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Home My WebLink AboutBLD2011-00129 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 #: BLD11-00129 Received Date 5/24/2011 SITE ADDRESS: 76 SEAFARER LN Issue Date 5/24/2011 PORT LUDLOW, 98365 APPLICANT: DARRELL L FETT PHONE: 360-437-0678 EVELYN M FETT 76 SEAFARER LN PORT LUDLOW WA 98365-9630 183 SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot: PARCEL NUMBER: 990603183 Section: 9 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, DARRELL L FETT PHONE: 360-437-0678 if different: EVELYN M FETT 76 SEAFARER LN PORT LUDLOW WA 98365-9630 PROJECT DESCRIPTION: REPLACEMENT HEAT PUMP 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 5/24/2012. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: `ib// 2- 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 BLD11-00129 IiILDING PERMIT APPLICATC Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00129 Received Date: 5/24/2011 SITE ADDRESS: 76 SEAFARER LN PORT LUDLOW, 98365 OWNER: DARRELL L FETT PHONE: 360-437-0678 EVELYN M FETT 76 SEAFARER LN PORT LUDLOW WA 98365-9630 PORT LUDLOW NO 2 AREA 3 SUBDIVISION: Block: Lot: 183 PARCEL NUMBER: 990603183 Section: 9 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 BRENNHA971 R9 Expires 12/29/2011 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt REPLACEMENT HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 4,180.00 ADD'L: HEAT TYPE CODE EDITION. 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: 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 Bv: Date: Receipt: Approved/Date Permit $111.25 LYK 05/24/11 123530 Plan Check $72.31 LYK 05/24/11 123530 State Building Code $4.50 LYK 05/24/11 123530 Total: $188.06 r Lri C `�� , •o JEFFERSONtOU �(13. °N� � d� NTY ` a DEPARTMENT OF COMMUNITY DEVELOPMENT wC 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �.q� O�p$ www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: k\G Dr b Pr • ct De cription(include separa a sheets s necessary): --e )(A ,---4-ki (\c\ \ru_clA Tax Parcel Number: (Ice3I rZ7 Property Size: C T acfes/s es/square feet ) Site Address and/or Dire Rs to Property: ,..“-- .*( cIZICA. Loc..\\ cl (c,'..3-- -4-kp 3f2 Property Oyyner(s)of Rec rd: Telephone:A-AO(; 4 C D , Fax: email: Mailing Address: n Applicant/ ent(if diffe t from owner): A -%. w __________ Telephone. : yl l.�FaxA.' ^�.il r,. Ly .".0.11 Mailing Address: s c.)...:.AA YO.Ci (. N..\ What kind of Permit?(Check each box that applies ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) ,. 1 ingle 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* ❑Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment 0 Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** ❑Propane 0 Long Plat'"' 0 Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑Stormwater Management ❑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 ❑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 = I to act as my agent in matters relating to this application for permit(s). • OWNER SIGNATURE -,FS) .S ', - -i Date: •S// ?I :94^,// 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,coulcosts,.reasonable-atterney's-fees-and expenses which may in any way accrue against Jefferson County as a result of or in consequence)-o Itea .. ;,T. - I I 1 further agree to provide access and right of entry to Jefferson County and its employees,represeIrtta' e BT' � I. of pplication review and any required later inspections. Staffs access and right of entry will be assumed unless't applicant informs the County in 'ti i at the time of the application that he or she wants prior notice. I w ,t Signature: �r (L \/.J ti_ site: "K `?yt 0 cl 7 or The action or actions Applicant will undertake as a result of the issuance of this permit may negat4y impact upon one or more threat or endangered species and could lead to a potential"take"of an endangered species as those terms are d i wn as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions th r ifi use this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on buN1lf d frig your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that� he,she it holds individual and non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaim f r and si ns and dates it below. Signature: , c� p 'b cam -_ Date: --// (7 ,2,6/1 G:\PecrnitCentcr\###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. i u , ENERAL CONTRACTOR OR ANUFACTURED HOME INSTALLER: PHONE: FAX: ig MAILING ADDRESS: toSAA bEMAIL: .ke eQAA .e_t—yi CONTRACTORS LICENSE & _ l ?,, WAIN G NUMBER: g,�u, \ ,�� ^ct', �/❑ NUMBER ARCHITECT/ENGINEER: �^ - �Y �- ` PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System 'Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System O Repair 0 Masonry SEP Permit# O Demolition 0 Other: Bedrooms: Water Supp!y: Existing: Setback: I Private well 0 Two Party Type of Heat: Proposed: 3 Public Total: Name of System: If this is a Commercial Prolect 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 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 I 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. 6t i▪, r z rt-F 4'11 i4 r ,•; 6"xrl 7 4 C,i 5 .y ip .',m': Square Footage Current Proposed Fd Aniio, nt I * - S Main Floor Heated ; rA,} `; EH Bid App Review: 2na Floor Heated n 1341 y Consistency Review: iftq Other Heated ° .' • .•' Base fee: III Mezzanine , y F% :lit,, Additional Section: Heated Basement i. "` , , Plan Check fee: d; a �a,3 � ` #Unheated Basement P` "' �F , 4, � State Surcharge fee: f 4 51 Other Unheated 4': aw • Pot Water Review fee: w, Garage/Carport . .0 SUBTOTAL Decks ,L �' 4, 911/Rd Approach fee: ikit Other d TOTAL: $ _ ____ Receipt Number:"'• `'',9 �T V 1� r 4 *1 - Cash/Check Number: 1 ESTIMATED COST(REQUIRED) Date: i A 2 4 2011 .Fair market a/ue of all labor and materials foundation to finish J, Initials: �LttEKJ • DEP I MUNITY DEVELOPMENT G:\PermitCentcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc ' 10/11/2006 01:51 12535380530 PAUL_CARTER PAGE 01/07 • e. e , -76 cea-a-t-e.r Icza vl e, 170 r .. G-c aj I0 )) t(-)A r \ . i ..: ,.„ (...,„ , „, ,...s, . , .,,,„ , . 71,..„ _. ..._ til \il .._____-_,t,_ I'D rcEuvE iL MAY 2 4 2011 JEFFERSON COUNTY DEPT OF COMMUNITY DEVELOPMENT