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HomeMy WebLinkAboutBLD2011-00184 0 • 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 #: BLD11-00184 Received Date 7/13/2011 SITE ADDRESS: 292 E ISLAND VIEW AVE Issue Date 7/13/2011 PORT TOWNSEND, 98368 APPLICANT: SKYLAR TRUST PHONE 915 NEPTUNE AVE LEUCADIA CA 92024-2065 5 SUBDIVISION: PROSPECT VIEW ESTATES Block: Lot PARCEL NUMBER: 989600005 Section: 35 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 ppll 33 5 Contractor's License SUNSHP"077QP Expires 11/67/20182 5875 OWNER, SKYLAR TRUST PHONE if different: 915 NEPTUNE AVE LEUCADIA CA 92024-2065 PROJECT DESCRIPTION: A/G 120 GAL PROP TANK, PIPING & 2 HEAT STOVES 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 7/13/2012. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 7 I f I 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 EMLDING PERMIT APPLICATIt BLD1 Review Type:Review Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00184 Received Date: 7/13/2011 SITE ADDRESS: 292 E ISLAND VIEW AVE PORT TOWNSEND, 98368 OWNER: SKYLAR TRUST PHONE: 915 NEPTUNE AVE LEUCADIA CA 92024-2065 PROSPECT VIEW ESTATES SUBDIVISION: Block: Lot: 5 PARCEL NUMBER: 989600005 Section: 35 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 11/17/2012 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOF A/G 120 GAL PROP TANK, PIPING & 2 HEAT STOVES 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 $213.00 LYK 07/13/11 127903 Total: $213.00 r • SITE VISIT REPORT S (PLOT PLAN)JOB L1'NQt� )''(' C Z DATE : ��� �l CONTACT: ADDRESS gc`a E i�5LAat VHQ.9A D(L- PHONE #: . DIRECTIONS 1,Q. \`1 -To TrOSPecQ- To 1Lot-i4fT 2)+(' FAX #: • ID ,ZS Ga MD \lt v2..tA c7'N R i . Email PLANNER: _ATZ.L -e•1 -q5 • Include all street names adjacent to property,property lines,tank,appliance&piping locations, distances of tank to property lines and buildings, septic, wells,wetland areas, distance to water bodies. 3 b a2C-� MOW I r t c.-' 1\ c. . O `112? 570 1) 4 57T)\rs a�STA\cs I r. [ram \ o4 v 5 s 3. 1 c- -,---F-1, \ \ \ _ '-- 1 __..._ . i ,..) \- -, 1 A , C V [E,0 sa J { 1 JUL 1 3 2011 i L1 JEFFERSON COUNTY E. �jc� V DEPT.OFCOMMUNITYDEVELOPMENT ND vIe w 120 , , 2 S'-T-13v-QS, \ Rb'V j 1 -TT\/ , Suet FiP - wl Ov NT -61Ac1 LZ.PD 0 . • , / - oo 1110 feJEFFERSON COUNTY ' ){,N DEPARTMENT OF COMMUNITY DEVELOPMENT • 'N ..' 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 74..4_ , www.co.jefferson.wa,us/commdevelopment Master Permit Application MLA: I I ' �� it I'� c':,• i-\' Pro'ect Description(include separate sheets as necessary): /1a is-n,a_ ra'1`,i (r�i Pam, 2 ,v Fire p-? 3 Parr-el Number: p 0- 1 �� Tax Par ' 60 Do S Property Size: (acres/square feet} Site Address and/or Directions to Property: • a y4:2_ E. • L,r/e of t/J`4 vie . Parr o e ...9_f G,l. . 9,F3`d Property Owner(s)of RecordL_/1 r-1am. o 7LKS � Telephone: Fax: - • email: Mailing Address: 1 L5 Nep1i e_ A PLE A i L-E' CAC/q Cfa✓• %2 o 2 Applicant/Agent(if different from owner): -c-,-,-1wr v : pi.....17,,,,....._____ Telephone: 3(55 - S7 c/7 Fax: -38 S.-- 8 75: email: /)' S"4-`d -t-,/r-Va-►-e ,co,.,.. Mailing Address: /a&.S 3 kJ/Q by .Oa• PT. ///TOC.U c!c_ r„)A What kind of Permit?(Check each box that applies 0 Lot or Toad Segregation 1 ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family 0 Garage Attached./Detached 0 Conditional Use[C(a), C(d),or C]*" ❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Special;Use(Essent �tr ❑ Change ❑Boundary Line Adju 0tVu Q a of Use 0 Address 0 Road Approach 0 Short plat** ❑ Home Business 0 Cottage'Industry 0 Binding Site Plan** i , ropane 0 Long-Plat** �� ; I 0 Sign 0 Planned Rural Resi ti I�Developmetnt3(PRRD)/Am is** O Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Altera i O Stormwater Management 0 Shoreline Master P gram ' ns** O Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Manage ent S t nt** ©Temporary Use 0 Shoreli a Manage OMT,UNlTY1l IVEIOPMFN 0 Wireless Telecommunication* 9 0 Comprghens(ve Plan/UDC/Land Use District Map Amendment O 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: ESIGNATION OF AGENT r, I hereby designate • to act as my agent in matters relating to this application for permit(s). J{' WNER SIGNATURE � A/ Date: `Z�/ 1 L J By signing this application form,the owner/agent attests th 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 attorneys 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 prov a access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any ed later spect . Staffs ss and right of entry will be assumed unless the applicant informs:the County in writing at the r time of the appli on.that r she want riopn tire, ct r . .nature: 1 Date: ( -1 I The action or actions Applicant will undertake as a re It of the issuance of this permit may 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 your action(s)even if ou a in compliance with the Jefferson County development code,The Applicant acknowledges that he,she grit holds individual and non-transferab e esponsi .i y for \ . ing town complying.with the ESA. The Applicant has read this discl�r.and signs and ates it below. Signature: c J _ Date: _ 1 r:•\Prrmirrrr,rrr\###FOR1vfS###\rgtn Frwmc\r,,.r.nrTIP F.....,•\?A..,�r.,.Pe.....:.n...,C......,,,,c nn noa..,. II II 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: 5�1., s-h,t n e do(2.—, 10,4-v` (2 d ) 3 FS- -r 7 y 7 ( 3 66) 3 eS-S a, TS MAILING ADDRESS: CONTRACTOR'S LICENSE /Q 5 p/ P 6( EMAIL: ,r < r7 WAINS NUMBER: .l t1 S( 5 r !> r (�0 NUMBER ARCHITECT/ENGINEER: PHONE ( ) Fax:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: _ Bank El Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair 0 MasonrySEP Permit# Li Demolition 0 Other: 9c ' cor=s: Water Supply: ry Existing: Setback: Type of-Heat: Proposed: ❑ Private well ❑ Two 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 Proposed IBC Occupancy: IBC Type of construction: • Will you have FoodService? Yes / No ' If this is,a Propane Tank and/or Appliance Installation permit,rnark all items below that apply: I Underground Tank Above ground Tank Size of Propane Tank: / 2 0 &,1 Heat Stov ook Stove 1 Woodstove 1 Fireplace Insert i Hot Water Tank I,Pellet Stove i Other j1-1 > 2 Cr2-C., s I appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tankyou 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. ��.4� �jl� rT��,s • tv�vj M1��T�"1Aif F'"C},A AL, N C; irq�# ;� ! ; p�n%,�'r �.°f�¢ � 'Square Footage Current Proposed -, ,A t 44 s y�:Ma� F is � t" t'+ Main Floor Heated ' W� ,��; EH BId A Review: 2"d Floor Heated j , m ! he'hi.. ,° -: Consistency Review: Other Heated e>:' ;4 i Base fee: / ,, .?Mezzanine tr,; � ;. .� , 1. I /Q}/t 4rro {I Additional Section: Heated Basement l ' ', 4'.ii i . ivyl'fit„-,°k 4 t Plan Check fee: Unheated Basement ,,' f�� , State Surcharge fee: ",4:';;; 'x _ • Other UUnheatedUnheated1 'it i `'r,>,i, i 4 Pot Water Review fee: Garage/Carport IC,i " +i. ) i SUBTOTAL „ri am Decks i ir, k 7 911/Rd A roach fee: sc �fr s -0, Other .s;t , I : . u TOTAL: $ k)� i,r •tar t rr r, -1'? Receipt Number r l _-I( ' P .; .,..:,r� ",` Cash/Check Number: fr � ,(. ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish I-i �': Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms'\Master Permit Application 5-29-08.doc