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Home My WebLink AboutBLD2010-00394 • 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 #: BLD10-00394 Received Date 11/23/2010 SITE ADDRESS: 2327 HASTINGS AVE W Issue Date 11/23/2010 PORT TOWNSEND, 98368 APPLICANT: SUSAN M OHLSON PHONE: 360-774-0750 WILLIAM R CURTSINGER 2327 HASTINGS AVE W PORT TOWNSEND WA 983689286 T 64 SUBDIVISION: SYNDICATE Block: 24 Lot: PARCEL NUMBER: 997600013 Section: 5 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17 2082-5875 OWNER, SUSAN M OHLSON PHONE: 360-774-0750 if different: WILLIAM R CURTSINGER 2327 HASTINGS AVE W PORT TOWNSEND WA 983689286 PROJECT DESCRIPTION: NEW A/G 100 PROP TANK& LINES TO EXISTING APPLIANCES 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: t L !+ ;--_ �_ I vh0IL FinalApproval: 4(24 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 BUILDING PERMIT APPLICA•N BLRD10-003394 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00394 Received Date: 11/23/2010 SITE ADDRESS: 2327 HASTINGS AVE W PORT TOWNSEND, 98368 OWNER: SUSAN M OHLSON PHONE: 360-774-0750 WILLIAM R CURTSINGER 2327 HASTINGS AVE W PORT TOWNSEND WA 983689286 SYNDICATE SUBDIVISION: Block: 24 Lot: T 64 PARCEL NUMBER: 997600013 Section: 5 Township: 30 N Range: 01 W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/19/2010 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW A/G 100 PROP TANK & LINES TO EXISTING APPLIANCES TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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 11/23/10 120285 Total: $142.00 :AD i SITE VISIT REPORT A/ (PLOT PLAN) OB 00LSoN l("uX 7 /A-)C67Z DATE : 7/3P/0 K . _ CONTACT: ADDRESS �� (;4 6,� PHONE #: . DIRECTIONS FAX #: . Email PLANNER: . 7 i �D Q i i (kiI 1 j v/ '/z poly l� a i")6f 6 I ik __— iI I 1.—_______ I w, ti ti NOV 2 3 ,j r^ 1 i7serniii‘ JEFFERSO OUNTY . ` DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 j, :4 360/379-4450 • 360/379-4451 Fax vvww.co.jefferson.wa.us/commdevelopment TNG ww.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: 1)0 rnal P Project Description (include separate sheets as necessary): Tax Parcel Number: 1 1— 6 06 - 0 /3 Prope y Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: i.Qo n 40h ern-- _Ls ern-- ///ia..,. ac/l,7`,ri r,. - - Telephone: 3 71 - /3 8d Fax: email: Mailing Address: . , Applicant/Agent(if different from owner): c,,..�� „.„. . f)/-L--er>oo<-y-_c Telephone: ge) -- 57 7 Fax: g 5 . ,i 875 email: r ° S`0`dl .tf - , _ Mailing Address: /O�53 .N 6)y CQ Pi . //ROL0 c/c 4,,)A What kind of Permit? (Check each box that applies 0 Lot or Road Segregation ❑Building 0 Critical'Areas Stewardship Plan 0 Demolition Permit ❑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 0 Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry . ID Binding Site Plan** ropane 0 Long Plat** ❑ Sign • ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development** .C) 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: i ' DESIGNATION OF AGENT I ereby designate to act as my agent in matters relating to this application for permit(s). ,(p 'WNER SIGNATURE G Date: I .)- 1 3 --I U ✓✓✓ 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 atterney's fees an 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 applicatin' review and any required later inspections, Staff' ss and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or sh w n pr.' \ St - •nature - Date: l j--l3"t ° i The action or actions Applicant will unde ke as a result of the issuance of this permitmay negatively impact upon one or mote 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 year I action(s)even if you are in compliance with the Jeffers n County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility hering t d co lying with the ESA. The Applicant has read this disclaiimer and signs and dates it beic I Sig�ture; Date: 1I-13 - I cJ i 1 (:\PP,mIt(',•nr,r\tat#FOR MS###\11R 11 MR MC\CI IrrPnr TlRTI Fr.,,,,,\AA.,,r,..P . ., A...,c,.,.:....G 0,no,,.... 1 6� 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 ER: PHONE: FAX SDI-, S 14 t rt C PA-v`e_ (96d ) 3 FS- s 7 MAILING ADDRESS: P'L �,� _ ( 3�� 1S-S 7S CONTRACTOR'S LICENSE r �l P. (( EtAIN NUMBER: IA �A �^ n WAIS 5 V-1 S-y` '* .0 r7 Q l� NUMBER • ARCHITECT/ENGINEER: Y MAILING ADDRESS: PHONE ( ) FAX:( ) EMAIL. Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: 0 Addition ❑ Steel Proposed: 0 Sewer 0 Alteration/Remodel0 Concrete Bank 0 Community System Total: Height: ❑ Repair 0 Mason . C Individual System - o Demolition 0 Other:ry Bedrooms: SEP Permit# Existing: Setback: Water Supply: Type'of Heat: Proposed: Private well Iwo Party Total: ❑ Public 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: IBC Type of construction: Proposed Jf this is a Propane Tank and/or Appliance Installation permit,mark all items elow hayou hve pplyiFoodService? Yes / No I Underground Tank I Above ground Tank Size of Propane Tank: / l Heat Stove l Cook Stove I Woodstove I Fireplace Insert 1 Hot Water Tank I Pellet Stove Q v r let a Is this appliance being installed i a Manufactured/Mobile Home? Yes / No the When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings, all pro.-erty lines, tank location and size, distances from the propane tank to all property lines, buildings and septic system components, including the reserve area. --i' ,VL' id o "� i7 Ta 1. ,11544.; .f " r� .axa1,,r _o', h « 4�iS k� . A " r 1ji�'3 oars Footage Current Proposed , h. a : . . , , ` rg �, . s71U a tf+Main Floor Heated ;47 2"0 Floori ` t,,`{ fi3 EH Bid App Review: Heated ,, c 1 Consistency Review: '. Other Heated `� ,� ; ; . - At, 1 f, ,�,,, Base fee: , _[ L.— Mezzanine `"�p � f t t1 ,,f"F, ?r Additional Section:° ��,t kr �,µ 1 to , -, Heated Basement g Plan Check fee i „`+, r Unheated Basement F y o tolr ,,,� State Surcharge fee: Other Unheated .A R If ;, ax _ j n• i •r • Pot Water Review fee: Garage/Carport ; ' ' ,`s SUBTOTAL ---- Decks # „i�' ;:°'" »I 911/Rd Approach fee: fr 6 i, ' Other ;' , : TOTAL: $ I `tZ Receipt Number: I �a '. I,' + '4 pf., Cash/Check Number.;. �rfb�4� ESTIMATED COST(REQUIRED). Date: 'Fair market value of all labor and materials foundation to finish j Initials: C�— c,\PemvtCenter\###FORMS###\DRD FORMS\Current 13RD Pomo\Master Permit Application 5-24-08.doc