Loading...
HomeMy WebLinkAboutBLD2012-00067 • 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 #: BLD12-00067 Received Date 3/5/2012 SITE ADDRESS: 581 PINECREST DR Issue Date 3/5/2012 PORT TOWNSEND, 98368 APPLICANT: JOHN C KULLER PHONE: 360-385-2288 ELIZABETH M KULLER 25 BLUFFS LN PORT TOWNSEND WA 98368-9572 408+ SUBDIVISION: KALA POINT#7 Block: Lot: PARCEL NUMBER: 965000267 Section: 27 Township: 30N Range: 01W CONTRACTOR: ALL WEATHER HTG & COOLING PHONE: 302 KEMP STREET PORT ANGELES WA 98362 Contractor's License ALLWEWH934MU Expires 8/3/2013 OWNER, JOHN C KULLER PHONE: 360-385-2288 if different: ELIZABETH M KULLER 25 BLUFFS LN PORT TOWNSEND WA 98368-9572 PROJECT DESCRIPTION: NEW HEAT PUMP 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 3/5/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: .3/ 12-112. 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_Propa ne.rpt 10/29/19 411J ILDING PERMIT APPLICA N BLD12-00067Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00067 Received Date: 3/5/2012 SITE ADDRESS: 581 PINECREST DR PORT TOWNSEND, 98368 OWNER: JOHN C KULLER PHONE: 360-385-2288 ELIZABETH M KULLER 25 BLUFFS LN PORT TOWNSEND WA 98368-9572 KALA POINT#7 SUBDIVISION: Block: Lot: 408+ PARCEL NUMBER: 965000267 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: ALL WEATHER HTG & COOLING PHONE: 302 KEMP STREET PORT ANGELES WA 98362 Contractor's License ALLWEWH934MU Expires 8/3/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 5,152.00 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 Permit $125.25 LYK 03/05/12 131514 Plan Check $81.41 LYK 03/05/12 131514 State Building Code $4.50 LYK 03/05/12 131514 Total: $211.16 03/L11'2012 13: 2E. 13E.0c152 ALL lklEATHER HEATS PAGE 02/03 41'. sOlu 006, JEFFERSON COUNTY ,„ r3 DEPARTMENT OF COMMUNITY DEVELOPMENT • "t 621 Sheridan Street • Port Townsend •Washington 98368 xG 360/379-4450 • 360/379-4451 Fax YQsG,sO Lvuvw,co.lefferson.wa,us/commdevelopment Master Permit Application MLA: rb MLA ILA CEO 16 Project Description(Include separate sheets as necessary); Tax Parcel c —�"� ,Number: Property Size: (acres/square feet) Site Address and/or Directions to Property: 581 Pi ne,c(es+ _Dr t Pork atry)e,rr ct 00 A ct 3 408' Property Owner(s)of Record: „101r1 r 11Gu l ter Telephone: -300- 'S`r5 -Reel Fax: _ email; Mailing Address: . .$ etiu: ). PL2..d W y?SC,aLl- 1N _�'(b`.3lo$•_ _ Applicant/Agent(if different from owner): -Ir t* (.r 6li n Telephone; -R(Doo— 4 a-q ?j3 Fax:.3 C,-y`5 -' mall: al►shr.Q olyptvl turn Mailing Address: •t or WA •S(o tad What kind of Permit?(Check each box that applies Oullding ❑Variance(Minor,Major or Reasonable Economic Use) O Demolition Permit Cf Conditional Use IC(a),C(d),or C)** n Single Family 0 Garage Attached/Detached ❑Discretionary"D"or Unnamed Use Classification 0 Manufactured Home O Modular 0 Special Use(Essential Public Facilities)'"" © Commercial" 0 Boundary Line Adjustment ❑ Change of Use C Short Plat** ❑ Address O Road Approach 0 Binding Site Plan O Home Business ©Cottagelndustry ❑Long Plat** O Propane ❑Planned Rural Residential Development(PRRD)/Amendments" ©Sign 0 Plat Vacation/Alteration*" ❑Allowed"Yes'Use Consistency Analysis o Shoreline Master Program Exemption/Permit Revisions** ©Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* O Jefferson County Shoreline Master Program Amendment O Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *May require a Pre-Application Conference "Requires a Pre-Appllcatlan Co»frrrnce Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate A ,4_ er to act as my agent In matters relating to this application for petmit(s), OWNER SIGNATURE // Date: � ��� a/ ay signing this application f9� th owner/agent attests that the Information provided herein,and in arty attachments,is true and correct to the best of J his,her or It's knowledge. Lrlpyimaterial 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 attomey'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. 1 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 leter_i spectiona, Staffs access and right of entry will be assumed unless the applicant Informs the County In writing at the time of the application at he fts4 'wants prior notice. Signature: ‘ q� ""r_"'t��—= Date:_ �/F'&' / z'" The action or actions Aip(cant will undertake as a result of the Issuance of this permit may negatively impact upon one or more threatened or endangered spedes4rfd could lead to a potential"take of an endangered spades 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 actions)even if you arelfl ompltance with the Jefferson County development code.The Applicant acknowledges that he,she or It holds individual and non•lransferabl respo ibility for adhering to and complying with the ESA. The Applicant has read this disclaim an signs and dates It below. Signature: . Date: /F,t> /L~ — C_\Documentx rind hcttinpe\enrol\Loral Soteing\'rcmponry Internet['ilea\()LIc8a\Neater Permit Applicadnn 1 t..iii 200ri-doc E13!E1/2012 13:26 13E045207 ALL HEATHER HEA• PAGE 03/03 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 t res nstbllity of the General Contractor for the proposed project, � A Signature: y ,�!c— Date: 7.441 GENERAL CONTRA R OR MANUFACTURED HOME INSTALLER: PHONE; FAX; Al1 ea' ' C Q.o. ►n c0o> -get3 Lisa-5i 77 �.i MAILING ADDRESS: �� a .e, 9 EMAIL: t .Whc..eOLypert CONTRACTOR'S LICENSE WAINS NUMBER: A Lv'+ G 441 1 D NUMBER ARCHITECT/ENGINEER: — t(Y'L{ PHONE ( ) F!x:( ) MAILING ADDRESS: EMAIL, Project Type: Frame Typo: Bathrooms: Shoreline: Type of Sewago Disposal: o New ❑ Wood Existing: ,_,.,_ . 0 Sewer O Addition ❑ Steel Proposed: Bank C Community System ci Alteration/Remodel 0 Concrete Total: Height: rl individual System 1 I Repair a Masonry SEP Permit# C Demolition ❑ Other; Bedrooms: i Water Supply: Existing:• AL--_.-Setback: 0 Private Well i:i Tw$1�artq' 'type of Heat: � Proposed: �L • ❑ Public hli f}s,`C pump Total: ,,.,L Name of System: 1 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 Instaliation permlt,_mark_all items below that apply: °Underground Tank [:3 Above ground Tank Size of Propane Tank; _ ❑Heat Stove 0 Cook Stove 0 Woodstove t1 Fireplace Insert C7 Hot Water Tank CI Pellet Stove 0 Other Is this appliance being installed In a Manufactured/MobllaJome? Yes l0 When applying for a permit to Install a propane tank you must also submit al 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 resew a area. Square Footage Current Proposed For Office Use Only _ Amount Revision Main Floor Heated , q5 EH Bid App ReViow: 2'�'Floor Heated Consistency Review: -- Other Heated Base fee: Mezzanine Additional Sectlbn: Heated•easement.- .-- .. . Plan Check fee, Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: W 1 ------- •• SUBTOTAL_ I ll (U) Decks 911/Rd Approadih fee: • ---.- TOTAL: $ a\k, tp Receipt Number: g 31 3 Cash/Check Number: c 33 ESTIMATED COST(REQUIRED) Date: j 'Fair market vat❑e of all!ebb!'and materials foundation to finish 3 — Initials: - - <<\T7ocurncnta and Sctdngg\earl\t.ocal Setdng;\"t'crnpontry Interner Filer\OLK8fi\Mostcr Permit Application l2-l9.20fG.doc