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Home My WebLink AboutBLD2012-00036 • 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 #: BLD12-00036 Received Date 2/9/2012 SITE ADDRESS: 17 TWINSVIEW CT Issue Date 2/9/2012 PORT LUDLOW, 98365 APPLICANT: RAY SCALABRINO PHONE: 360-437-5024 JILL SCALABRINO 17 TWINSVIEW CT PORT LUDLOW WA 98365-9219 13 SUBDIVISION: LUDLOW POINT VILLAGE DIV 4 Block: Lot: PARCEL NUMBER: 969800013 Section: 16 Township: 28N Range: 01E CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7054 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2014 OWNER, RAY SCALABRINO PHONE: 360-437-5024 if different: JILL SCALABRINO 17 TWINSVIEW CT PORT LUDLOW WA 98365-9219 PROJECT DESCRIPTION: ELECTRIC HOT WATER HEATER 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 2/9/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: PUy /71/ 1 .7 ` f -73 FinalApproval: J J - /2 /77---P 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_Perm it_Propane.rpt 10/29/19 IU ILDING PERMIT APPLICA•N BLD12-00036 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00036 Received Date: 2/9/2012 SITE ADDRESS: 17 TWINSVIEW CT PORT LUDLOW, 98365 OWNER: RAY SCALABRINO PHONE: 360-437-5024 JILL SCALABRINO 17 TWINSVIEW CT PORT LUDLOW WA 98365-9219 LUDLOW POINT VILLAGE DIV 4 SUBDIVISION: Block: Lot: 13 PARCEL NUMBER: 969800013 Section: 16 Township: 28 N Range: 01 E CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7054 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2012 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt ELECTRIC HOT WATER HEATER REPLACEMENT 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: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routinq Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $47.90 LYK 02/09/12 131437 Plan Check $31.35 LYK 02/09/12 131437 State Building Code $4.50 LYK 02/09/12 131437 Total: $83.75 555905 III 110 `yg,SON c, JEFFERSON COUNTY et IA r4 `\. h-3 DEPARTMENT OF COMMUNITY DEVELOPMENT '`'I `N 621 Sheridan Street• Port Townsend•Washington 98368 360/379-4450 • 360/379-4451 Fax , ZNa,�p www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: DC) nY)01- 1 Project Description(include separate sheets as necessary): Remove/Replace Electric Water Heater Tax Parcel 969800013 Property Number: Size: (acres/square feet) Site Address and/or Directions to Property: 17 TWINSVIEW CT Property Owner(s)of Record: SCALABRINO, RAY Telephone: (360)437-5024 Fax: email: Mailing Address: 17 TWINSVIEW CT PORT LUDLOW, WA 98365 Applicant/Agent(if different from owner): FAST WATER HEATER COMPANY Telephone: 425-636-709 4 Fax: 425-636-705S emailliUlie Ltastwaterneater.corn Mailing Address: What kind of Permit?(Check each box that applies building 0 Variance(Minor,Major or Reasonable Economic Use) El Demolition Permit El Conditional Use[C(a),C(d),or C)** Xl Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification 0 Manufactured Home 0 Modular ❑Special Use(Essential Public Facilities)** 0 Commercial* 0 Boundary Line Adjustment ❑ Change of Use ❑Short Plat** El Address 0 Road Approach ❑Binding Site Plan** 0 Home Business 0 Cottagelndustry ❑Long Plat** 0 Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Varian s� —4 i Ir--i ❑Temporary Use ElComprehensive Plan/UDC/Lan triet Ma},A„tuitdmenl 0 Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment I ❑Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request tt • *May require a Pre—Application Conference **Requires a Pre-Appiicatibn Confer+nte Please identify any other local,state or federal permits required for this proposal,;if known: Li uI DESIGNATION OF AGENT - "' " I hereby designate to act as my agent in matters rel4ting tritfi'is 1'f rdailf' 16� ` BAR NT OWNER SIGNATURE See attached Date: Sy 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 it's 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 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 required later Inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap ficatipn that Jae-pr she wants prior notice. Signature: t Za (_' I.--N., Date: 1/27/12 r The action r 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 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 you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,*she or it holds individual and non-transferable esponsi ility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ,L Date: 1/27/12 - C\Documents and Settings\caret\Local Settings\Temporary Internet Files\OLKB6\Master Permit Application 12-19.2006.doc 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 responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: FAST WATER HEATER COMPANY ( ) 425-636-70'St{ ( )425-636-70y5 MAILING ADDRESS: 12601 132ND AVE NEKIKKLANU,WA 95U34 EMAIL: { - JUIi ra _ 1k, _ - to .0 CONTRACTOR'S LICENSE WAINS NUMBER: FASTWWH948BC NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New D Wood Existing: 0 Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System OXAlteration/Remodel 0 Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ 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 ] c� U /J I -1 f Number of Parking Spaces: Current: Proposed: Number o� U V l� Number of occupants(includes owners,tenants,employees,etc) Current i P-oposed IBC Occupancy: IBC Type of construction: Will you have Food,Serv�e Ye_s No- If this is a Propane Tank and/or Appliance Installation permit,mark all items below tha p�) E `_ 0 Underground Tank [.J Above ground Tank Size of Propane Tank: ` J ❑Heat Stove 0 Cook Stove ❑Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stovd ❑Othe_r Is this appliance beinq installed in a Manufactured/Mobile Home? Yes / No lEFftRtON COUNTY When applying for a permit to install a propane tank you must also submit a site plan sirewirnr n "i Ui'Tll OEVrI. PMENT ope►ty 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 Office Use Only Amount Revision Main Floor Heated EH Bld App Review 2nd Floor Heated Consistency Review: Other Heated Base fee: -47. 90 Mezzanine Additional Section: Heated Basement Plan Check fee: S 31. E Unheated Basement State Surcharge fee: Z4 SO Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other Water Heater 1 TOTAL: $ g--3,75 Receipt Number: I '3 I ' l 37 Cash/Check Number. 1 (0/ 1 3 C0 10 ESTIMATED COST(REQUIRED) Date: c�� .Fair market value of all labor and materials foundation to finish Initials: _> C �--- - C:\Documents and Settings\canal\Local Settings\Temporary Internet Files\OLKSG\Master Permit Application 12-19-200G.doc '-