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Home My WebLink AboutBLD2012-00249 • A 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#: BLD12-00249 Received Date 8/16/2012 SITE ADDRESS: 1924 W HASTINGS AVE Issue Date 8/16/2012 PORT TOWNSEND, 98368 APPLICANT: MICHAEL G CAVETT PHONE: 360-385-0503 JUDITH K CAVETT 1924 HASTINGS AVE W PORT TOWNSEND WA 98368-9638 TX 59 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001054002 Section: 5 Township: 30N 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, MICHAEL G CAVETT PHONE: 360-385-0503 if different: JUDITH K CAVETT 1924 HASTINGS AVE W PORT TOWNSEND WA 98368-9638 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 8/16/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: - 3 c - l Z M FinalApproval: ` 3 / Z fib 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_Propane.rpt 8/16/2012 4CILDING PERMIT APPLICATION B Review 0249 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00249 Received Date: 8/16/2012 SITE ADDRESS: 1924 W HASTINGS AVE PORT TOWNSEND, 98368 OWNER: MICHAEL G CAVETT PHONE: 360-385-0503 JUDITH K CAVETT 1924 HASTINGS AVE W PORT TOWNSEND WA 98368-9638 SUBDIVISION: Block: Lot: TX 59 PARCEL NUMBER: 001054002 Section: 5 Township: 30 N Range: 01 W 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 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 3,250.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: 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: �pi3C�1rd1 Ate OVEr Permit $97.25 LYK 08/16/12 135107iU— F,,Plan Check $63.21 LYK 08/16/12 135107 State Building Code $4.50 LYK 08/16/12 135107 Alit) ( �U;? Total: $164.96 Jefferson County Planning & Building Department \\firlcmor4\rinfe\fnrmc\G RI fl Ann PIA rnf A/1RMrl1 1 r oN cOO,, JEFFERSONbUNTY `41 DEPARTMENT OF COMMUNITY DEVELOPMENT _ 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax to c fifi.,k1/1 ,(-4 q (,„ „gip$ www.co.jefferson.wa.us/commdevelopment Master Permit Application MI.! .A: �)() m(A Project Description(include separate sheets as necessary): \ f\ \.\ \_ . _ A— � ;n, (Q Tax Parcel Number. ( N o5 p l.,r Property Size: (acres/square feet) Site Address and/or Directions to Property: lk ci�>v n.3r�� Property Owner(s)of cord,(' cs;t _A--."' kr 1l_l 0%\I c Telephone: D),•��°'�,�,Qc..�� • C Fax: email: Mailing Address: dL'`— (� Applicant/ ent(if different rom owner): `�(�� Telephone: : Fax: email•CO in) il b- in u Mailir..g Address: L_ --� . el irl What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance al Use,(M „�,._5•=% qr ,, q yes Single Family 0 Garage Attached/Detached 0 Conditional Use(C is , G ❑ Manufactured Home O Modular 0 Discretionary"D";or y rlamea use Ciassiflcatlon 1 ❑ Commercial* 0 Special Use(Essential ublic Facilities)** ❑ Change of Use 0 Boundary Liie AdjusiMent AUG 1 2012 ❑ Address 0 Road Approach 0 Short Plat** ❑Home Business 0 Cottage Industry 0 Binding Site Plan 1 Lw i I ❑Propane 0 Long Plat** i l ❑Sign 0 Planned Rural Residential DeRib rOVRIRD)/Amendm nts** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vaca io-l/Alteratiofin OF COMMUNITY DEVELOPMENT 0 Stormwater Management 0 Shoreline Master Program Exemptio erml evisions ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* El Compreht;nsive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate 4!\=�QA\ a \M to act as my lent in matters relating to this application for permit(s). OWNER SIGNATURE .� >Q� (k3 &( /Y�-cik ��1 l�1 ...LA. V1 VW... vie: 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 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 agents for the sole purpose of application review and any required later inspections. Staffs access and nght of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior notice. Signature: Date: The action or 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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • 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: ENERAL CONTRACTOR OR ANUFACTURED HOME INSTALLER: PH 7f E: FAX: ,�� ` \ ( u )Lk -VA pc, ( Ok, ( ,3,3 5 MAILING ADDRESS: ..'1�0\ 3 ,�r\ vs `H4 '... EM411.:.\a„.,YY1.i.t �b N(< ‘4,,,Ju \ 0,41 Y�C�' . CONTRACTOR'S LICENSE �(t y "'CV -1\l (� ) iIUS c � NUMBER: ` NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAII. Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: —. Setback: Li Private well 0 Two Party Type of Heat: Proposed: LI Public Total: .— - _ Name of System: If this is a Commercial Protect 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 oe I If this is a Propane Tank and/or Appliance Installation permit,mark all items below that a E 1 1 Underground Tank 1 Above ground Tank Size of Propane Tank: i, I I 1 Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank 1 PelleStgve 1 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No i I i , 4 -112 • When applying for a permit to install a propane tank you must also submit a site plat{showing all of the buildings,al r rty lines,tank location and size,distances from the propane tank to all property lines,b di and se tic system com' n , including the reserve area. �! EFFF SQp_,,,pu � r tli Square Footage Current Proposed •F' �,lrt's'. .-.•.3 •� ',,.,`, �.•;.vl .'. 4; n* 3Fl .. Main Floor Heated , I R ., 3 EH Bld App Review: 2n°Floor Heated ~,pzt\ Consistency Review: 4. Other Heated ' ' „ ' �r �9 Base fee: Mezzanine r r ;'i �' Additional Section: a Zit, rv. ar 4 _ Heated Basement a r m° ; Plan Check ff:e 1113 �1 ( Unheated Basement e � -'• • State Surchu ge fee: t • Other Unheated �,o r ''1�' Pot Water Review fee: fit • z ,• Garage/Carport SUBTOTAL '7`. r ,t' 911/Rd Approach fee: Decks "e, to ,_. Other •, 'I Y TOTAL: $ ` Let- (1,, •i^ `" Receipt Number: t 35 tr', Cash/Checi Number a � co �rrt' I ESTIMATED COST(REQUIRED) 1 '3,g 7 ) Date: 1.(,., .Fair market value of all labor and materials foundation to finish '` J t Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc