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HomeMy WebLinkAboutBLD2011-00218 • 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 *: BLD11-00218 Received Date 8/8/2011 SITE ADDRESS: 291 VICTORIA LOOP Issue Date 8/8/2011 PORT TOWNSEND, 98368 APPLICANT: PATRICK J MC FAUL PHONE: 425-985-7358 M CHRISTINE MC FAUL 7949 NE 112TH ST • KIRKLAND WA 98034-3408 18 SUBDIVISION: CAPE GEORGE COLONY DIV 1 Block: 1 Lot: PARCEL NUMBER: 937800118 Section: 12 Township: 30N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 0p 33 55 Contractor's License SUNSHP*077QP Expires 11/((33 167/20182-5875 OWNER, PATRICK J MC FAUL PHONE 425-985-7358 if different: M CHRISTINE MC FAUL 7949 NE 112TH ST KIRKLAND WA 98034-3408 PROJECT DESCRIPTION: A/G 120 GAL PROP TANK, PIPING & 2 FIREPLACE INSERTS 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 8/8/2012. REQUIRED INSPECTIONS: Tank/Line/Appliance:' 6'(- FinalApproval: ' • R-tZ'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 tILDING PERMIT APPLICAISN BLD11-00218 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00218 Received Date: 8/8/2011 SITE ADDRESS: 291 VICTORIA LOOP PORT TOWNSEND, 98368 OWNER: PATRICK J MC FAUL PHONE: 425-985-7358 M CHRISTINE MC FAUL 7949 NE 112TH ST KIRKLAND WA 98034-3408 CAPE GEORGE COLONY DIV 1 SUBDIVISION: Block: 1 Lot: 18 PARCEL NUMBER: 937800118 Section: 12 Township: 30 N Range: 02 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 DESCRIPTIOr A/G 120 GAL PROP TANK, PIPING & 2 FIREPLACE INSERTS 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: 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 By: Date: Receipt: Approved/Date Propane Tanks/Stoves $213.00 LYK 08/08/11 127984 Total: $213.00 • - • °SITE VISIT REPORT • (PLOT PLAN) �t1 � JOB l Jhr� ` Pa- I l F u L DATE : 4111111 . CONTACT: ADDRESS 2-I l VV ---ru to:, t0@f° PHONE #: '`}2,S-9e -735Z DIRECTIONS Cry -2 et i(' e. ga �--p (�?�(, FAX #: n�e0(9e-.Dr l c N I( Lam,I O VI 4 D(Gtmai1 L-6�4, PLANNER: Tb6w�e.1,‘ • Include all street names adjacent to property,property lines,tank,appliance&piping locations, distances of tank to property lines and buildin.s,septic, wells, wetland at.:as,distance to water bodies. t9 r 4-- p c J fo 01 \ 0 ° a Cr'' fu G•carext-y- L 'Q_LII___ ----- fik :j� �� 3/ �/}� ; 5 --,, , ; - 3�4' fi -u1 ur-e TionnOrti Cr 4 - ED c I L11111, 1i AUG 8 2011 J Z I sic,-Ks s s-1 3I+ 7 CAT t"!a i_,,i‹; r _ .- i.OF CO" U144EV 01:M[yT 7 G.i .7 (OP i brl) 120 V 1 1 ( 1't• ON Ze t_J_ '� '" � �� JEFFERSON C•N • COUNTY 4 . ' \� DEPARTMENT OF COMMUNITY DEVELOPMENT 'N a: 621 Sheridan Street • Port Townsend •Washington 98368 ,.FIIN > ; 360/379-4450 • 360/379-4451 Fax ' www.co.jefferson.wa..us/commdevelopment Master Permit Application Projec Description(include separate sheets as necessary): Parcel Number: fJ0 �'Tax 937 l fl Property Size: (acres/square feet) Site Address and/or Directions to Property: 9/ /./'/ 7z�j , • /C0j9 /'i.. � c�-� '-"-0 Li/t Property Owner(s)of Record; 4wtre '/c . , ,�-Lj Tr I c' —ez- Telephone: 1S 5'aS 7158 Fax: - email: Mailing Address: 6-zit Applicant/Agent(if different from owner): �..„-c,,,-„j L.. , a f P/L-7.i>d,;-,---4..--- Telephone: , '&5 - ' 75 7 Fax: 38 5-" ;875: email: Gy s"4dti• -,/rVa-.-e ,c-,,,,x, Mailing Address: /0 d',;3 kit/p by 60. PT T. //R-flLo c/c // What kind of Permit?(Check each box that applies O Lot or Road Segregation OBuilding 0 Critical Areas Stewardship Plan O Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) O Single Family O Garage Attached/Detached 0 Conditional Use[C(a), C(d), or C]** ❑ Manufactured Home :0 Modular 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment O Address ❑'Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑Binding Site Plan** , 'ropane 0 Long Plat** ❑ Sign •- • 0 Planned Rural Residential Development(PRRD)/Amendments** O Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/permit Revisions** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development**©Temporary Use 0 Shoreline Management Variance O Wireless Telecommunication* 0 Comprehensive 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 O Tree Vegetation Request **Requires:a Pre-App/ication Conference Please identify any other local, state or federal permits required for this proposal, if known DESIGNATION OF AGENT , I ereby designate - 3o act as my agent In matters relating to this ap lication for permit(s). ii a WNER SIGNATURE { 1 pak; By signing this application form,the owner/agent attests that the informati ri on provided herein,and in an 6 ` rat , ' �v his, her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/hen WIth respect to this application� e t f may result in this permit being null and void. P uacWet I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,Judgments,court costs, reasonable attorney's fee omit expenses which may in any way accrue against Jefferson County as a result of or in consequence of the greriting of this permit, I further agree to provide access and right of entry to Jefferson County and its employees, representativeis or a write fortheJ review and any required later Inspections. Staffs access and right of entry will be assumed unless the p plicant Infodfrli ttieRlifaitiiTYi writing P ti n ' time oft II' ` nth t he:or nor no ce, Ai ' U nrPT.I)E 'Nlal N DEVELOPMENT i .nature: ( ,. Pate: The action or actions Applicant will undertake 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 your action(s)even if yo 'n compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and no n ei o and mplying with the ESA. The Applicant has read this disci trier d siigns and dates it below. Signature: G V` Date: 77c� /� 3t(:•\Prmutrf.nter\###FfRMS###\DR rl RCM MS1r'n,,..nrflRTI Pr,,,,,•\rT..or..,ue...,:.4.,.,1,.,,,;,,,,c on ne.4,._ • , k .,►. . 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-+t n e cP 2� t°A-v -< (0l a ) 3 Zs.- .r 7 T 7 ( 3 64 3 d'S-S P 75 MAILING ADDRESS: /0 cl 53 ae, �, ('fit P. (.� EMAIL: CONTRACTOR'S LICENSE F� WAINS NUMBER: S LA.l-1 sky,* (;341 7 Q NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New 0 Wood Existing: 0 Sewer ❑ Addition o Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other: bedrooms: . Water Supp y: Existing: Setback: ❑ Private well d Two Party Type of Heat: Proposed: ❑ 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 Food Service? Yes / No 4—If this is a Propane Tank and/or Applianc&Installatjon permit,mark all Items below that apply: I Underground Tank Above ground Tank- ' e of Propane Tank: 761 0 G,17 l Heat Stove 1 Cook Stove ove 1 Fir-place Insert 1 Hot Water Tank 1 Pellet Stove I Other Is this appliance being installed in a Manufac u ,. • .. e 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. li 43 %r -.il 1 ttf r F.1 `S�1 ,}fir },,,. y�,f'7 �q,,vy� ,�9#-C w' >Wtg @;.. a S•uare Foote•e Current Pro s osed Ott ., : ' � , :)':it•� ,d'1uJ4tt1`ict 3 « g,,,- (.�� 1 t'k� ?t; Main Floor Heated F, ' of?'• '' EH BId App Review: 2'Floor Heated `It } A Consistency Review: Other Heated °`'1 y.` . � 4 �.l� Base fee: ^ c p'y, 1'a,r�'n, 1 Mezzanine y 4}$y °n:` Additional Section: Heated Basement {' ,I ' #3,' Plan Check fee:" 3"S {03 ,: xY 1'' Unheated Basement ,,� ''i; State Surcharge fee: Other Unheated " ? f,' f Pot Water Review fee: J , gf i�,te, ,, i Garage/Carport 'to 'rs ' '� SUBTOTAL Decks "{'^%�, yr"' a 911/Rd Approach fee: Other '` s ,, TOTAL $ I 9 `}8 %;,F .. j a a Receipt Number: - `1 (� �" ' 'WWI),ltd.,..,, F. Cash/Check Number:. ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish. i Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forma\Master Pe nit Application 5-29-08.doc