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HomeMy WebLinkAboutBLD2012-00385 • 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 #: BLD12-00385 Received Date 11/29/2012 SITE ADDRESS: 33 RAINSHADOW DR Issue Date 11/29/2012 PORT TOWNSEND, 98368 APPLICANT: JAMES E VOILAND PHONE: SYDNIE L BARON PO BOX 108 PORT TOWNSEND WA 983680108 SUBDIVISION: Block: Lot: PARCEL NUMBER: 101324009 Section: 32 Township: 31N Ranqe: 01W CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2014 OWNER, JAMES E VOILAND PHONE: if different: SYDNIE L BARON PO BOX 108 PORT TOWNSEND WA 983680108 PROJECT DESCRIPTION: 3-headed ductless heat pump system 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 11/29/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval. 10 2-3 -13 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 11/29/2012 JILDING PERMIT APPLICAT N B Review 0385 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00385 Received Date: 11/29/2012 SITE ADDRESS: 33 RAINSHADOW DR PORT TOWNSEND, 98368 OWNER: JAMES E VOILAND PHONE: SYDNIE L BARON • PO BOX 108 PORT TOWNSEND WA 983680108 SUBDIVISION: Block: Lot: PARCEL NUMBER: 101324009 Section: 32 Township: 31 N Range: 01 W CONTRACTOR: AIR FLO HEATING COMPANY INC PHONE: 360-683-3901 221 W CEDAR SEQUIM WA 98382 Contractor's License AIRFLI*206DG Expires 4/25/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI 3-headed ductless heat pump system TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 8,314.00 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: Approved/Date Permit $222.00 JLA 11/29/12 139787 Total: $222.00 NOV A' 2012 Jefferson County Planni,,; & Building Departmer' \\1irlcmorlr\rlofo\fnrmc\C RI fl Ann RIr!rn+ 11/)OP)i11 2012-11-27 14:49IIII »• 360 683 3971 P 1/1 4-0 � gON 0 4 o6, JEFFERSON COUNTY 142 DEPARTMENT OF COMMUNITY DEVELOPMENT y - <C 621 Sheridan Street•Port Townsend•Washington 98368 360/379-4450• 360/379-4451 Fax Ag lo— www.00jefferson.waus/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessary): Tax Parcel Number. /0/ ,3Z, f Q 0 D Property / . ' W X-C -S (acres/square feet) Site Address and/or Directions to Property: 3 3 itf/k//,rc//14 d IV , A4-Z) Mo .ii5 Li'w NL� vv4- f Q i‘g Property Owner(s)of Record: ✓44e .5 VO/L.4-Nb'L5 /VI N Telephone: _3,0 :33?'5 ./0 f G Fax: email: --- Mailing Address: /?6. 641- /O ' P047- 7 Ui .5 r v !-P 3 6 g ApplkantrAeertt(If different from owner! Telephone: , Fax: email: _ Mailing Address: '— What kind of Permit?(Check each box that applies OBuilding O Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use IC(a),C(d),or C]" ❑Single Family ❑Garage Attached/Detached O Discretionary"D'or Unnamed Use Classification O Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* ❑Boundary Line Adjustment ❑ Change of Use ❑Short Plat`" O Address ❑Road Approach Cl Binding Site Plan" ❑Home Business 0 Cottagelndustry 0 Long Plat" ❑Propane ©Planned Rural Residential Development(PRRD)/Amendments"r` CI Sign ❑Pfat Vacation/Alteration"* ❑Allowed'Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions" O Stormwater Management 0 Shoreline Management Substantial Development" 17 Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wreless Telecommunication" ❑Jefferson County Shoreline Master Program Amendment ❑Forest Practices Act/Release of Six-Year Moratorium 0 Tree Vegetaion Request *May requLw a Pro-Application Conference ,q Please identify any other local,state or federal permits required for this �:U �J ft" f I //1i(r./r(,t�•- 5 Sc(ad(e77-4." SIGNATION OF AGENT - ! I hereby designate ,4iie rLte E4 ' I!to act as my agent in matters relating to this application for (k), OWNER SIGNATURE y � ' .t l[�l Date: !i/Z7/12 By signing this ap cation form owner/agent attests that the information provided herein.and in any attt3nnsl rs ttwo a correct tc the best of his,her or its know1 tge AYl'material falsehood or any omission of a material fact made by the Ownellatteitt with resew to flusiippticetlon packet may result in this permit being null and void. I further agree to Save,indemnify and hold harmless Jefferson County against all liabiities,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 a • ght of i'1try to J-•- -. . my and its employees,representatives or agents for the sole purpose of application review and any requi•.. later i •-.=dio ?.. s a- •. of entry will be assumed unless the applicant informs the County in wrong at the time of tine application�..�or�- • ! w 0 Signature: Coate: (/ .�7 � The action or action-=..I.-:•.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 detlned 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 E indivi. • p Or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in corn ante wit rson I� •._veloprnent code.The Applicant acknowl edges that he,she or it holds individual and non-transferab ty for .., .q: - the ESA. The Applicant has read this disdaimef and ye anti dates it below. il. 2r _ C\Documents and Setringe\rani\Ihcs1 SettmgaVrempoinry Internet Files\OLK$d\Master Perrot Applicsgion 12..19-2006,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: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System O Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: I7 Private well ❑ Two Party Type of Heat: Proposed: 0 Public ITotal: 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 items below that apply: I Underground Tank I Above ground Tank Size of Propane Tank: I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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 property lines,buildings and septic system components, including the reserve area. a ' i ' a � 4 ' Square Footage Current Proposed s .'kr";f:�:ect ,J " �� rr ` zo-.;:t- ' Y tr�� € .�' 6�.:.��Fk' `-'t� ,eF'' 'f � •6�I T �-..,sb�.,�,.� �� `9•;.n A' F f:1�, Main Floor Heated %' T_'1 EH BId App Review: 213 Floor Heated ' Consistency Review: y Other Heated -• Base fee: �. -- ors,_ Mezzanine y Additional Section: 7 °1s.. Heated Basement Plan Check fee: -- II r-~ Unheated Basement W � State Surcharge fee:, , — a_: ; ,, Other Unheated 3�A. +t_ . Pot Water Review fee: +' f ate _w!5 Garage/Carport 4. SUBTOTAL �� 1EFTr45pa COIN ? Decks -F .pi 911/Rd Approach feeTpT OF-' "UNITY DF'�r-! Other 3-N{ 6 Fib 31*. � ''' TOTAL $ vZ --- bo LESJ (� Receipt Number. /;C) 1Y7 3= - pv� 6 -1 .�. Cash/Check Number: cog I ESTIMATED COST(REQUIRED) Date: !/_2-1.-1 2 .Fair market value of all labor and m terial undetion to finish _ _ _ _ I 4 i 3 ` I Initials: I 4—A. i l G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc