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Home My WebLink AboutBLD2012-00384 • • 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 #: BLD12-00384 Received Date 11/28/2012 SITE ADDRESS: 261 SAILVIEW DR#6 Issue Date 11/28/2012 PORT TOWNSEND, 98368 APPLICANT: LOUIS A NICK PHONE: 425-636-7054 ALYSON S NICK 23155 ASLAN PL NE KINGSTON WA 98346-8246 1034 SUBDIVISION: KALA POINT CONDO#1 Block: Lot: PARCEL NUMBER: 964900022 Section: 26 Township: 30N Range: 01W CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7054 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2014 OWNER, LOUIS A NICK PHONE: 425-636-7054 if different: ALYSON S NICK 23155 ASLAN PL NE KINGSTON WA 98346-8246 PROJECT DESCRIPTION: REPLACE ELECTRIC WATER HEATER. 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 11/28/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 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 11/28/2012 tILDING PERMIT APPLICAT BLDI2-00384 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00384 Received Date: 11/28/2012 SITE ADDRESS: 261 SAILVIEW DR#6 PORT TOWNSEND, 98368 OWNER: LOUIS A NICK PHONE: 425-636-7054 ALYSON S NICK 23155 ASLAN PL NE KINGSTON WA 98346-8246 KALA POINT CONDO#1 SUBDIVISION: Block: Lot: 1034 PARCEL NUMBER: 964900022 Section: 26 Township: 30 N Range: 01 W CONTRACTOR: FAST WATER HEATER COMPANY PHONE: 425-636-7054 12601 132ND AVE NE KIRKLAND WA 98034 Contractor's License FASTWWH948BC Expires 1/4/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REPLACE ELECTRIC WATER HEATER. TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION 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 $51.87 LYK 11/28/12 139786 State Building Code $4.50 LYK 11/28/12 139786 A P P R O V E Plan Check $27.17 LYK 11/28/12 139786 �/ Total: $83.54 NOV 213 2012 Jefferson County Planninr & Building Department \\firlcmorL\rl ofa\fnrmc\C RI f1 Ann I I.f rnf 11/9A/7(119 ,SON Co 6 /6 6 JEFFERSON WNTY// ' `kil4,IN DEPARTMENT OPICOMMUNITY DEVELOPMENT • `a 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax S 1 o www.co.jefferson.wa.us/commdevelopment ONG'S Master Permit Application MLA: QC MLA Project Description(include separate sheets as necesJir ): RC'-v14,C V e-6( R c lct,�.cz 1 c 60 0. -P r Itea.Q--e 9 Tax Parcel Number: 9(Ptno j Property Size: (acres/square feet) Site Address and/or Directions to Property: a61S (Xi e.w1'r46 Property Owneh N rr(s)of Record: 1( .\<) L OU(, Telephone: r-`)6'1 g - d 1j`, 1 Fax: • email: Mailing Address: a 1 ,rj S A.C14 \ N e. _...Li. 5'.A) r1 wit R R y b Applicant/Agent(if different from owner): .1 GYLI )1 Cam_ lip CA'Y 3 11 77� p p Telephone: 2,,S-6_36- -I D c,L( Fax: IV-t ��'-7 O )c email: oncis Q p rt,(451 erg IUID,x-.00 Mailing Address: 1?�0 1 13 z Ph,.E ('Jr Vt-3"1c-lct.ri c( i.', (t 4l �' 3 4 . LO W at kind of Permit?(Check each box that applies cih Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) li Single Family 0 Garage Attached/Detached ❑ Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** E l Change of Use ❑ Boundary Line Adjustment 11 Address 0 Road Approach ❑Short Plat** U Home Business 0 Cottage Industry 0 Binding Site Plan** U Propane 0 Long Plat** El Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions CI Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** Temporary Use ❑Shoreline Management Varian ((L (� �/� CI Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Lah ttte6NbpV(m 0 Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program mean ment?� I *May require a Pre—Application Conference 0 Tree Vegetation Request ,i **Requires a Pre-Application Conferencec;1 Please identify any other local,state or federal permits required for this proposal,if known: ri - — - - --/ E ---- ---y- ' 1 rrrq,`� .,,.....T.I - DESIGNATION OF AGENT ,r hereby designate to act as my agent in matters relating to this application forn perntit(s). 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 made by the owner/agent with respect to this application packet may result in this permit being null and void. I further a ree 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 right 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:\PeimitCenter\###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: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: .- ,off wQt Q'x�ti &r c/'� L t (1-1• �> t,36--) TLi MLam634- 0SSy MAILINGADDRESS: 1 l i,() , '32 Av.& IV_ tiYc((A 4 t,�(T'MAIL: pc_'�n.l" )_ &/./Itzucti-erigkilet- W'°/ CONTRACTOR'S LICENSE gat:AtIAINS NUMBER: [ AS'C" w i.�ltk y R NUMBER ARCHITECT/ENGINEER: '` PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: i New ❑ Wood Existing: 11 Sewer n Addition [I Steel Proposed: Bank ❑ Community System fj' Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System L1 Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ❑ 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 Pafkind- Number of occupants(includes owners,tenants,employees,etc) Current Prppbaed___ 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 Underground Tank I Above ground Tank Size of Propane Tank: i' I Heat Stove i Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank T Pellet Stove I Other -I Is this appliance being installed in a Manufactured/Mobile Home? Yes / No i,nI 'J), When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all pmperty lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage I Current Proposed For ceUse Only ,1„ . "- -- Amount yvisian T_ Main Floor Heated Ii:':'� � _�= EH Bid App Review: 2""Floor Heated t.' Consistency Review: rOther Heated , A' Base fee: 51 7 s Mezzanine - Additional Section: Heated Basement . Plan Check fee: Iil Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport T SUBTOTAL S Decks , 911/Rd Approach fee: Other TOTAL: $ 3 — Aa ' �? =_s ,,, Receipt Number: 9 " Cash/Check Number: ESTIMATED COST(REQUIRED) Date: //1 xr-/ .Fair market value of all labor and materials foundation to finish rJ I or ig, 0 0 Initials: ' G:\PcrmitCcnter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc . �� . . �� _ . / �� _��_�� ' �� _ � � __ �� . �` �� ` �� ` � �� ' � �� ~ - --' ----- � -- - ---''----'--- �---' -- -- ' ' - - - — --' | | '-- - --- . � � -- - - ------- r-� --�� ---- ---- . _ ' - - -- _- _ ' � ' -- ' � ' _ � -__- �_�- � - -- - ^_ � � � ' ---__ '--_ -_-____-_-- _ -_'__ _ -__ ' _---'-.� ''-- � ' _-�-_' --- -'- �� | � ____ _-_ _ -_' ' -__'' -~ -- __---__-�- -- __ _ �� '_' �--_-_-- --_' - __ _-__�__ - _-_' � ' \ \ � \ . \ \ \ \ ___� _ ---_~_~ n -----� - - -f'�- -- -- — _ _~- -_' -__'_-_--- ---�_ - -�� _ -- -_ ' -x --°�� -� '--- - � -- - --'' --- --- - - , '^ � \ \ \ � �-- _�� - _- �'_ '-- ___- -_~ ' ^ - _ __- -_-' _ __- ___ ' __� - __. _- � _'_' _ _ - _ -_ - �+- - __ ---� i ---'-�-- ' ' — --- - > ' '---- ---- - --_------_�-__ _ � -� --- ----'J --'------� �---'� ---- --- ---'- - -- -' '- --- ' - `'7-�� --- '-- - - --_ -__ ---_'--�_� __--__ � -- � T. -- '- - � --- ' --- -�7-� ' ' �--- ! . 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