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HomeMy WebLinkAboutBLD2010-00393 • • 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 #: BLD10-00393 Received Date 11/23/2010 SITE ADDRESS: 1300 E LUDLOW RIDGE RD Issue Date 11/23/2010 PORT LUDLOW, 98365 APPLICANT: RICHARD C REIN TRUSTEE PHONE: 360-437-8047 R & P REIN REV TRUST 1300 E LUDLOW RIDGE RD PORT LUDLOW WA 98365-9716 SUBDIVISION: Block: Lot PARCEL NUMBER: 821104006 Section: 10 Township: 28N Range: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2011 OWNER, RICHARD C REIN TRUSTEE PHONE: 360-437-8047 if different: R & P REIN REV TRUST 1300 E LUDLOW RIDGE RD PORT LUDLOW WA 98365-9716 PROJECT DESCRIPTION: GAS FURNACE 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 11/23/2011. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: jZ—(o- I 0 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 BLD10-00393 •UILDING PERMIT APPLICA•N Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00393 Received Date: 11/23/2010 SITE ADDRESS: 1300 E LUDLOW RIDGE RD PORT LUDLOW, 98365 OWNER: RICHARD C REIN TRUSTEE PHONE: 360-437-8047 R & P REIN REV TRUST 1300 E LUDLOW RIDGE RD PORT LUDLOW WA 98365-9716 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821104006 Section: 10 Township: 28 N Range: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2011 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI GAS FURNACE REPLACEMENT TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION CODE EDITION: 2009 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 Permit $97.25 LYK 11/23/10 120284 Plan Check $63.21 LYK 11/23/10 120284 State Building Code $4.50 LYK 11/23/10 120284 Total: $164.96 • > Cod, JEFFERSON COUNTY • r \ `i DEPARTMENT OF COMMUNITY DEVELOPMENT e• 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax q p'$ www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: " 16 Project De criptip(t(include separ t sheets as necessary): �"y ('X I,}-\-)\ (\C J 'rt., C Y k C > Tax Parcel Number:c,9 1 \ LA t) jj Property Size: (1 cif-t j (acres/square feet) Site Address and/or Directions to Property: 0o4I ? e'Q, E L`.)a �L..� Lv c L 0(- q � Property ner(s)of Record: A C -( A l `(- Telephone D D' t---1` -4 - C\' Fax: email: Mailing Address: \ ` Applicant/Agent(if differen from owner): 'r --e---L1/4..= Telephone Fax: - C+ Pmail: Y Mailing Address: h — . C-C`-,f1-1 What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ©Single Family ❑Garage Attached/Detached ❑ 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 ❑Short Plat** ❑Home Business 0 Cottage Industry 0 Binding Site Plan** ❑ Propane 0 Long Plat** ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis El 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* ❑ 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 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 �jf to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Jet-e-{. ?.4a-4--s- - Date: I I • 01— 1 Cp 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 of the application th t he or she wants for notice. (P Signature: " i =AA A Date: 1 I ' •( -,t 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 re ponsibil' for adher g to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ""�` P, ' c- .� Date: 1 I C Y r 1 G:\PermitCenter\###FORMS###\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 be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: bENERAL CONTRACTOR OR ANUFACTURED HOME INSTALLER' PHONE: �y FAx: v C-bL�'l_Lt_h' \ i-�'�1��-It�l _.-- 4 C_ v"'���rgq i SIR�j (w '7 5 o -2_,5 MAILING ADDRESS: ^J \3� 1 EMAIL: • tjt rn L �hp YYI CONTRACTOR'S LICENSE ILL�. 1- ., L )O`- LC Ito$2, WAINS NUMBER: \OY( A/�.✓1 f W-C1`41 a NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: i i Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ' Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: I Private well ❑ Two Party Typo of Hoot: I _ — - Proposed: _ ._; P,�s,lic L ,0.:z 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 :tT:'34--Tz75,44 Main Floor Heated EH Bld App Review: 2n4 Floor Heated Consistency Review: Other Heated Base fee: 6r1 'a 5 Mezzanine II Additional Section: Heated Basement Plan Check fee: I c1 Unheated Basement ".. State Surcharge fee: 4 5) Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL • Decks 911/Rd Approach fee: Other TOTAL: $ I /A4_Q Receipt Number: ' 137 11 • Cash/Check Number: Z(� ` n T ESTIMATED COST(REQUIRED) Date: L .Fair market value of all labor and materials foundation to finish - .511 ?j` 3 ) Initials: — G:\PermitCcnter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc s I , _____.„ • f I I l 1 C-,r1/4cI___- . EMI s t fl EX\si !pill ) Zr