HomeMy WebLinkAboutBLD2011-00309 •
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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 #: BLD11-00309 Received Date 11/14/2011
SITE ADDRESS: 230 RIDGEVIEW DR Issue Date 11/14/2011
PORT TOWNSEND, 98368
APPLICANT: SCOTT L BROWNING PHONE: 360-379-9428
LORI A BROWNING
230 RIDGEVIEW DR
PORT TOWNSEND WA 98368-2512 13
SUBDIVISION: WOODLAND HILLS NO 1 Block: Lot
PARCEL NUMBER: 001345002 Section: 34 Township: 30N Range: 01W
CONTRACTOR: HOOD CANAL HTG & COOLING INC PHONE: 360-375-4992
PO BOX 2940
BELFAIR WA 98528
Contractor's License HOODCHCO27LJ Expires 2/11/2013
OWNER, SCOTT L BROWNING PHONE: 360-379-9428
if different: LORI A BROWNING
230 RIDGEVIEW DR
PORT TOWNSEND WA 98368-2512
PROJECT DESCRIPTION: HEAT PUMP 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 11/14/2012.
REQUIRED INSPECTIONS:
Tank/Line/Appliance:
FinalApproval: 16 -I(, - t a
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
9ILDING PERMIT APPLICA1N BLD11-00309
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD11-00309 Received Date: 11/14/2011
SITE ADDRESS: 230 RIDGEVIEW DR
PORT TOWNSEND, 98368
OWNER: SCOTT L BROWNING PHONE: 360-379-9428
LORI A BROWNING
230 RIDGEVIEW DR
PORT TOWNSEND WA 98368-2512 WOODLAND HILLS NO 1
SUBDIVISION: Block: Lot 13
PARCEL NUMBER: 001345002 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: HOOD CANAL HTG & COOLING INC PHONE 360-375-4992
PO BOX 2940
BELFAIR WA 98528
Contractor's License HOODCHCO27LJ Expires 2/11/2013
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION HEAT PUMP REPLACEMENT
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC
VALUATION 7,300.00 MAIN:
CODE EDITION: 2009 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE:
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
Permit $153.25 LYK 11/14/11 128323
Plan Check $99.61 LYK 11/14/11 128323
State Building Code $4.50 LYK 11/14/11 128323
Total: $257.36
FROM : FAX NO. :360-379-9428 Aim. 13 2011 02:36AM P1
Nov#0 11 02.O6p Hood Canal Hea g And Co 360-241W605 p.1
JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street•Port Townsend•Washington 98363
•
300/37S-4450• 360i379-44y 1 Fax
C . ` www Co.jelferson,wa.us/commdeVeloprnent
Matter Permit Application MLA: ie althek-o • s
Pndiaa;t Orct.iptian iincSsopqrassfots rry)'
Teoc'Parmi Number. Q 13145 0 Property size: (aereatstrarefeet)
Site Addees and/or Directors to Property: --.--
.tom � CD -
property owner(,)of ond: , -1 rot,Jn t'v - T i
Telephone `"( _Fax: ermrti:&Ls:Y 0-(.err: qrY ,,1 -(-Lei''`
Mating Ad]ress: -- 1 1,J
Applicant/A ant(If different from owner): X11 Jtyl ►" - t t 11"eC.
Telephone - Fax(•^ /%"- I )5 ems .•
S 1 ems. c�c�t-k Cyh
Meiling Address: X c�4`�.� le t *k-k i ' (J 91-5_Q _ _-.r
kind of Permit?(Chest each box that applies
{ idkp C Critical Areas Stawardanip Plan
0 Dattedidon Permit C Variance(Minor,Major or Reasonable Economic Use)
C Single Family O Garage Attached J Detached 0 Ccnd onat Use(C(a),C(d),or CI"'
❑ Manufactured yore C Modular C Discretionary"D-or Unnamed Use Classification
p Commercial' ❑Spedal Uco(Esaartial Public Facdrtit3s)"
❑ Change of Use O Boundary Lire Adjustment
II C Address C Road Appocach ❑Shed Piet" •
C Home Business' ❑Cottage industry C Binding Sea Plan**
❑Propane 0 Long Plat"
p Sign 0 Planned Rural Redden fa!Doveldlornettt(PfRFIVAmendrnerifa"
0 Allowed'Yes'use Consistency Analysis ❑Plat VacebcrJAlteration'"
0 Siornhweter Marc ement C Shoreurte Master Program Exewpbor.Pe►rtit Revisions"
0 Site Plan Apprvrai Advance Determinelion(SPAAC)" U Shoreline Management Substantial Development** 1 .
C Temporary Use Cl Shoreline Management Variance
C Wireless Te1ecornnxssicaton" Q Cotnorehrenaive Plen/UDCil.anQ Use Wittc Map Amendment
C Forest Pratxioee Act/Release of Six-Year Moretortum C Jedersan County Shureftne Master Program Amendment
'Mayntgrdrve Pre-A adon Corflrsnce 0 Tree Vegetation Request
''ReqvIntarocation C nfea es
Please Identify any other local,state or federal permits required for this proposal,If knower t
- DESIAtr1A►TICN OF AGENT
I hertaf>yrdeskgr: a _ ___to act as my enl in matters relearn to this aptsi�al for wanks).
Owrillh SSMI1e eg Dale:_ II'"/0- 1) `4
Iaj signing des a :h liar+.the owmerragent att that the Information provided!amain.end In any atbfclimenta.4 WS and cane r to the heat of
his,her or is knee...ledge. Any?notarial tsraet'oad or any omission ce a material fa=made by the ewneeritentwith Peeped to this appiraeon pattort
may mutt in tie permit being mull and void.
I f•rttsr agree to save.inaennrty and hold rarnlass Jeffemon County against sly fisollihe.judgments,.couttamts.reaso llble a*emefs tees 2nr
trtepansss Wheel may re an?way semis 2nair.st Jefferson County as a result of or Ir oaneeQuenoe of the slanting*Min permit
i tanner agree to pr i e amine arse dytn of entry to Ja t rsoo Cot:rty and its errelereea,rapreaetletivea ar egerWo to toe tale pu Mace of sp5Gcetian
review aid any required isle:impecLens. Matra access and right of entry.wit ee aeatrnod unless the applicant Ware the County in rrritlne at.
time of the aQ oeton 1!u he or she rants prier MAIM. .
Sign : ___ Cafe: i it' 10, (I
TM outer or era.Ap•1I„ant Will uncle as a Mel of t r:lsaaaoe of tlfo permit may nogst:saly inpact upon one&more thtxatened or
cadets/prod species and aouid lead to a potential take"of an errslangered species as those terms era defined in the f5dei'M row known an the
•Endangered Spadaid Aei`or SSA:Jefferson County makes no assurances to the applicant that the train that eel be undertaken hosannas bin
malt Asa bean issued out not violate tits GSA. Any Individual,group or agency tart ale a!awsult on Whaler an endangered spaces regarding your
action(9)Oven if aro iri con piano with tie.:dferaor County development cods.The Aepi aat a krowrtedaee that ile.she or It iicida individual
ao0 narrtra le des. Way for adhertng to and W+rptyinp wit.the ESA. The Appttare tat read this declaimer and alms and dales it below.
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0007 NI-10A L i, 1
codes:zO TTOC 90 •.4a� i1�I. NOV 1 _
i JEFFERSON COUNTY
DEPT.Of COMMUNITY DEVELOPMENT
1 • •
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:
fit 0 v C71/4(L.- ltr , /-6004.,.wec ( ) ( )
MAILING ADDRESS: ?O i 2 y 3 EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: & 0 ( — 0 6 L14 — 5 6 Cj •--r I♦ NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX;( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New ❑ Wood Existing: I Sewer
❑ Addition II Steel Proposed: Bank rI Community System
❑ Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System
❑ Repair 0 Masonry SEP Permit#
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: 0 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
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
i Underground Tank 1 Above ground Tank Size of Propane Tank:
i Heat Stove 1 Cook Stove I Woodstove i Fireplace Insert i Hot Water Tank 1 Pellet Stove i 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 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.
Square Footage Current Proposed For �v L
_ enlY Amount .Revision
Main Floor Heated EH Bld App Review:
2"O Floor Heated Consistency Review: _______
Other Heated Base fee: ->
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee: 1 G��
Other Unheated J
Pot Water Review fee:
Garage/Carport t- nn f TOTAL l
i--) r c - ,, , a
Decks I r- -- 911IRd Ap fee:
Other rj
j1 TAL:PC� $ 3T 3
Receipt Nt r: -'
, �+ fllCheck Number: I ' (-7
ESTIMATED COST(REQUIRED) I--- — Date:
.Fair market value of all labor and materials foundation to finish I '- 1 I ( (
.3LCi. " Initials:
_
G:\PemtitCenter\###FORMS###\DRD FORMS\Master Pemit Application 5-29-08.doc