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Home My WebLink AboutBLD2012-00024 • 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 #: BLD12-00024 Received Date 1/26/2012 SITE ADDRESS: 82 PARKVIEW LN Issue Date 1/26/2012 PORT LUDLOW, 98365 APPLICANT: FREDRICK B BELL PHONE: 360-437-5151 ILONA C BELL 82 PARKVIEW LN PORT LUDLOW WA 98365-9718 3 SUBDIVISION: BRIDGE VIEW ESTATE TR DIV II Block: Lot: PARCEL NUMBER: 821355015 Section: 35 Township: 28N Range: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2013 OWNER, FREDRICK B BELL PHONE: 360-437-5151 if different: ILONA C BELL 82 PARKVIEW LN PORT LUDLOW WA 98365-9718 PROJECT DESCRIPTION: REPLACE GAS BOILER 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 1/26/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 1 /2_ 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 WILDING PERMIT APPLICA TON BLD12-00024 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00024 Received Date: 1/26/2012 SITE ADDRESS: 82 PARKVIEW LN PORT LUDLOW, 98365 OWNER: FREDRICK B BELL PHONE: 360-437-5151 ILONA C BELL 82 PARKVIEW LN PORT LUDLOW WA 98365-9718 BRIDGE VIEW ESTATE TR DIV II SUBDIVISION: Block: Lot: 3 PARCEL NUMBER: 821355015 Section: 35 Township: 28 N Range: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2011 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP REPLACE GAS BOILER 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: 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 Bv: Date: Receipt: Approved/Date Permit $97.25 LYK 01/26/12 131400 Plan Check $62.31 LYK 01/26/12 131400 State Building Code $4.50 LYK 01/26/12 131400 Total: $164.06 oNC 4111 I l� q (r • �� O JEFFERSON COUNTY ` DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •wan;- n 8368 _. 360/379-4450 ', 360/379-4451 Fax (� ��4s ,SO www.co.jefferspn.wa.uslcommdevelopment �jx[lv0 Master Permit Application \ ,1 A n! 2 MLA: 00 MLA- teiD 1.6 Project Description(include separate she s as necessary): -e X,i ` r (.+ c •.� L'C i k-c.,:r t Lk liL \t. ' 14- . } Eis0N MINTY Tax Parcel Number t5 - Ptopert;Size: (acres/square feet) 2 �� [�F°T.OFt,CfO�A��^UNITY Il'�� O Site Address and/or Directions to Property: 9, �C�'( 'L V't L&L) til- c't c- L. )A l '--; Property Owner(s)of Record: FC a c `1:1„=.\\ Telephone:"k(C L\ .--).D.-- -- i �j 1, Fax: email: Mailing Address: Applicant/Agent(if different from owner): .al:. v\}_. (1`S (',Z;t'\-rc (t.(..--\-r:(s Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** 0 Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat** ❑ Home Business ❑Cottage Industry 0 Binding Site Plan** ❑Propane ❑Long Plat*" ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: ESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATUR ( �./`4, � Date: '/' By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its 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 attorney'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 assunied unless the applicant informs the County in writing at the time of the application that h r 5 e wants prier notice. 7 Signature: / ---. 0 Date: / o 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 the st terms are defined in the federal law known as the "Endangered Species Acr 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 respon ' ility for adhering to,and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signatni. . / l'_-&,f Date: / ' (',-) - U( Z. G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.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: ENERAL CONTRACTOR OR ANUFACTURED HOME INSTALLER: PHONE: FAX: ,�r�.11v U-r� � f `%► ( lf% )4 4 . -IA M (�10ki' (,/'3'3 4-3'j MAILING ADDRESS:y\\ 3 1 VA:ltr\ -IW.. 1-<— EMA": rn.,-e a\p t{.IA, kJ GL-h tom{ . CONTRACTORS LICENSE �x-,t �,v-\ Ok- i Q` (.j�� INS (,�,inNUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: ' EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: 0 1 Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System LI Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well C Two Party Tye of Heat: Proposed: 0 Public (.C, ; Total: Name of System: If this is a Commercial Protect 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 i Above ground Tank Size of Propane Tank: i H• eat Stove I Cook Stove I Woodstove i Fireplace Insert i Hot Water Tank I 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. �� x r 1 r ': .1 "'ft,.� �,+a J I. f ''o A f 1F:',G�wf l°'rye.y 1 .r_ ,:.� f 1l} �,�r s�.yris ! s i. ai an1� y� -�Yk�+l x z f t✓uti Square Footage Current Proposed 7)r IKIRMi+.s,.lt _ { r r Main Floor Heated f EH Bld Review: y�M ' App 2'Floor Heated r" -, '' Consistency Review: -14,44 Other Heated rI p,. 1 •�' a' Base fee: (� Mezzanine ,.,,'{4 Additional Section: Heated Basement . orMr ' Plan Check fee: 3: r v, (.V 7 31 44 Unheated Basement r State Surcharge fee: /( .50 i. f Other Unheated e: ,fi"p '` Pot Water Review fee: N1r Garage/Carport ,4 -4f ' SUBTOTAL f#41:4;4,:i,;',I �.R' . Decks911/Rd Approach fee: w, , Other r TOTAL: $ \�.0 L ,`! s� 4 u - __) 13 t--E op ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish , U �j ` -Z b —l2— 32� °'� I Initials: 4 (______---�� i � • 1 JEFFERSON COUNTY . 'rnT 0 rn'^l"V T'DFVLl OPMENT G:\PermitCcntcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-06.doc'