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Home My WebLink AboutBLD2010-00311 O 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 #: BLD10-00311 Received Date 8/30/2010 SITE ADDRESS: 24 FREEMAN LN Issue Date PORT TOWNSEND, 98368 8/30/2010 APPLICANT: SUSAN J HIGBEE 24 FREEMAN LN PHONE 360-379-6866 1101 CHERRY ST PORT TOWNSEND WA 98368-9704 SUBDIVISION: DISCOVERY BAY VILLAGE 61 Block: Lot: PARCEL NUMBER: 947400061 Section: 13 Township: 29N Range: 02W CONTRACTOR: FAST WATER HEATER COMPANY 12601 132ND AVE NE PHONE 425-636-7054 KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2012 OWNER, SUSAN J HIGBEE PHONE: 360-379-6866 if different: 24 FREEMAN LN 1101 CHERRY ST PORT TOWNSEND WA 98368-9704 PROJECT DESCRIPTION: REMOVE & REPLACE HOT WATER HEATER 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 8/30/2011. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: t } ! 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 • • 503157 cow JEFFERSON COUNTY p t1-; '� DEPARTMENT OF COMMUNITY DEVELOPMENT `4 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450• 360/379-4451 Fax I� INGc www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: KO" MLA t h Project Description(include separate sheets as necessary): Remove/Replace Electric Water Heater Tax Parcel 947400061 Property Number: Size: (acres/square feet) Site Address and/or Directions to Property: 24 FREEMAN LN Property Owner(s)of Record: HIGBEE, A.W. (DON) Telephone: (360)379-6866 Fax: Mailing Address: 24 FREEMAN LN PORT TOWNSEND, WA 98 ail: Applicant/Agent(if different from owner): FAST WATER HEATER COMPANY Telephone: 425-636-70f 4 Fax: 425-536-7055 email:caroir(c@tastwaterneatti-con Mailing Address: What kind of Permit?(Check each box that applies building ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditionai Use jC(a),C(d),or C]** ®Single Family 0 Garage Attached/Detached ❑Discretionary"D"or Unnamed Use Classification 0 Manufactured Home 0 Modular ❑Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑Short Plat** El Address ❑Road Approach 0 Binding Site Plan*" ❑Home Business ❑Cottagelndustry ❑Long Plat'" ❑Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration*" ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development'" ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment El Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *May require a Pre—Application Conference Please identify any other local,state or federal permits required for uthis proposal,ires a la if known tion Conference DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE See attached Date: By signing this application form,the owner/agent attests that the information provided herein,and In any attachments,is true end correct 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 attomey'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 agre ,to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and y relquired I. -r .-ctions. Staffs a ss and rl ht of t iI be assumed unless the applicant informs the County in writing at the time of the once that =? e an to 1 Signature: Date: 8/17/10 The action or actions Applicant will u dertake as a r suit 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 • ..... .. with the ff .n County development cobs.The Applicant acknowledges that he,she or it holds individual and non-tra stet respo for a., eri g • , • • 'plying i! t je •.V •Applicant has read this disclaimer and signs and dates It below. Signature: ._ A Date: 8/17/10 C\Documents and Settings\cant!\Load Settings\Temporary Internet Files\OLK&l\Master Permit Application 12-19-2006.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 be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: FAST WATER HEATER COMPANY PHONE: Fes. ( ) 425-636-7054 ( )425-636-7055 MAILING ADDRESS: 12601 132ND AVE NEKINKLAND, WA Y5034 EMAIL: CONTRACTOR'S LICENSE carnlrt�n factwatPrhPatt=r rnm NUMBER: WAINS FASTWWH948BC NUMBER ARCHITECT/ENGINEER: PHONE MAILING ADDRESS: ( FAX EMAIL Project Type: Frame Type: Bathrooms: ❑ New 0 Sewer Shoreline: e of Sewage Disposal: ❑ Wood Existing: E1 Addition [I Steel Proposed: Bank UXAlteration/Remodel CI Concrete Concrete Total: ❑ Communityv Systemem ❑ Repair 0 Masonry ❑ Indiidual ❑ DemolitionBedrooms: SEP Permit# 0 Other. Water Supply: Existing: Setback: — ❑ Private well C Two Party Type of Heat: Proposed: Total: 0Public 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 IBC Occupancy: Proposed p Y 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: ❑Underground Tank in Above ground Tank Size of Propane Tank: ❑Heat Stove 0 Cook Stove ❑Woodstove Q Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 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 ail property lines,buildings and septic system components, Including the reserve area. Square Footage I Current Proposed For Office Use Only Amount Main Floor Heated Revision EH Bld App Review: 2"°Floor Heated Consistency Review: - Other Heated Base fee: Mezzanine Additional Section: Heated Basement • Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other Water Heater 1 TOTAL: $ 6 i Receipt Number: 1 aoop Cash/Check Number. 9(0-70 ESTIMATED COST(REQUIRED) Date: (�-�lF! lJ .Fair market value of all labor and materials foundation to finish �) -31. 71 Initials: C:\Documents and Settings\carol\Local Settings\Temporary Internet Ries\OLIC86\Master Permit Application 12-19-200Ectoc A • Page 1 of 1 417/0000y I I .7400863 W7400057 Ci 902f31007 �7400081 41T100038 • - 947400069 , -''. ' \ \ ,' , ,,ity. ,.._...... , \. aasGzm3 / J947400028 / 947400029 / I -- 1 947400060 1: 964�5 4 Map.oam 9ymien,Ct.r.Cenral�„0 G6 r( - - - 1.....,,_ /_ YlJ }OEYf - \CX•krt\.1) C___,, 0 k--\ \-\'` .\-\.,-#t c:4<eer'' w6 - or 4a"3 70 . http://maps.co.jefferson.wa.us/output/parcels_gisserver246858123322.jpg 8/24/2010