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Home My WebLink AboutBLD2011-00208 • 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 #: BLD11-00208 Received Date 7/28/2011 SITE ADDRESS: 267 FOXFIELD DR Issue Date 7/28/2011 PORT TOWNSEND, 98368 APPLICANT: JAMES A HODGES PHONE: 360-379-9020 ANDREA G HODGES 267 FOXFIELD DR PORT TOWNSEND WA 983689549 113 SUBDIVISION: KALA POINT#4 Block: Lot: PARCEL NUMBER: 965000107 Section: 27 Township: 30N Range: 01W CONTRACTOR: FAST WATER HEATER COMPANY PHONE 425-636-7054 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2012 OWNER, JAMES A HODGES PHONE 360-379-9020 if different: ANDREA G HODGES 267 FOXFIELD DR PORT TOWNSEND WA 983689549 PROJECT DESCRIPTION: ELECTRIC WATER HEATER 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 7/28/2012. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: :40-11 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 IILDING PERMIT APPLICATA BLD11-00208 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00208 Received Date: 7/28/2011 SITE ADDRESS: 267 FOXFIELD DR PORT TOWNSEND, 98368 OWNER: JAMES A HODGES PHONE: 360-379-9020 ANDREA G HODGES 267 FOXFIELD DR PORT TOWNSEND WA 983689549 KALA POINT#4 SUBDIVISION: Block: Lot: 113 PARCEL NUMBER: 965000107 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: FAST WATER HEATER COMPANY PHONE 425-636-7054 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2012 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr ELECTRIC WATER HEATER REPLACEMENT TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: 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 $71.00 LYK 07/28/11 127955 Total: $71.00 Ill e 524736 �.�gON COS JEFFERSON COUNTY a tl � lotDEPARTMENT OF COMMUNITY DEVELOPMENT ` 621 Sheridan Street• Port Townsend•Washington 98368 360/379-4450 • 360/379-4451 Fax „� 0 0 www.co.jefferson.wa.us/commdevelopment Master Permit Application ► MLA: ' C ' 01C0 -_,.- N Project Description(include separate sheets as necessary): Remove/Replace Electric Water Heater Tax Parcel 965000107 Property Number: Size: _ 0 „c�s e ) Site Address and/or Directions to Property: I U r 267 FOXFIELD DRIVE Property Owner(s)of Record: HODGES, JAMES r !Id I 2 $ 2U11 t Telephone: (360)379-9020 Fax: erllai L —�J Mailing Address: 267 FOXFIELD DR PORT TOWNSEND, WA 98 Jiff vRSON COUNTY Applicant/Agent(if different from owner): FAST WATER HEATER COMPANY' DEPT.0 "iriiY I[VU.OPME T Telephone: 425-636-705 Fax: 425-636-70sr5 email: t aterneat corn Mailing Address: What kind of Permit?(Check each box that applies — IXBuilding ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit El Conditional Use jC(a),C(d),or C)** Xl Single Family 0 Garage Attached/Detached 0 Discretionary"ID"or Unnamed Use Classification El Manufactured Home 0 Modular ❑Special Use(Essential Public Facilities)** El Commercial* 0 Boundary Line Adjustment El Change of Use El Short Plat"* ❑ Address ❑Road Approach ❑Binding Site Plan"`" ❑Home Business 0 Cottagelndustry 0 Long Plat"* ❑Propane ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration El Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions"* ❑Stormwater Management ❑Shoreline Management Substantial Development*" ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment O Forest Practices Act/Release of Six-Year Moratorium D Tree Vegetaion Request •May require a Pre—Application Conference **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 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE See attached Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true end correct to the best of 1 his,her or it's 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. 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 that he or she wants prior notice. Signature: -7/�(-0/// Date: 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 responsibility for adhering to and complying with the ESA. The Applicant has read this discla'mer and skins and dates it below. Signature: Date: 7 a W C:\Documents and Settings\earn/\Local Settings\Temporary Internet Files\OLKBG\Master Permit Application 12-19-2006.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: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: FAST WATER HEATER COMPANY ( ) 425-636-70$+f ( )425-636-70YS MAILING ADDRESS: 12501 132ND AVE NEKIRKLAND,WA 98034 EMAIL; Jh{�:QfagtwatPrhPatPr corn CONTRACTORS LICENSE WAINS NUMBER: FASTWWH948BC NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX;( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: 0 Sewer ❑ Addition 0 Steel Proposed: Bank 0 Community System OXAlteration/Remodel 0 Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other. Bedrooms: Water Supply: Existing: Setback: 0 Private well ❑ Two Party Type of Heat: Proposed: U Public 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 Fob ry A,-- gli 11 V E -,--1 If this is a Propane Tank and/or Appliance Installation permit,mark all items below that a : k-/ 1-- ❑Underground Tank j1 Above ground Tank Size of Propane Tank: ❑Heat Stove ❑Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Sto 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 show! g a i',of the buildings,all property lines,tank location and size,distances from the propane tank to al/property lines,buildings d pt/c s ste including the reserve area. FEFFRSON COUNTY Square Footage Current Proposed ForOffice Use Only, A EPT.0 OMMs'Noln DFVEIOPMtN Main Floor Heated EH Bld App Review; 2nd Floor Heated Consistency Review Other Heated Base fee: Mezzanine I Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other Water Heater 1 TOTAL: Receipt Number: I")-7C) f) Cash/Check Number. i I ESTIMATED COST(REQUIRED) Date: '7 I .Fair market value of all labor and materials foundation to finish 4 - 1 Initials: _ — —________1_5 C:\Documents and Settings\cam]\Local Settings\Temporary Internet Files\OLKE16\Master Permit Application 12-19-2006.doc