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HomeMy WebLinkAboutBLD2011-00220 S 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 #: BLD11-00220 Received Date 8/8/2011 SITE ADDRESS: 226 HIGHLAND DR Issue Date 8/8/2011 PORT LUDLOW, 98365 APPLICANT: REBECCA J JANNING PHONE: 360-437-5099 TIMOTHY J JANNING 226 HIGHLAND DR PORT LUDLOW WA 98365-8752 46 SUBDIVISION: SOUTH BAY#1 Block: Lot: PARCEL NUMBER: 995500046 Section: 21 Township: 28N Range: 01E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 p) 385-5875 Contractor's License SUNSHP*077QP Expires 11/67/2012 OWNER, REBECCA J JANNING PHONE: 360-437-5099 if different: TIMOTHY J JANNING 226 HIGHLAND DR PORT LUDLOW WA 98365-8752 PROJECT DESCRIPTION: GAS FIREPLACE 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 8/8/2012. REQUIRED INSPECTIONS: Tank/Line/Appliance: glig 2" - / Z P1', FinalApproval: 7 / Z P13 Cf `S L c k cZL / 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 MILDING PERMIT APPLICATI BLD11-00220 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00220 Received Date: 8/8/2011 SITE ADDRESS: 226 HIGHLAND DR PORT LUDLOW, 98365 OWNER: REBECCA J JANNING PHONE: 360-437-5099 TIMOTHY J JANNING 226 HIGHLAND DR PORT LUDLOW WA 98365-8752 SOUTH BAY#1 SUBDIVISION: Block: Lot: 46 PARCEL NUMBER: 995500046 Section: 21 Township: 28 N Range: 01 E 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 DESCRIPTIOP GAS FIREPLACE REPLACEMENT 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: DECK: SETBACK: 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 $71.00 LYK 08/08/11 127986 Total: $71.00 • `4 1i SITE VISIT REPORT (PLOT PLAN) Y`\ � ‘- A14 K 1 � DATE: l I\ . ONTACT: ADDRESS 2 ZCp A t V\[,1/4":1 `b�' . PHONE #: 4 3?~5-0 11`j . DIRECTIONS , TO SQ, FAX #: Email PLANNER: T L eiVYN % . 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. V tax. y2c5sT 261 3 1 �- cssr ./11 rk •) CC� OMIT s • �1r V ° 21 FILIAN.0v42_ T N tQA Q. ' cam- u_ t(021 M i NftgatN\7Q F<<soli c LINTY DF`.�I(VW.NT • rolv eo JEFFERSON COUNTY • f - \ y ; DEPARTMENT OF COMMUNITY DEVELOPMENT r v o 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA; � 0/j-1-- CE.,€) 1,1 Project Description n((include separate sheets as necessary): Tax Parcel Number: �I SOU p y Property.Size: (acres/square feet} Site Address and/or Directions to Property: , Property Owner(s)of R ord; 7/ ,77 ,eQ,/,�c co— e./a-a'7(., Telephone: 5(3 7 c,5fl 9 5 � Fax: - email: Mailing Address: 5L-e Applicant/Agent(if different from owner): a '3 ), Telephone: ."4i5 - S7 7 Fax: 875; email; l S`ry1-d .c Mailing Address: /0�53 ;�l-10 by6P. Pi I. //11'OC_a c% A . lJ Gam' What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Building 0 Critical Areas Stewardship Plan O Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) 0 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or CJ** 0 Manufactured Home 0 Modular - 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Special,Use(Essential Public Facilities)** O Change of Use 0 Boundary Line Adjustment 0 Address 0 Road Approach 0 Short plat** O Home Business 0 Cottage!Industry 0 Binding Site Plan** 'ropane 0 Long Plat** ❑ Sign •- • 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ©Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 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-Ap•/icatlpn Conference Please identify any other local,state or federal permits required;for this proposal, if known: I ereby designate • DES IGNATION OF AGENT to act as my agent in matters relating to this application for permit(s). {AI a WNER SIGNATUR � Date:--_ZtC—/y./ ZO/ By signing this application form,the owne agen atte sthat.the informatl6n ided herein,.and in any attachments, is true and correct to the best of his,her or its knowledge. Any materi alsehood or any:omission of a nal fact made by the owns/a gent with-respect \/ iicuo- f may result in this permit being null and void. . I further agree to save,Indemnify and hold harmless Jefferson County against all liabilities,Judgments,Icoiurt'costa;re sam�ul!au r y s lies 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 oF4p fiction review and any required later inspections. Staffs a ss and right of entry will be assumed unless thejapplicant informs the County in wriiin0 et.the. r time of the application or she w n 5 r 'nature: i cafe The action or actions Applicantwil nde ke a result of the issuance ofth' ermit maynegatively Il endangered species and cot:, ad to a pote ial°"take."of an enda termsse e �effiet,iun n the federal e.er l law.known as t e "Endangered Species Act"or"ESA,"Jefferson County makes no assurances to the applicant that the actions that will bee 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-transfer sibillity fo adh ing t and complying with fhe`ESA. The Applicant has read this disclaim and igns and dates it below. `r Signature:/`- -zO 1/ t / Date: ��� (:\Prrmirf'rnrrr\#titsnRMR###C Rrl F(IRM.CIC,,.-re•nr Mil F......,,•\A,f.,,.,.A....,: .,.,1:-,"4,,,,c on no,r.._ ( Q-3 • 0 , '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 responsiaility of the General Contractor for the proposed project. Signature: Date:,: . GENERAL CONTRACTOR ER PHONE: FAX 51-L1„ Ziilne rF2 to/41" . (?bo ) 3 Zs'- .r 7 I ( 36e 3 es-Sa) 7S MAILING ADDRESS: 1 0 e 5 3 0.44_,- p r p. (1 EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: S .-&i'1 S• 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 0 Steel Proposed: Bank 0 Community System O Alteration/Remodel 0 Concrete Total: Height: 0 Individual System ❑ Repair 0 Masonry SEP Permit# O Demolition CI Other: . Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type"of-Heat: Proposed: ❑ Public Total;.. Name of System:. If this Is a Commercial Projec`.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 ' _*-Jf this is,a Propane Tank and/or Appliance Installation permit,mark all items below that apply: 1 Underground Tank 1 Above ground Tank 7 �� Size of Propane Tank: i=X<J/ /'V�7 /424,' . 1 Heat Stove 1 Cook Stove 1 Woodstove Fireplace - 1 Hot Water Tank I Pellet Stove 1 Other d—k/J T7 4C7 is this appliance being installed in a Manufac • 1 obile Home? Yes / No /t-f #002-02 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. �p+• �„y { '4t 6 '!ti?�"F n, -a'� w {H ,t41 S"i} 'Sg 8t C .9 y Y4fiG.17.•,{ B,k z=}r 'Ss e* y'`'e4 'Square Footage Current Proposed :�' `' + t a�•. r Main.Floor Heated ' x,. ii , EH Bid App Review k 2na Floor Heated t j ^ rt + ? Consistency Review: Other Heated n , r 1,104 Base fee:' q Mezzanine, 1`' ,'°� Additional Section: _ N t :y� . Heated Basement 1`;,,t,w4 3`* Plan Check fee: Unheated Basement �r; t" 4 r State Surcharge fee:. ' Other Unheated: •'„ ,,•• '•A P Pot Water Review fee: cak, Garage/Carport t' ;k, nF�`�4a SUBTOTAL } ` Decks t ,r .r 911/Rd Approach fee: Other v a �.�r, TOTAL $ - 1 t — t 4 rr r'�-7Q 1 t' r Receipt Number: 1�c�4 f�gk ' ,;£ F Cash/Check Number.: . /`'///�', ESTIMATED COST(REQUIRED) Date: 11 ll .Fair market value of all labor and materials foundation to`finish L ) Initials: G:\permitCenter\###FORMS###\DRI)FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc