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HomeMy WebLinkAboutBLD2012-00365 41111, 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#: BLD12-00365 Received Date 11/8/2012 SITE ADDRESS: 704 OLYMPIC RIDGE DR Issue Date 11/8/2012 PORT LUDLOW, 98365 APPLICANT: RICHARD E MOQUIN PHONE: 503-884-0000 MARCIA G MOQUIN 704 OLYMPIC RIDGE DR PORT LUDLOW WA 98365-9555 8 SUBDIVISION: OLYMPIC RIDGE ESTATES Block: Lot: PARCEL NUMBER: 821355044 Section: 35 Township: 28N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 1'f/((33 r-pau-5875 OWNER, RICHARD E MOQUIN PHONE: 503-884-0000 if different: MARCIA G MOQUIN 704 OLYMPIC RIDGE DR PORT LUDLOW WA 98365-9555 PROJECT DESCRIPTION: HEAT STOVE & PIPING 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 11/8/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: ',el- J t 1- FinalApproval: �. j Z - l7 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 11/8/2012 •UILDING PERMIT APPLICAN BLD12-00365 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00365 Received Date: 11/8/2012 SITE ADDRESS: 704 OLYMPIC RIDGE DR PORT LUDLOW, 98365 OWNER: RICHARD E MOQUIN PHONE: 503-884-0000 MARCIAG MOQUIN 704 OLYMPIC RIDGE DR PORT LUDLOW WA 98365-9555 OLYMPIC RIDGE ESTATES SUBDIVISION: Block: Lot: 8 PARCEL NUMBER: 821355044 Section: 35 Township: 28 N Range: 01 E 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 DESCRIPTION HEAT STOVE & PIPING TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 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 Propane Tanks/Stoves $148.00 LYK 11/08/12 135390 ...,� Total: $148.00 '3ft2;"3;1`,:m 1ty Piann]nr, & Building D part^mnn± \\firlcmer4\r4ofo\fnrme\C RI f1 Ann Rlrl rnf 11/2/9A19 11/06/2012 16: 12 FAX 360385E SUNSHINE PROFANE • IJ001/002 t icilril JEFFERSON•COUNTY'DEPARTMENT OF COMMUNITYD'EVELQPMENT .4.:if' : - - 621 Shtfcidan Street• Port l ownsend,Washingtort',983B$ , •,«� 360/379-440• -36Di 79-44'tv1 Pgc www,co.Jefferson,wa..us/oornmdevelopment Master Permit Application MLA; ID r -- Project Description(include separate sheetg As necessary); • b i1j ed f.i•P 6 Tax Psartel:Numbe.r. . 'BS5 O • •� RroPeny Wig' (scres/square•feet) site Addrese.and/or Directions to Property; . .o Li D 1 G• ' 1?3,12✓3— Li4d2t. ' Property.Owner),of Record: y9/L.t • Telephone: OD — -70C)Q 0 Fax: - . ••email • .. Mailing Address: (47• 1 !Z: �i AppiiCenVAgent Of•different from owner): Telephone: 85 r 5 7/7 • Fax: -Tg,S--.�8 75 . . erne: j r d 4•.!r•A.J0 •ces,, Mailin9,Address: 0 d' 3 Hoy • 4)1Q: ' - - Pr. t/R-aLo ci- • +..,,)R What kind of.Perrntt4,(Che •each•bex that applies- 0 Lot orftoed Segreeatioit , DBUliding 0 Crlticaf�Areria Stet rdshlP PIdti ,''• © Demolition Permft ' . •.• W Variant*(Mlnor„Majeiror Reemaitabie•Economlc•tUse) Single.Family • • 11 Garage„P.dtathed.l Detached • 0 ConditiQ'tval t.se;r e),,C(d , Manufactured}lame- 0 Mc liner. , ' ,• 0 DiSoredoitdry`t:6r..W.nrla 0 a s .O �/] 0 Commerdal* • p sped ;'U�• ,( sttt}rit►al.pu 1i0 �J 0 Change of Use :, 0 6 urkary%C1rre djustrit9t'i)' M Address ,_, - .. Aced Approach '0 Short Post*' • , ❑ Horne Busine4 . Cj Gotta e''I lustry S 0 elnding,S1te1flati " - ;,2 , itpeng . - .d L0,W,Rjat * .,- - , . r• .Ei 4gn. ' • • ' ". '• C Planr RIraJResldonIfal;Deua(opinei�t.(PRw Anertd w nt ' . ,Aitow,e `Yes'•UseConsistencyMaats ' , 0 Plat Va Uld.nAtte tl n' . • • •0'StomtraterMenagernent• • . . • 0 Stiarellhebi'eeter Prigre n.Fet o r `tg1‘taki*i r• ,O.SIte;Plan'Approua�.AOvar ;petermii 1ton;($.Pf 4); ,Ca'9ho'r'el}rt6'= artagsr�erit'Sutaat i iivr p 10,^RENT 0 Ternpar ; .tJse • nadertent Variance ' • �'�•Shorsll a . . .I. EI4 itlefis rilit ImWWftt dibr!'* > Y• p.' orh ' i s, re Ptarl/UO?/Larid Ose=blatriet Map Arpentit lent, o Fbresi Practices}yct'Release of Six-Year Moratorium• ' C JefferaP,t:County.Shoreline Master Program Amendment A May require a•A're-,4ppltcabon Confeiarrcw ,d Tree ark ri.Request " . �.:. " rjriirrtotia Pre:Appitca.fir f-Csanererroo- Pieas.e-identify any other iocair•st ate o r'federal,.petxtrtl*required l3 thii's-propgsai;:i>f,known, 1 td �t>rl �-' al±Sl(3NAIt3N 4t=AG i , , •I.hereby designat r) to act-es my:e ,et'�t.jn,mettera reletlrtg.to this ap;Ilcatioit for pamtit(a), j 'WNR SloNkrt. Imo ./! / -2�' "d:: f � •p t8: / �l Sy signing this eppiloation form,the • ne ant atteeta:tltatthe Infomletlpn prcvited ie I',end In any.ettec ernte,,s true and oorrpctto iPe,bestof ' hia,her or.tte knowledge.,4hy m:.erial: •ehooitcr any,,om(sajoitof a rrraterlalffaa`tri'ida t'a•owner/agent with•resped,to.this'appiloalf m diet,' may result in this permitbeing•n I a old, ; . • 1 1 further agree to save,indemnity and hold heriniess',fefferst:f �Cpunty age Inst till IlaylititoktlItsi cavil costs,reasonable.attorneyt$fees and • expenses whlon may in any Way a0 rtre agalri;t Jefferson'County as a result of or in-conee9U,iinee of the granting of this permit, 4 further agree to provide.aeoaSe•and right of entry t0 jelifegiontochty`and Its employees,,rap/esontativea or agents for the sole pu,rpoas'at application review and any r tilted- r•Inspections, tttff a'cease end,right;of entry*live asarrr ted;l4A1aas the.appIIpaf#1 tnfomis.the County In writing at the r mini®of the a on Opt�{h •p 6'1 , ,, natur43 - e ` Daka •The action or actions Applioad[ I and ke as a result of#lie•lesuan' 19•of tit r- ;pe�rttt,r�i„ •;n�attvetY impat#u n o •ar,rpote threatened or ' endangered species arad'cau• lead a.Fotentlal,"take.",,,of.aarslpdangored species aa`tkoeitem,s•are daftn it the federal law known as the 'Endangered Species Act` ''ESA, Jefferson Couhty'malt'es no assurances to,the eppllcalit'.tlh'at.the action •tltat yeti(pa underta1Sen;beeause this permit has been Issued w I net violate the EA,-Ahy.individual,group or agency can file a lawiuit;on behalf of art melba ored:apebles regnrdiirg;your. aactionl(a)even If yqu a In compliance ith,the J4fferson County development code.The Appticint•acknowiscigeri•`thet he;•ehe•tlr•Ittrolda:lndlvIdti'ei- and ilort-tranef • tk i k� r g�to anq oornplying.with;f .e:L A. The Applicant hasread'this dos Iaf a -a .si.na and digest below. ` Sign tur __ • r:.1 R,....i.f'rnrrr\#iz3i'Fr1R *mil RORMC\r iir.tnr rlp1-1 Fn-....\Al...,..P....,:.4....14,.......4•.n�a.,_,. 11/06/2012 16: 13 FAX 360385511 SUNSHINE PROPANE • [j002/002 i BUILDER STATEMENT The signor of this statement does reby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be se a ib"ity of the General Cont_rpdOr for the proposed project. Signature'` � Date: — - . GENERAL CONTRA R �,tlflSfrtt{ER: P ONE' FAx ` 5��, s iYYYr111J e P 2 P�r-e, _ t�6U ) 3 S- s 7 �7 t 36 3 es.. a? 75 MAILING ADDRESS: 1 p 5 pp �j !� f;fdrlt_ CONTRACTOR'S LICENSE J WAINS - NUNIER; S't.t 7 NUM aER ARC#ilTEGT/ENGINEER: — PHONE ( ) FAX( ) MAILING ADDRESS: �� EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of swage Disposal: n New ❑ Wood Existing: u Sewer I o Addition C Steel Proposed: Bank i Community System o Alteration/Remodel o Concrete Total: ! Height: 0 individual System I Repair C Masonry 0 Demolition 0 Other: Bedrooms: —' WateP r Supply: - ._..� Existing: Setback: o Private well a Two Party. Type of Heat: Proposed: TO�l' ❑ Public Name of System: If this.is a Commercial Project v4unust answer the fQliowlno: c c Number of Parking Spaces: Current: _ Proposed: Number of : {.. j Number of occupants(includes owners,tenants,employees.etc) Currant Proposed IBC Occupancy: IBC Type of construction: Will you have Fddd'Servioe? Y f (f this i ane'iank a r Appliance Installati bel on narmE ark all ltsame ow thpt a'sply: 2 II j I U round Tank I Above ground Tank Sire of Propane Tank: Heat Stov 1 Cook Stove 1 WoodStoVe I Rapist:a Insert I Hot Water Tank I Pallet St !$this appliance being Installed in Manufactured/Mobile Home? Yes Nc Ji' ` `Z! tATUNIy When applying for a permit to Install a propane tank you must also submit a site plan showing-Of-of '' TV`� "c p n lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, Including the reserve area. u b'•� ': i text* .xr;P hfiyi bed Fs4"�jt�" ' I ray t"I I. P"Y Square Footage Current Prb•osed ti !G��� 1 } '' a 1 �c} i, • ' 't /' ., -i �o *.� via �'y��'i�., ♦ �p I - r r �Yr � V. � H*CID.. Main Floor Heated � � ; �+4h� � i, ,..Li G,.,!v;' Y�._a,x�` .'�.1����'���%' .) In ��.....•; � �..'t��,�^a � a'� `�iiy "ii V` ;S.'k '' EH 81d App Review: 241 Floor Heated x 4.... iirvW4.' ;'r Consistency Review: Other Healed ,,' i "" .;.;n,''•t Base fee: . Mezzanine `} r;r ri„ .• Additional Section: 4. Heated Basement I/"' '„..t ,ir Plan Check fee: -� Unheated Basemen: 1 i,',t',K.I' ,,'r,•� State Surcharge fee: •;.,,, ,, •.; .' Utftr3r Unheated l.%' :p Pit Water R vi f f Garage/Carport ` `,:.-;,,' SUBTOTAL it ,i._ . :` I Decks `` ? ' . c,:' 911/Rd Approach fee: i '` Other 116R., M Ya�r TOTAL: $ ` Li g . ' f' '�;rii Receipt Number: c••-, s f _ r�yy��1wr,. ' ,,y.;;,,* Cash/Check Number: i ESTIMATED COST(REQUIRED) Date: i - *Fair market value of sit labor and material9 foundalort to finish ' `��'1 __ ... Initials: G:\Pami Ccracr\###FORMS###\bRD FORMS\Currmu DPdI?emu\aster FerricApphemion 5-2o-08.doc