. q-?�-'.-i 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 APPLICAI)N BRD10 001eview p05 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00105 Received Date: 4/8/2010 SITE ADDRESS: 1110 PROSPECT AVE PORT TOWNSEND, 98368 OWNER: LANCE ROSMAIER PHONE: 360-385-2638 DONNA ROSMAIER PO BOX 1197 PORT TOWNSEND WA 98368-0997 IRONDALE SUBDIVISION: Block: 140 Lot: 1-8+ PARCEL NUMBER: 962114001 Section: 35 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW PELLET STOVE INSTALLATION TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: 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 LYK 04/08/10 117537 Total: $142.00 • --� 3 2'-a,! • • / / N cri 8. xO < xOD y � oS'. O 03K —< I �Q Z -.� -V 0 om �o z r�0 al _ H ; i . x 0 09. :\ IihilX, U x:+ as A _ �+ f tj < t 1. 0 _, (-.) .inh ..'...!:,:',,.-:Nis.: . zi.-.:-c.:,i.,: ,---i r"----\\\\,\:,,.1,\.\\,,,,.\\\\`;°4":'\471*• o uv- „...:,,.,„, ..:,,,:,,,,,,,T ,....,,,,, ,_ , , ,,,,, \ , ,,,,,„",,,,:„..- .. ..„, : 0,...,,,,,„:„,,„.,. j ,.... . 5. _... \ Y) O V C N DDO ti X 611--- R3 0 /11 S ,.1 0� j 6 • • z i 0 ' iN/ 0 9 u Ri �I nr Uz` "I. r n, .t c 1> F.i RI • n -- ' - r- ni ni d i kciq _,9.--- ,..._ G tt ° (�i t \ ._/ 1-. ), e ti , .) vi, \ .), \ . , 1 L. IJ • F- 23'= 4c �44i ox` °L JEFFERSO UNTY • W • ,� DEPARTMENT OF COMMUNITY DEVELOPMENT in A, `'C 621 Sheridan Street • Port Townsend •Washington 98368 360/379 4450 • • �qp� www.co.jefferson.wa.us/commdevelo360/379-4451Faxpment HIrT Master Permit Application MLA: f p L C' Project Description(include separate sheets as necessa T-rwska I l I-a.11« SE /a 1-w-a-1 Tax Parcel Number: 962.1140o1. Property Size: 21.4400 5.f: (aeres/square feet) Site Address and/or Directions to Property: .1..1.E+ ►-bsec c-A,/• t—'nr4 TOMMs�nd Property Owner(s)of Record: Lane �S • +- m as 14t„ 7�-/ ::.n via. jarYia i,z,r. Telephone: �J(co ' 385 2 :::, Fax: vb/ e email:bnc.z.n. .,rra i,c.(- h ma1(,cr=r Mailing Address:lG+3o)c Lie/ ?oval..7q„f �oI WA 98 Applicant/Agent(if different from owner): Sc341,1 ¢. Telephone: — Fax: email: --c Mailing Address: — Wh t kind of Permit?(Check each box that appliesril ❑ Lot or Road Segregation Iding 0 Demolition Permit 0 Critical Areas Stewardship Plan ❑Variance(Minor, Major or Reasonable Economic Use) 0 Single Family ❑ Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed Use Classification � 0 Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** 0 Propane ❑Long Plat** ❑ Sign • ❑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 ❑Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 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 rigs of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any re.'.d later inspectStaffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the a-p {��• that he or st ,a prior notice. ��jj ignature: d C?— Date: in; ��" 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 tederal 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 SA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you in compliance the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual . dad non-trap sponsibility for n g to and complying with the ESA. The Applicant has read this dAIa r and signs and dates it below. ✓ Signature: Date: r f -z‘:)14E) G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • • BUILDER STATEMENT The signer oft,�.tatement doe reby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will .- -:••. •_ing the resp:d of the General Contractor for the proposed project. ! Signatu �� Date: � �� A GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PFIONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER • ARCHITECT/ENGINEER: PHONE ( ) , . . . ENS:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ri New ❑ Wood Existing: ❑'Sewer . ❑ Addition ❑ Steel, . ,Proposed: , Bank , • ❑ Community System Total: Height: ❑ Individual System ❑ Alteration/Remodel ❑ Concrete y ❑ Repair ❑ Masonry SEP Permit# Demolition ❑ 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 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: 2nd Floor Heated Consistency Review: Other Heated Base fee: 42 Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL i , 1 Decks 911/Rd Approach fee: Other TOTAL: $1 -- Receipt Number: 1 I-15 Cash/Check Number: (72 ESTIMATED COST(REQUIRED) Date: , •Fair market value of all labor and materials foundation to finish Initials: • G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc