Loading...
HomeMy WebLinkAboutBLD2011-00219 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 #: BLD11-00219 Received Date 8/8/2011 SITE ADDRESS: 60-2 UPPER BLUFFS DR Issue Date 8/8/2011 PORT TOWNSEND, 98368 APPLICANT: VIRGINIA H DIAMOND PHONE 650-400-5361 426 PALO ALTO AVE PALO ALTO CA 94301-1217 SUBDIVISION: THE BLUFFS BLDG 21 Block: Lot: PARCEL NUMBER: 965300042 Section: 26 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 pp)) 338g55 Contractor's License SUNSHP*077QP Expires 11/167/2012-5875 OWNER, VIRGINIA H DIAMOND PHONE: 650-400-5361 if different: 426 PALO ALTO AVE PALO ALTO CA 94301-1217 PROJECT DESCRIPTION: A/G 120 GAL PROP TANK, PIPING, & GAS FIREPLACE 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: I 1-,1-L,NL/ 71-1,:;L- /F4.1.6P am) FinalApproval: ( z- /, Ly13 / v1T 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 Ii ILDING PERMIT APPLICAN BLD11-00219 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00219 Received Date: 8/8/2011 SITE ADDRESS: 60-2 UPPER BLUFFS DR PORT TOWNSEND, 98368 OWNER: VIRGINIA H DIAMOND PHONE: 650-400-5361 426 PALO ALTO AVE PALO ALTO CA 94301-1217 THE BLUFFS BLDG 21 SUBDIVISION: Block: Lot: PARCEL NUMBER: 965300042 Section: 26 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 DESCRIPTIOr A/G 120 GAL PROP TANK, PIPING, & GAS FIREPLACE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 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 127985 Total: $213.00 SITE VISIT REPORT Y c (PLOT PLAN) JOB I r I �tOff.-bL a`�V1,GT�`�[.J DATES 3 I CONTACT: ' q : ( ADDRESS CeiC k..f IV r , PHONE #: DIRECTIONS 5R l O -OSn T1---9 L4 FAX\: pat ta c�c 1-o �lv c TU ()1 (k� t6I OrliCTEmail • PLANNER: f .A Ve:..... 2....., . Include all street names adjacent to property,property lines,tank,appliance&piping locations, distances of tank to property lines and buildings septic wells wetland areas distance to water bodies. S TI C 4010 �x t sT TNG%- A�� p T ENA T-i N_ CAvri t-e, c E NLLoS VRS. ))2 n �J qoq$ J p-e-� b $o DM Co Kcor 11 N t cJ N L�r� o c=or F•f. fl 1 la mar.^ rel -n-,11/4n.i -----/ -----)__ i ji • 1.1\41 kA 2 5. ' , \ V r ' 2n,l 12o TroNtZ. LL 1N Da C�R"� 4O2, /- 1'1N(Z11 IJ zpz-r JJ 1jJ O bO F,p , , e.,N-1- • °N co JEFFERSON,UNTY f - ` \q DEPARTMENT OF COMMUNITY DEVELOPMENT '\ 4 a 621 Sheridan Street • Port Townsend •Washington 98368 , 360/379-4450 • 360/370-4451 Fax www.cojefferson.wa.us/commdevelopment Master Permit Application MLA, ��� i; nua f, ,N Project escription(include separate sheets as necessary): 1- Tax Parcel umber: /� L1 L C� f �/C <� � 7� Property.Size: (acres/square feet) Site Address and/or Directions to Property: r, ll I Property Owner(s)of Record, N� Telephone: c2 5 6 C 0,S.g G/ Fax: 5 email: Mailing Address; �� Applicant/Agent(if different from owner): \`' .p — A.....77/,<_„...4 -- Telephone: 385 - 57, 7 Fax: 38 5 -,!5 875; email: /tiShcg ,La-"a-.e , J,„ Mailing Address: . /a cr5 3 k/-/o 6 y /JR. PT //fl-O c.v c% 44.)A What kind of Permit?(Check each•box that applies ❑Lot or Road Segregation ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) ❑ Single Family ❑ Garage Attached./(Detached ❑Conditional Use[C(a), C(d), or C)** ❑ Manufactured Home . 5 Modular - 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment lO Address 0 Road Approach 0 Short plat** O Home Business 0 Cottage Industry _ ❑Binding Site Plan** 'ropane ❑Long Plat** ❑ Sign •- 0 Planned Rural Residential Develo ment PR O Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** P ( RD)/Amendments*" O Stormwater Management 0 Shoreline Master Program.Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** 0 Temporary Use 0 Shoreli ie Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment O Forest Practices Act/Release of Six-Year Moratorium o Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference 0 Tree Vegetation Request **Requires a Pre-APplicatipwe rjfere = T Please identify any other local, state or federal permits required;for this proposal, if know+ , _ _ .. 'J i i 44 i i i DESIGNATION OF AGENT I ereby designate_ to act as my.agent in matters relatin to this appli tion for permit(s). :, , 931'/0 •WNER SIGNATUR i�-r--- Date: By signing this application form,the owner/agent attests that the information provided herein,and in any achments, is true and correct to the best of his,her or its knowledge. Any material falsehood or anyy 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 provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any re later inspections. Staffs access and right of entry will be assumed unless the applicant Informs the County in writing at the time of the a plication tit he or she wants prior notice. � "nature 1 ') L�` 1 pate.,?( L% �/ // The action or actions Applicant will undertake as a result of the issuance of thispermitponJ//// or endangered species and could lead to a potential'take of an endangered species as those term negativelyre defined un the federal I w known as one or mote 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 fife a lawsuit on behalf of an endangered species regarding your action(s)even if you are' piiance with the J erson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf cable reap ns ility for heri to nd complying,with.the ESA. The Applicant has read this d' ci Signature: L.,1 , 1>7 a slgm and dates it below: Date: 7 I (:•\RrrmirC6,nrr•\###FrlRwttit#\T?Rn Frmmc\r,i ,,,,rnRn p.,,--\N4„,,.,P-...,:.A.,.,I.-..,;,,,,F on no a„_ • • • 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: Cate:, , GENERAL CONTRACTOR OR MAN it ER: PHONE: FAx: 5/.4.. Z t n e tP 2.o I©A-vs /1 (94d ) 3FS- s 7 y 7 ( 3 Ge) 3 eS-.5 P 7S MAILING ADDRESS: 'O E 5? - - i p f P, (.( EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: S c 11 S• > 7 7 Q f . 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 O Addition 0 Steel Proposed: Bank 0 Community System O Alteration/Remodel 0 Concrete Total: Height: 0 Individual System O Repair n Masonry — SEP Perrnit.# Bedrooms: Supply: ❑ Demolition 0 Other: • yllater Existing: Setback: o Private well ❑ 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___Jf this is a Propane Tankand/or Appliance Installation permit,mark all items below that apply: 1 Under•r. •• ank Above ground Ta Size of Propane Tank: /- .v -.eat Stove o•f) ook Stove 1 Woodstove I Fireplace Insert 1 Hot Water Tank 1:Pellet Stove Cl Othp cr--a "7yt._ is this appliance being installed.in a Manufactured/Mobile Home? Yes / No J 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. 151 N • �. c �iny.3 4.'T�1h F 11, ,r t M1 at 2 rY4,i%a^� v a. Square Footage Current Proposed r ',r�,„,; ;^0 � x„ ti q Main Floor Heated ' .u; w;T�. EH Bid App Review: nl , x 2' Floor Heated " x" �A ' ` � �, Consistency Review: Other Heated x T 3 Base.fee: j 15 Mezzanine — — �a `rah ; k,,, ' Additional Section: Heated Basement ,,, ,,0, ' ' Plan Check fee: Unheated Basement ,lw,' �r s i ra State Surcharge fee: Other Unheated ��, y, 'f"t' Pot Water Review fee: 4 Garage/Carport c 3y�; j SUBTOTAL Decks �`{)��V�' a V 911/Rd Approach fee: - Other _ �� �{ ';�' l -� i �c� 7 qt§ TOTAL $9 \J t -h $,J , . Receipt Number: I 'D- 1 g4 h�r �k F .,r; a ,,rw g Cash/Check Number: .z 'r( ESTIMATED COST(REQUIRED) Date: • 7, •Fair market value of all labor and materials foundation to finish Initials: -- ' ,-- __ G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Foi ns•\Master Permit Application 5-29-08.doc