The URL can be used to link to this page

Home My WebLink AboutBLD2010-00196 • 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 #: BLD10-00196 Received Date 6/8/2010 SITE ADDRESS: 161 N BAY LN #3 Issue Date 6/8/2010 PORT LUDLOW, 98365 APPLICANT: JOSEPH C KRUEGER TRUSTEE PHONE: 360 437-7888 TERILYN M KRUEGER TRSTEE 7520 E MARITIME DR TUCSON AZ 857569186 SUBDIVISION: PORT LUDLOW Block: Lot: PARCEL NUMBER: 990200033 Section: 8 Township: 28N 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 OWNER, JOSEPH C KRUEGER TRUSTEE PHONE: 360 437-7888 if different: TERILYN M KRUEGER TRSTEE 7520 E MARITIME DR TUCSON AZ 857569186 PROJECT DESCRIPTION: Woodstove Replacement 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 6/8/2011. REQUIRED INSPECTIONS: Tan ine/Appliance: / / / ` 46' FinalApproval: / ) 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_Propa ne.rpt 10/29/19 • BUILDING PERMIT APPLIAION BLD10-00196 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00196 Received Date: 6/8/2010 SITE ADDRESS: 161 N BAY LN #3 PORT LUDLOW, 98365 OWNER: JOSEPH C KRUEGER TRUSTEE PHONE: 360 437-7888 TERILYN M KRUEGER TRSTEE 7520 E MARITIME DR TUCSON AZ 857569186 PORT LUDLOW SUBDIVISION: Block: Lot: PARCEL NUMBER: 990200033 Section: 8 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 DESCRIPTIOI` Woodstove Replacement 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: Approved/Date Permit $72.00 RAC 06/08/10 117826 APPROVED Total: $72.00 JUN 7, 2010 Jefferson County Planning &Building Department 6 LO /0 - 1*, • 9 JEFJEFFERSON COUNTY 4 W ' \,,, �1 DEPARTMENT OF COMMUNITY DEVELOPMENT '' 621 Sheridan Street • Port Townsend •Washington 98368 �� 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment btTN� Master Permit Application MLA: JV Q Ai, .4 Project Description(includeo separ to she is as necessary): (J` 02 5 1 V e—necessary): A c,6' ,1 2(2 0.s-14. Tax Parcel Number: 0 33 Property Size: (acres/square feet) Site Address and/or Directions to Property: /'(1 �Q,ea<4 �'�9 G� o, i-tic=flo u) Ci%1 qK3 43 -- Property Owner(s)of Record: J aS ,— C '2 c) �/ Telephone: (3 ie1 y43.7 7 g g f Fax: email: Mailing Address: ✓• Applicant/Agent(if different from owner): '/Y.6 f__-. 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 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home .0 Modular - 0 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** ❑ Propane 0 Long Plat** ❑ Sian - 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 0 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 right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later• -ction . staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application to-' - •A,1 a,4• s prior notice. Q' Signature: — " Am / /L�;� IS Date: U — /v nap- • The action or actions • icant (undertake as a re• of the issuance of this permit may negatively impact upon one or more threatened or endangered specie• =nd 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 c•m•liance ith the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfera. - -sp. , • adhering to and complying with the ESA. The Applicant has read this disclaaier and signs and dates it below. Signature: 444/1 - _ Date: �.-� a 1 G:\PemutCente;'#FORMS###\DRD FORMS\Curren'.RD Forms\Master Permit Application 5-29-08.doc • III 1.. 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 be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: Fax: � Wed 1� 4-i' ( ) ( ) MAILINGyk--fe,444 DRESS: fri./ / a EMAIL: CONTRACTOR'S LICENSE w /D( �, (e S WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: LI 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: 1 Underground Tank 1 Above grou Size of Propane Tank: t Heat Stove t Cook Stov I Woodstove Fireplace Insert 1 Hot Water Tank 1 Pellet Stove t Other Is this appliance being insta e u actured/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: i o(-' Mezzanine Additional Section: / - Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 20 c) Decks 911/Rd Approach fee: Other TOTAL: $ 7 2 00 Receipt Number: // 7 r^ T2 6 Cash/Check Number: /. J 2 ESTIMATED COST(REQUIRED) Date: —�,�O •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 0 c. m C) z a 3 m , -o a . m , r 1.:,....___,....____. is i , . i___ rtt, c, 1. i , rn i c n 1 0 'I . \rNki i IN 73 '11\ 4,":::-"`"---------.....t. 0 a m %-\ A m t co . r n G -...0.,J of � 1 z 3 • m a 4 m 1 cn co T O z rn z �� i co 73 rn rn y 0 73 .o . a 73 01 III z