Loading...
HomeMy WebLinkAboutBLD2012-00056 • 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 #: BLD12-00056 Received Date 2/22/2012 SITE ADDRESS: 11 DANBURY CT Issue Date 2/22/2012 PORT TOWNSEND, 98368 APPLICANT: KATHLEEN DEVANNEY PHONE: 203-531-1602 MARIA MENDES 11 DANBURY CT PORT TOWNSEND WA 98368 442+ SUBDIVISION: KALA POINT#3 Block: Lot: PARCEL NUMBER: 965000052 Section: 27 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 pp Contractor's License SUNSHP*077QP Expires 11/67/�0123g5 -5875 OWNER, KATHLEEN DEVANNEY PHONE: 203-531-1602 if different: MARIA MENDES 11 DANBURY CT PORT TOWNSEND WA 98368 PROJECT DESCRIPTION: A/G 120 GAL PROP TANK, GAS PIPING &2 FIREPLACES 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 2/22/2013. REQUIRED INSPECTIONS: c Tank/Line/Appliance: / vl SP q ( 0/. / i �Q 3,16 ./ FinalApproval: ( _ I - I 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 itILDING PERMIT APPLICATION/ BLD Review ew Type: 56 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00056 Received Date: 2/22/2012 SITE ADDRESS: 11 DANBURY CT PORT TOWNSEND, 98368 OWNER: KATHLEEN DEVANNEY PHONE: 203-531-1602 MARIA MENDES 11 DANBURY CT PORT TOWNSEND WA 98368 KALA POINT#3 SUBDIVISION: Block: Lot 442+ PARCEL NUMBER: 965000052 Section: 27 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, GAS PIPING & 2 FIREPLACES TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW 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: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Propane Tanks/Stoves $222.00 LYK 02/22/12 131485 Total: $222.00 c SITE VISIT REPORT (PLOT PLAN) DATE: i—25-rz. .:',-;CONTACT: 4rADDRESS 1) :),r4mi3c..yri:\ —4-1 PHONE #: IPIRTIONS l<A 1--A PG\1\11"-b se , To \156W—I t,+A 2, FAX #: •4.-. TO rbic='i`q3Q-re`) Email PLANNER: -1)‘1--x/Wilin . Include all street names adjacent to property,property lines,tank, appliance r8ipip sc:•;0452cifsvenf t.)property lines and b thldit_ iga, tic,wells,wetland areas, distance to water bodies. i ) •-••• .-- - I ?-71 ,0 ii S tiyli L ... s‘ . , FEB 2 2 2012 / - b r . L. \ I ' JEFFERSON COUNTY 8B‘ L i DEPT.OF COMMUNITY DEVELOPMENT ;-- 1'1 I : . Room tIt3 kar, )) IvA5bta3 CAM rt;WRI. . , , • C.VA 5-e Ifrsi 151 47( bA15 -12:7- 2.‘vkl. A,^pn..e.,-ncm-020TiS 0 tit(4.' ,ir;•,:',4., Z•C•-• • a 0 V" k- , '3111,ii 1 - 411----"--------C) ' • r r Li-D 111111Mil . . TEE " r e6 c\-1-- i " 5 Co G0) i I-DE -r E-Nr-r-R.,i 1 -: L., * , GY*Af kV, i - - ) /\ „:.,, ... , • ,...,,,, ..„ ) • . ,„,. 4, „.. . ,„_„,.,,,,,,,,, ,. _,, i ,., ,..:., ,,2_,, v ,c,, ,, , ri p k(Nati 1 C‘5 ge,-2-' --mF ) C‘ti\A 3 j (Loz.3 c.,), 5144 I ,, L..t V I N c) 12-0 0 ( • i,;• 4.• :,:•;.t,, • • t‘. i t',k-,;- • ".1 . ,!-,- • • • • ON co JEFFERSON COUNTY 'iilif . DEPARTMENT OF COMMUNITY DEVELOPMENT 'N o 621 Sheridan Street• Port Townsend•Washington 98368 K.,..... 360/379-4450 • 360/379-4461 Fax www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: RD (Ylc,,o- i) Project Description(include separate sheets as necessary): D 'ct r-e�o a ` iv.A o nck vo p r 4J t 4'Ir Tax Parcel Number: Ci,tp G,c)OS 2-- —ProperlySize: (acres/square feet) Site Address and/or Directions to Propert : I i ot..)�u v�" -ra l-Obi Property Owner(s)of Record: '!'l� , �� / e2 (A -t kb-CS Telephone: O — j-1 Fax Mailing Address: ..�V3111 'L C-T1 O(2 j` 1, - 2 , . l y Applicant/Agent(if different from owner); M i?'+"""— � S Telephone: .?85 S7, 7 Fax: 3g 5-- g 75 r\ i email: ' ' a.-e- Mailing Address: /0 6'4 3 k/-/o 6i2. PT. //,'-OG.o c% '' A y� ` �� cam, What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Building 0 Critical Areas tewaraship JBItitSON COUNTI ❑ Demolition Permit ❑Variange •(Minor, •Maj roRgas'OUtte: ` .•.-- .1 • ❑ Single Family 0 Garage Attached./Detached 0 Conditional Use[ C(d),or(.,)** ❑ Manufactured Home 0 Modular - 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment O Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑Binding Site Plan** ropane 0 Long Plat"* 0 Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management 0 Site Plan 0 Shoreline Master Program Exemption/permit Revisions** 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 O Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment May require a Pre—Application Conference o Tree Vegetation Request **Requfresa Pre-Appiicatlpn Conference Please identify any other local, state or federal permits required',for this proposal, if known: DESIGNATION OF AGENT I ereby designate r to act as my a gent in matter relating to this application for permit(s). WNE,R SIGNATURE a—�/ p y 54 I C"i G^A n ' ' o7 Leo.. ,r "9: f Date: c—/i 71/2- By signing this application form,the owner/agent attests t t..he 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 a9ents 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 t time of the appiicaf n that he or she w is prior notice, . , , _ " -'•nature. C1"� , et. � / �` �,' /17_- The J Date: _3�/T action or actions Applicant will undertake as f�esuu�t of the issuance of this permit may negatively impact upon one.or more threatened or endangered species and could lead to a potential.ktake"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-transfer ble responsibility f r �hering to and corn ly' with th 'ESA. T e Ap ant s read this disci Imes and signs and dates it below. Signature: / d./ ._ . /z C`a i � ��' //!' Lr'2 Date: J-�7/y?i )� t (:\P,,,,,ir('rnrrr\###FMNIS###\DWI FORMS\CIi r,.n in--)Fri.,,,.\Ttoor..,P....,:.4....1.— z on no a • • BUILDER STATEMENT The signor 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 forthe proposed project. Signature: Date:.•, 1 GENERAL CONTRACTOR ER: PHONE: FAX: Sr. ..t , sfiln e ti°l2A I° t', ( 4/6 ) 3 Fs -r. 7 17 ( 3G4 3 es-SP 7S MAILING ADDRESS: 'O R 5? I. p r P. ti EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: SC.II'lS• >kpil7Qr NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: 'EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: 0 Sewer O Addition 0 Steel Proposed: • Bank 0 Community System •0 Alteration/Remodel 0 Concrete Total: Height: 0 Individual System O Repair ❑ Masonry SEP Permit# pp y: O Demolition 0 Other; Bedrooms: Water Su l Existing: Setback: 0 Private well 0 Two Party • T of-Heat: Proposed: yPe Total: - ❑ Public 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 Fooil'Service? Yes / No ' •• 4-jf this is,a Propane Tank and/or Appliance Installation permit,mark all Items below that apply: 1 Underground Tan ground Tarty Size of Propane Tank: (.212 l Heat Stove I Cook eve oodstove 'replace Inse 1 Hot Water T k I:Pellet.Stove 1 OtherZC ice 1.6" Is this appliance being installed in a Manufactured/Mobile Home? Yes When applying fora permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lints, tank location and size, distances from the propane tank to all propertylines,buildings and septic system components, Including the reserve area. yr . .. ..: �,�� � ;.4�7i{Tx' Ill E��S� '���1 p {1f���4• 4�, ���,. '84�3� ,+(l(�v�"",�f�6ro '#P � 471 'Square.Footage Current Proposed f� Vc r " • `�•IM : ua. �' ,��to N , 4, 1°A." .AA• or Heated k �'�Main Flo ��,M. ���� EH Bld App Review: 2'Floor Heated a„y'� i ,bi. Consistency Review: Other Heated • i '67r ,s,`, Base fee.. . • Mezzanine • kr; ., Additional'Section: --, jay+4e':. Heated Basement •,,a°}•" Plan Check fee: 4. Unheated Basement rr} State Surcharge fee: Mir s �_ Other Unheated ' s•r`,f;,' a Pot Water Review fee: - Garage/Carport. • Py r SUBTOTAL ' R ,7 T A9'm ye,. .., Decks }•�, r- . 1 911/Rd,Approach fee: Other $�' — TOTAL: rp sf %,,1 �X Receipt Number `1 �J ,_ _ . . . . ,,,. ,4•n �• , Cash/Check Number.: ,4 (//� ESTIMATED COST(REQUIRED) Date: ` +Fair market value of all labor and materials foundation to finish Initials: G.\PemvtCenter\###FORMS###\DRD FORMS\Curtent DRD PoitrifiA Msurer PArn,4 A,.hIL-.,:..«c_ln_no a.._ --- _---) L