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Home My WebLink AboutBLD2010-00112 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 #: BLD10-00112 Received Date 4/15/2010 SITE ADDRESS: 870 OLD GARDINER RD Issue Date 4/19/2010 SEQUIM, 98382 APPLICANT: DONALD ISLEY PHONE: 425-281-8881 REBECCA ISLEY 824 BENT CREEK DR FORT PIERCE FL 34947-1325 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002331020 Section: 33 Township: 30N Range: 02W CONTRACTOR: EVERWARM INC PHONE: (360)452-3366 257151 HWY 101 PORT ANGELES WA 98362 Contractor's License EVERWI*088NL Expires 8/17/2010 OWNER, DONALD ISLEY PHONE: 425-281-8881 if different: REBECCA ISLEY 824 BENT CREEK DR FORT PIERCE FL 34947-1325 PROJECT DESCRIPTION: NEW HEAT STOVE 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 4/19/2011. REQUIRED INSPECTIONS: Tank ine/Appliance FinalApproval: -- }41\Io 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 APPLICAN BLD10-00112Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00112 Received Date: 4/15/2010 SITE ADDRESS: 870 OLD GARDINER RD SEQUIM, 98382 OWNER: DONALD ISLEY PHONE: 425-281-8881 REBECCA ISLEY 824 BENT CREEK DR FORT PIERCE FL 34947-1325 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002331020 Section: 33 Township: 30 N Range: 02 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 DESCRIPTIOP NEW HEAT 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: 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 $213.00 LYK 04/15/10 117602 Total: $213.00 FLOORPLAN • Borrower:ISLEY File No.: 2972-09 Property Address:870 OLD GARDINER RD Case No.:12551895 City:SEQUIM State:WA Zip:98382 Lender:BANK OF AMERICA-RETAIULANDSAFE 2tE i2, 24.0' SID 16.0' Sitting Room 12'0' 34.0' 35.0' Shop 35.0' Bedroom Bath Kitchen , 42.0' Living Room N 22.0' 5.0 ICI GEN Master Laundry Dining Room 24.0 6.0' SHE. 24.0' Bedroom 6.0' Master 26.0' Bath 8.0' 24.0' 30.0' Garage 30.0' 24.0' Sketch by Apex IV Windows.' AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code Description Size Totals Breakdown Subtotals GLA1 First Floor 1484.00 1484.00 First Floor GAR Garage 720.00 22.0 x 50.0 1100.00 Shop e40.00 1560.00 8.0 x 24.0 192.00 OTH UTIL SHED 30.00 12.0 x 16.0 192.00 GEN SHED 36.00 66.00 TOTAL LIVABLE (rounded) 1484 3 Areas Total(rounded) 1484 **.`"I °N JEFFERSON.UNTY • tO DEPARTMENT OF COMMUNITY DEVELOPMENT 5 AP� `� 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax �q O$ www.co.jefferson.wa.us/commdevelopment iiING Master Permit Application MLA: Project Description(include separate sheets as ne ssary): '( �1-1Qcor-v€_ N-erx-k-i-y)aN pp 1 ;a1/)C_k1 -- hs�4, kgiC 4>3 Tax Parcel Number:dp'0,-lj I Property Size: 0.Sla e (acres/square feet) „ Site Address and/or Directions to Property: '<'_r� h nu) G--i i 1J .-a. `�Jki W-R 9 c)3 Property Owner(s)of Record: D On't,k C. + 1�-e -C-C.ct `"` �S 10_ Telephone:Li `D.S aC4A-Qi9$ Fax: email: 1 5t-et,5a CAA @ tr. Y i'vlYJ GOAU �1 Mailing Address: CI-1 t �. B f QNE-a- I+0I N d S U in,, 11)A _ Y .i?i;.-_ Applicant/Agent(if different from owner):SQy1-‘._e 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) 0 Single Family ❑ Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ 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 ❑Binding Site Plan** 'PropaneS \- p ❑ Long Plat** 70 Sign 0 Planned Rural Residential Development(PRRD)/Amenaments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development** 0 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 right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time-ef-the ap licaaio that he or she wants prior poti . Signature: -} U/5,c A ) �I L ce : - U S- ( 0 The action Of actions Applicant will undertake as a result f 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 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 ApplicantsaQJcnowledges that he,she or it holds individual and non-traps ferab es o sibility for adhering t and plying with the ESA. The Applicant as read this disclaimer and signs and dates it below. _ Signature: Date: (( /E -)Q/ �) G:\PemritCenter\###FORMS###\DRD FORMS\Current 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 b uming the responsi j ity it he eneral Contractor for the proposed prof ct. Signature: c ' Date: 'Y nS' d )( b GENERAL CONTRACTOR OR MANU ACTURED HOME INSTALLER: PHONE: FAX: (Kg,----ate (115 --33 MAILING ADDRESS: I f EMAIL:QJ�Y 1�lft1N\ �,� (-)l� 1 f\ „(Dy�� ✓� CONTRACTOR'S LICENSE�� L ��f i WAINS _ NUMBER: VE R Lc�- C, b Ni L_._- NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: 0 Sewer O Addition ❑ Steel Proposed: Bank 0 Community System O Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System O Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well D Two Party Typeof 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 a lv: C' 1 Underground Tank 1 Above ground Tank Size of Propane Tank: ( l iO 1'leat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Ta k 1 Pellet Stove 1 Other wv\'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 tte 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"°Floor Heated Consistency Review: Other Heated Base fee: --l' Mezzanine Additional Section: - Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL I3 ,/ Decks 911/Rd Approach fee: Other 0fi TOTAL: 12 l 3 Receipt Number: ( I 1(0O? - Cash/Check Number: I 1p ESTIMATED COST(REQUIRED) Date:_ �_ .Fair market value of all labor and materials foundation to finish Initials: L ------ G:\PernvtCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 1 70 I -_ _.. . ..._ , • Z Z • .! a I o. w IX j a a W a u. ce WM W ` O co . I__ Y`f J ` G 0 1, _ � e,_ a W 2 ...p ("J .. . cp ., _ ,..____ 1 ... , ,N5:-.) . ip p . _.1 . 03 \.0 , _ . , _. J . h H Ili t J I t _/ --. , , . 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