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Home My WebLink AboutBLD2012-00205 • • 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#: BLD12-00205 Received Date 7/9/2012 SITE ADDRESS: 783 RHODODENDRON DR Issue Date 7/9/2012 QUILCENE, 98376 APPLICANT: JOHN N KAPP PHONE: 360-316-1068 MARY J KAPP 783 RHODODENDRON DR QUILCENE WA 98376-8602 1+ SUBDIVISION: MACDONALD SHORT PLAT Block: Lot: PARCEL NUMBER: 701344050 Section: 34 Township: 27N Range: 01W CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 12/29/2013 OWNER, JOHN N KAPP PHONE: 360-316-1068 if different: MARY J KAPP 783 RHODODENDRON DR QUILCENE WA 98376-8602 PROJECT DESCRIPTION: REPLACE GAS FURNACE 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 7/9/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: ' l FinalApproval: >-- L -1t: 17 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_Permit_Propa ne.rpt 7/9/2012 ItILDING PERMIT APPLICATION BLD12-00205 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00205 Received Date: 7/9/2012 SITE ADDRESS: 783 RHODODENDRON DR QUILCENE, 98376 OWNER: JOHN N KAPP PHONE: 360-316-1068 MARY J KAPP 783 RHODODENDRON DR QUILCENE WA 98376-8602 MACDONALD SHORT PLAT SUBDIVISION: Block: Lot: 1+ PARCEL NUMBER: 701344050 Section: 34 Township: 27 N Range: 01 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 DESCRIPTIOr REPLACE GAS FURNACE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 2,890.00 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: A ripADatePermit $83.25 LYK 07/09/12 134971 Er Plan Check $54.11 LYK 07/09/12 134971 State Building Code $4.50 LYK 07/09/12 134971 JUL q 2012 Total: $141.86 Jefferson County Planninc & Building Department \\firlcmnrb\rlofn\fnr.nc\C RI ll Ann Rlrl rnf 7/O/1111 ,ggON C, /I IL"\ \ ,�y4i �� JEFFERSON OUNTY ` DEPARTMENT OF COMMUNITY DEVELOPMENT- 621 Sheridan Street• Port Townsend •Washingtr:r 98368 360/379-4450 • 360/3Port T 1 Fax �$S,�N �O� www.co.jefferson.wa.us/commdevelopment III Master Permit Application MLA: Project Description(include separate sheets as necessary): �� -Q.o \t 1 cA a ., ( Y\rt C-< r Tax Parcel Numberr<< Y.t._ �Q(��OG,� Property Size: (acres/square feet) Site Address and/or Directions to Property: CY)) Q.h c,AR4, c o{\ Dr Cry ; 1 c- e -z 03 a-- Q Q 3 G Property Owner(s)of Record: o _ Telephone:"tJ O - .6t t t. C)(.o Fax: email: Mailing Address: .' 7— Applicant/Agent(if different from owner): ,, �" YA Telephone' Off" ' S k O Fax. '} email; A rvl1 e ri hccin.'u r'N 1T'q Mailing Address: 1" L `j `-e-_ LA..)o.- C ••k�c c,., Cz CY\ What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance;Minor,Major or Reasonable Economic Use) . Single Family ❑Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular 0 Discretionaiy"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use (Essential Public Facilities)** ❑ Change of Use 0 Boundary L rie Adjustment ❑ Address 0 Road Approach 0 Short Pla *" ❑Home Business 0 Cottage Industry 0 Binding Site Plan" ❑Propane 0 Long Plat*' 0 Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes'Use Consistency Analysis 0 Plat Vacatir n/Alteration'* 0 Stormwater Management 0 Shoreline N,aster Progr--- • .• ,"• . --. • ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline N,anagement Sw t IC: -,-• -nv `t ❑Temporary Use 0 Shoreline N.anagementtVin ❑Wireless Telecommunication* 0 Compreh ar sive Plan/Ub0 d Use District Map Amendrr n ❑Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreiin Oster Program Ame ndment dment May require a Pre-Application Conference ❑Tree Veg at;ation Request I C 9 U *Req_Tres a Pre-Appli on Conference I Please identify any other local,state or federal permits required fcr this propgsal, known: ✓ JEFFERSON COUNTY D SIGNATION OF AGENTBFPT.Of CO I hereby designate �Y1-, vt�► o act as my agent in matters relating to thi application for permit(s). -7 3 OWNER SIGNATURE - �'-- „-/ _-•_ 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 mad a I ty 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'nspections. Staffs access and right of entry will be assut'1E0 unless the applicant inf s the County in writing at the time of the application that he r she wants nor notice. Signature: - \ -�j�--- Date: / y/ The action or actions Applicant will undertake as a result of the issuance of this permit n a) negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as than,terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the appi c:°rt 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',awsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.Th s,applicant acknowledges tha he,she or it holds individual and non-transferable responsib it for adherin to arid complying with the ESA. The Ap.�li:ant has read this disclai ran signs and dates it below. Signature:_� " /c e"-�-7'-- _ Date: i 3��/ 2----- G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc BUILDER STATEMENT 111 The signer of this statement does hereby certify that they are the Owners of the parcel refe re 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: ENERALCONTRACTOROR ANUFACTUREDHOMEINSTALLER: PiIONE: FAX: II( r�-,-, (a: )y t?: -1 M ( 04 q V3 3 0 m?3'.3 MAILING ADDRESS: C EP IA L: y\c> 3 1 • h � -�.. �a,;rn Al, a;h°c-{.�.v��-,-� �1.r a�:-h rt� . CONTRACTOR'S LICENSE �� ,1tiY� `AA (� 4tal},'$ cc NUMBER: ` NI IMBER ARCHITECT/ENGINEER: PiIONE ( ) FAX:( ) MAILING ADDRESS: ' EMA:L. Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: —_ 0 Sewer ❑ Addition ❑ Steel Proposed: ,__ Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System X' Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: -- —` Existing: _._ Setback: ❑ Private well Li Two Party Ty of Heat: Proposed: _.__ 0 Public �- ' , Total: _._ 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 Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all iterr s below that apply: I U• nderground Tank 1 Above ground Tank Size of Propane Tvnk: I Heat Stove t Cook Stove I Woodstove I Fireplace Insert I Hot Water"d"k I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / t', 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 propeiry fines,buildings and septic system components, including the reserve area. Square Footage Current Proposed ;Ft1 ,,, j'„ k,,' ,. j,f. -Atha .,"t'`.�°,a Main Floor Heated - EH Bld App Review: 2na Floor Heated ' -' ,; Consistency Review: ri Other Heated au z-=N 4 g o` Base fee: Mezzanine $tti' f ,, Additional Section: :t r �, r'it=, Heated Basement ' Plan Check tie: [1 V .,ram _' .� Unheated Basement 1T� State Surcharg i fee: 1 c I Other Unheated $, j '-' . Pot Water Re:vieW fee:2,, ; JUL d 2012 a `0. Garage/Carport r SUBTOTAL Y 1L1 Decks 1911/Rd Approach fee: JEFFERSON COUNTY `'`' _ f DEPT.OF COMMUNITY DEVELOPMENT Other Q'_ "� TOTAL: $ (4 1 •go { 4__ Receipt Number: 3Uq 7 - fAA _ Cash/Check 1,Limber: ESTIMATED COST(REQUIRED) Date: I .Fair market value of I labor and� materials foundation to finish :)(r)/10 Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc