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Home My WebLink AboutBLD2011-00133 • • 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 #: BLD11-00133 Received Date 6/2/2011 SITE ADDRESS: 302 RIPLEY CREEK RD Issue Date 6/2/2011 QUILCENE, 98376 APPLICANT: CHARLES E GREENERT III PHONE: 360-765-4020 DONNA S GREENERT PO BOX 337 QUILCENE WA 98376-0337 TX 11 SUBDIVISION: Block: Lot: PARCEL NUMBER: 802353004 Section: 35 Township: 28N Range: 02W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2011 OWNER, CHARLES E GREENERT III PHONE: 360-765-4020 if different: DONNA S GREENERT PO BOX 337 QUILCENE WA 98376-0337 PROJECT DESCRIPTION: A/G 500 GAL PROP TANK, LINE & HEAT STOVE IN AGRICULTURE Directions BUILDING 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 6/2/2012. REQUIRED INSPECTIONS: Tank/Line/Appliance: i i'- 1--,PE 44- =f,,,,,th«c4 / L.,^,f_, 6,--7 if FinalApprova . •, yiri-- 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_Perm it_Propa ne.rpt 10/29/19 BLD11-00133 •ILDING PERMIT APPLICAT �� Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00133 Received Date: 6/2/2011 SITE ADDRESS: 302 RIPLEY CREEK RD QUILCENE, 98376 OWNER: CHARLES E GREENERT III PHONE: 360-765-4020 DONNA S GREENERT PO BOX 337 QUILCENE WA 98376-0337 SUBDIVISION: Block: Lot: TX 11 PARCEL NUMBER: 802353004 Section: 35 Township: 28 N Range: 02 W CONTRACTOR: MOUNTAIN PROPANE PHONE: (360)385-6883 265 CHIMACUM RD PORT HADLOCK WA 98339 Contractor's License MOUNTPI983O6 Expires 9/26/2011 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION A/G 500 GAL PROP TANK, LINE & HEAT STOVE IN AGRICULTURE BUILDING 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: 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 Bv: Date: Receipt: Approved/Date Propane Tanks/Stoves $213.00 LYK 06/02/11 123547 Total: $213.00 • fr cow JEFFERSONCOUNTY , DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax $."7, p$ www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: t' t) l l )P e_Q_C Project Descrip ion(include separate sheets as necessary): i.rs t // i rc.'&77i.( //t(i it Tax Parcel Number: $5 )_ 3 C 3 5 y Property Size: ,,l 0 AC vr.1 (acres/square feet) Site Address and/or Directions to Property: ova J4..die/ n/4 14iq i 6 v. '4,,( �� a S �6 Property Owner(s)of Record:_e Act V ill ( et n e'F Telephone: 3 C 0- 7K C-- you U 0 Fax: email: verrit %i/ F /4-c.� -'w,;.,.I.("c•, Mailing Address: A 0. 4c,x ?4 7, 6 t, 'icerie. G�i1 7 J S'�r Applicant/Agent(if different from owner): Telephone: Fax: email:r� 66'+ `' Mailing Address: P, a /3 0g 3 3 7 4 (..,./cevre &yye I A e v/ e wvRL/) i'f1QA// ev,4-c 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) ❑Single Family 0 Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** O Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** El Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach El Short Plat** ❑Home Business El Cottage Industry ❑Binding Site Plan** XPropane ❑Long Plat** El Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed`Yes"Use Consistency Analysis ❑Plat Vacation/Alteration'" ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ClShoreline Management Variance r ❑Wireless Telecommunication* 0 Compre endment 0 ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson *v n,,, •-'` lVir endment C, *May require a Pre-Application Conference ❑Tree Veg a ::: ••;i d '"*R ell : a Pre-Application Conferenc c - Please identify any other local,state or federal permits required ' pro p al, i kr��1n: - pure', - N11 i /� DESIGNATION OF AG .1 ' I hereby designate to act as my ag.int in ' ton jor permit(s). (... - SO COUNTY OWNER SIGNATURE DEPT.OFKAWMUNITY DEVELOPMENT 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 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. 9.j 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 require later inspections. Staffs access and right of entry will be assumed unless the applicant informs t e County in writing at the time of the applicati n hat he/ she wants prior notice. /// L Signature: ec t/ �/ ��--- Date: c/'�T1/ / 4 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 9l "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this d 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 S.- 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-transfera I responsibility for adhering to complying with the ESA. The Applicant has read this discla mer a signs and dates it below. Signature: 4 4 j - Date: 5/d 2(/( G:\PermitCcntcr\###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 e responsibility of the General Contractor for the proposed pro' .- Signature: ( .IV % .-, Date: ) d (/f GENERAL C NTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: jIi10%,it a." PV,'24ri( (36v 315--6(C-1- I( ) MAILING ADDRESS: q C Ch r',--46-,,,,. get' EMAIL: G / CONTRACTOR'S LICENSE WAINS NUMBER: 6 G 0/3 3 o t2.. NUMBER ARCHITECT/ENGINEER: /Ue if"1- ` A hG.r� PHONE (2 a 3/f.1 6"cf- (;60) 3 i S-6, /ji MAILING ADDRESS: ch 1 7 EMAIL Project Type: Frame Type: Bathroomh S Shoreline: Type of Sewage Disposal: 1,4_New X Wood Existing: [1 Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System [1 Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# CI Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: e.1---Private well ❑ Two Party Typq of Heat: Proposed: 0 Public I' , , ,�+d vt 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 ;Above ground Tank Size of Propane Tank: (d d 6"1 (Heat Stove i Cook Stove i Woodstove I Fireplace Inser1V111111.111MMIMIt I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / 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. '; T1j .. 1 •'• +1 .Fi Nb. F S 'Z ..4 Square Footage Current Proposed •'Fq`�, i x`r':;U nlfi, ,;'IW.,zt„a, -„ AinlDunt, .: evlsiort^ Main Floor Heated �� D '` EH BId App Review: 2-Floor Heated t z" L r' Consistency Review: Other Heated a ,7a.,r,,i w Base fee: •1` N ' Via' +� Mezzanine .- - •1 ``' Additional Section: ,,00 sty-.]M r. Heated Basement ...744 Plan Check fee: Unheated Basement + ""f ,;�� State Surcharge fee: Other Unheated °-' . R wewlfee: ;. Garage/Carport , B AL Decks «�, ;29' J Ap a l� ee: 1b r gym.: Other )>, ' l"', 1f AL: $it �UNTY `T?P'iR!tr Mfnber: 17 y ' :, :. Cash/Check Number: C J 10 ESTIMATED COST(REQUIRED) Date: _�.� •Fair ma et value of all labor and materials foundation to finish ') /61 4✓ -2 Initials: �--..„,..-- G:\PcnnitCcnter\###[:DBMS###\DBD FORMS\Master Permit Application 5-29-08.doc _.----------) v • • v 1 . j f 4 ) - . ....'..'") z --.. rC, i 3 c ,l i p n t ly M 3Z t .1 ,Y t .J 1 ,--D c [-EgviE -, .,. .._.„ ,, , 1 ,< f ul JUN - 2 2011 J • J JEFFERSON COUNTY 3 DEPT.OF COMMI MTV DEVELOPMENT