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Home My WebLink AboutBLD2012-00199 1110 • 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#: BLD12-00199 Received Date 6/28/2012 SITE ADDRESS: 250 SUNSET BLVD Issue Date 6/28/2012 PORT TOWNSEND, 98368 APPLICANT: WILLIAM H WOODSON PHONE: 360-554-0414 250 SUNSET BLVD PORT TOWNSEND WA 98368-8912 8 SUBDIVISION: CAPE GEORGE COLONY DIV 2 Block: 3 Lot: PARCEL NUMBER: 938100308 Section: 12 Township: 30N Range: 02W 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, WILLIAM H WOODSON PHONE: 360-554-0414 if different: 250 SUNSET BLVD PORT TOWNSEND WA 98368-8912 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 6/28/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: n FinalApproval: X(--- �'2'1 Z 1 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 \\tidemark\data\forms\F_BLD_Perm it_Propane.rpt 6/28/2012 OUILDING PERMIT APPLICATON BLDI2-00199 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00199 Received Date: 6/28/2012 SITE ADDRESS: 250 SUNSET BLVD PORT TOWNSEND, 98368 OWNER: WILLIAM H WOODSON PHONE: 360-554-0414 250 SUNSET BLVD PORT TOWNSEND WA 98368-8912 CAPE GEORGE COLONY DIV 2 SUBDIVISION: Block: 3 Lot: 8 PARCEL NUMBER: 938100308 Section: 12 Township: 30 N Range: 02 W 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 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION 3,025.00 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 By: Date: Receipt: Approved/Date Permit $97.25 LYK 06/28/12 134953 Plan Check $63.21 LYK 06/28/12 134953 State Building Code $4.50 LYK 06/28/12 134953 Total: $164.96 \\firlcmork\rl..f,\fnrrrlc\F RI Il Ann PIrl rnf C.Y)f919rl1') • . �� 4eN cbe, JEFFERSON COUNTY , ' ...„.li DEPARTMENT OF COMMUNITY DEVELOPMENT_ �� 621 Sheridan Street• Port Townsend •Washington iffilik kiiii 98368 360/379-4450 • 360/379-4451 Fax $�`�BINC`�O� wwvir.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: IVO t 1 l- Project Descriptio (include separate sheets as necessary): I n J&t A�- S)`, Tax Parcel Number: l 'c,5, 0 g PropP,rt 9 Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: Sri r-N Telephone: C) •.'.�� • OLI I'k Fax: email: Mailing Address: ,_ ;(__Q.--- • Applicant/Agent(if different from owner): {a _ Telephone;,(tr�C•- a k -ACt_ Fax: tic, . • .1_ email Mailing Address: `- ' �h tt, �, I�t_A_ YILi C-e Y-\ t What kind of Permit?(Check each box that applies ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance (Minor,Major or Reasonable Economic Use) ,,,tgzSingle Family El Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular ❑Discretior,aiy"D"or Unnamed Use Classification El Commercial* 0 Special USE (Essential Public Facilities)** ❑ Change of Use 0 Boundary L ne Adjustment El Address ❑Road Approach ❑Short Pla *' — ❑ Home Business ❑Cottage Industry 0 Binding Site Plan** I .—. c f t\fl I -1\ ❑Propane 0 Long Plat*" • (1 v ❑ Sign 0 Planned itt.ral Residential Iry n PRRD)IAmendments."* ❑Allowed"Yes'Use Consistency Analysis ❑Plat Vaenn lit n/Alteration** / ; I,I ❑Stomiwater Management ❑Shoreline, M aster Program pt• ion/Permit Revisions I ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline. N anagement Sub§tantial DeVetopment** ❑Temporary Use 0 Shoreline IV anagement Van rice ❑Wireless Telecommunication* ❑ Compreh�r sive Plan/UDC/LandUsia Distriet M ❑Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Prog g�1 *May require a Pre-Application Conference 0 Tree Veg atstion Request DEPT.OF COMMUNITY DEVELOPMENT **Re hu fires a Pre-Application Conference Please identify any other local,state or federal permits required fc r this proposal, if known: ESIGNATION OF AGE1I1 I hereby designate to act as my agent in matters relating to this application for permit(s). OvnINFR Sir:NATi PE - Date: [/' l,'" J L"JY(.- 7,0 11L/ By signing this application form,the owner/agent attests that the information provided he:ie r,,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 mada i'y 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 liabilitiils,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in cor sequence of the granting of this permit. I further agree to provide access and nght of entry to Jefferson County and its employees, 'epresentatives or agents for the sole purpose of application review and any required later inspections. to s access and right of entry will be assui net,unless the applicant informs the County in writing at the time of the applicati t 'a he or shi yants rio not l+ Signature: li ' / ! . _..� Date: �1 :r1 7,e) ? 2/ The action or actions Applicant will undertake as a result of the issuance of this permit rr k 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 appl ci int that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can filr a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with th Jeff rson County development code.Th t.pplicant acknowledges that he,she or it holds individual and non-transfera a r s onsibility for adheri to nd mplying with the ESA. The Appli cant has read this disclaimer`ant,si ns and dates it below. Signature: L� i4L �, 1/ . t Q� _.._ Date: " /,i J V)'I L / L- G:\PetmitCenterVfl#FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 1 _. IIIBUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel refere iced 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: Pl10 IE: FAX: ( ,1'\11(LG✓Yl L [�—A'1 (PN[? )Lk gk. m ( OL, q-1' '3 C 4 '5 MAILING ADDRESS: '1�(I3 , EJ'P L: CONTRACTOR'S LICENSE `n(e,v\.Y\ Aj'-- --4_k, (>L 4�,�p-INNS ('ic rr NUMBER: '\ NUMBER ARCHITECT/ENGINEER: P:Io iE ( ) FAX:( ) MAILING ADDRESS: Er gA;L Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New [] Wood Existing: !_l Sewer ❑ Addition ❑ Steel Proposed: ._.. Bank 0 Community System CI Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: __,. Setback: 0 Private well 0 Two Party Type of Heat: Proposed: _._- ❑ Public c t e (_ Total __-. 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 Installation permit,mark all items below that apply: 1 U• nderground Tank I Above ground Tank Size of Propane Trunk: I Heat Stove l Cook Stove I Woodstove I Fireplace Insert I Hot Water "ank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying fora 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 propel ty lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed 'Fp � ,',.1.. . ., m ttt '' ;.._. RIAAM. 4t.._ Main Floor Heated 'r( tiq: EH Bld App F.e new: Floor Heated h ` Consistencyi2(view: Other Heated ° r � f �" Base fee: Mezzanine ; Additional Secton: v Heated Basement .L' 't' ' Y. Plan Check f:e: Unheated Basement .'. State Surcha-g fee: //`� Other Unheated �jt; Pot Water Review fee: Garage/Carport 1 St IBTOTAL Decks �,I i :_ Other i `� ;1� s _...I• i $1�4{-'�W — Fl '`! Receipt Nr .� umt erll ( `—( '1S� w1, Cash/Check h um ei; Z S— ESTIMATED COST(REQUIRED) o 09iEF-ERe000NTY (p� —� .Fair market value of all labor and materials foundationl to fini _.R "_T OF COV11li jyilEVELOPMENT • G:\PcrmitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc