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HomeMy WebLinkAboutBLD2014-00094 OU ILDING PERMIT APPLICAN BLD14-00094 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00094 Received Date: 3/18/2014 SITE ADDRESS: 481 THORNDYKE RD PORT LUDLOW, 98365 OWNER: JANET A DE DONATO PHONE: 360-437-8054 ROBERT W GRINDELAND 481 THORNDYKE RD PORT LUDLOW WA 98365-9568 ADMIRAL'S ROW SUBDIVISION: Block: Lot: 8 PARCEL NUMBER: 721095008 Section: 9 Township: 27 N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REPLACE BOILER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2012 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 $152.00 JLA 03/14/14 148464 APPROVED Total: $152.00 Jefferson County DOC \\firfcmar4\r7o4o\forme\G RI fl Ann Rid rnf 1/1R/9f11A Screen: 01 REAL PROPERTY MASTER Mode: INQUIRY Parcel # 000721095008 Cd 272109208231 411 Auto Roll : OFF ADMIRAL' S ROW Nbhd Cd 3425 LOT 8 W/PTN OS V10/P26 Loc ID * Taxpayer Cd DE*D 6800 DE DONATO, JANET A T/P Chg Dt 2/27/2002 * Title Owner T/P Chg Usr JODI Tax Code 0231 Status TX TAXABLE Land Use 1100 RES-SINGLE Affidavit 94008 Vol/Page / C/U Code COMPLETE ADDRESS WINDOW Taxpayer DE*D6800 JANET A DE DONATO ROBERT W GRINDELAND 481 THORNDYKE RD PORT LUDLOW WA 98365-9568 Search Key CMD 6: End Window CMD 7: End of Job . • � JEFFERSON COUNTY p DEPARTIV,IENT OF COMMUNITY,DEVEIAPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450. 360/379-4451 Fax -,..... ,,,, ,.... 7:-' 05-...,,,,..., www c o Jefferson w a us/Commdevelopment J,l -teti._ ,.„, . _. Master. Permit.Appiication . MLA; i-.., ). ......... . . . .: Project Description(include separate sheets as necessary): �' 1, 20 Li + � � ' _Tax Parcel Number 1 O '1 5 - . Property Size: JEri ER .,`;�,5",„,�•. , ' ' Site Address and/or Directions to_Pro rty MMUNFlYbLE/OPyrAT. Property Owner(s),of Record r.-v.64 i air?0 k U1' iJ <" Telephone:: 1. 7e-Fz?S cri= Fax -email: Mailing Address: . { , Applicant/Agent(if-different from owner): Telephone: Fax: -'. email: Mailing Address ;What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan -' 0 Demolition Permit ,- ❑Variance(Minor,Major or Reasr n-able Scorn:4 io"Use) 0 Single Family ,, . ❑°Garage Attached/Detached °' ,0 Conditio'rfal Use[C(a),=C(d),Or C]'"' - ' ; O Manufactured Home .-.C7 Modular' ❑Discretionary D'or Unnamed Use Classification O Commercial"* , , . 0 Special=:Use.(Essential:Public,Fr cilitles) _ ❑ Change of Use . D.Boundary Line Adjustment ❑ Address .. 0 Road Approach ❑Short Plat'"' ❑Home Business ❑Cottage Industry 0 Binding Site'Plan** Propane ❑tong Plat** ,. ~. 0 Sign,. . . _.= ,, _.• . 0 Planned Rural Residential Development(PRRD)!Amertidments",--"' 0 .llowedtf`Yee'Use Consistency Analysis. „ ,. ❑Peat Vacation/Alteration 0 Stormwater Management ❑Shoreline Master Program Facemption/Permit Revisions** O Site plan Approval-Advance-peterrnination(SPAAD)*' - Cl Shoreline Management Substantial Development*' Cl Temporary se , CI Shoreline Management Variance ' CWireless==Telecommunication*.- 0 ComprehensivenPlan/UDC/t and Use District Map Amendment ❑Forest Practices Act/Release of Six Year Moratorium ❑Jefferson County Shoreline Master Program Amendment ``May'equire•'Pre-Application Conference " O Tree Vegetation Request *"RegruIres a Pre-Applicafion Conference . Please Identify-en),other local,state or federal permIts required for thIs proposal, if known: '. -DESIGNATION OF AGENT I hereby designate to act as-my-agent m matters relating to this application for permit(s) .Z_ / 1 By Signing this application form,the owner/agent attests that the information provided herein,and in any,attachments istrue and correct_to the test of his her or its knowledge. Any material falsehood or any dit issionaof It material fact made by the'owner/agent with respect to this application,packet may result In this permit being null and void. A further agree to save Indemnify and hold harmless Jefferson County against all liabilities;judgments.court costs,reasonable attorney's feet and ,expenses which may in any way accrueagainst Jefferson County as a result of or in 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.nit of entry will be asstlmed.unless.the applicant informs the County in writing at the. 1 e apple t. . he or she wan prior-,notice r The action or actions.Applicant will undertake rose-result of the issuance of this permitmay negatively Impact upon one or more threatened,or :endangered species and could lead to a potential"take"of an•endangered°species as>those termsr 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. Ahy 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 tie;Sheer it holds individual • ,7tranaferable .,• -ibili for adhering to and complyng with,the ESA. The Applicant has read th disclainer a signs}end dates it below. ''. . i ne y l 41.- ai' G:\PeumtCenter\###FORMS###\DRD FORMS\Master Permit Applicatuxi 5-29-0adoc 1 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 contrartors.end that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUF TUBED HOME INSTALLER: PHONE: FAX: MAILING ADDRESS: - EMAIL: CONTRACTOR'S LICENSE 1 t� `. WAINS NUMBER: S L-�a�? s t"'�I 0.) b 7 7 a v NUMBERa r ARCHIT,ECT/ENGINEER: I: PHONE ( ) FAX (: :,)`. ., MAILING ADDRESS: EMAIL Project Type Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New ❑.Wood. _ Existing:,, ❑ Sewer ❑ Addition,a 0 Steel Proposed: Bank ❑ Community System O Alteration/Remodel 0 Concrete Total: Height ❑ Individual System o Repair 0 Masonry SEP Permit# C Demolition 0 Other- -' - Bedrooms: Water Supply: , Existing Setback:. ❑ 'Pit/ate well '"0{�Two Patty: Proposed: Type of Heat: 0 Public Total; Name of System - if this is a Commercial Protect vo,r must answer the following: Number of Parking Spaces Current•, Proposed: . Number of ADA Parking Spaces._y. 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 andlor-Apoliance Installation permit.mark all items below that avail,: t Underground Tank 1 Above ground Tank Size of�Qropane Tank: I Heat Stove I Cook Stove I Woodstove I Fireplace irsseri i Hot WakrTank Pellet Stove I Other 6 i i'`42--1'..- Is this appliance being installed In a Manufactured 1 Mobile<Hor6�TYas-T fro When applying fora°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-reservezrea: S•uare Foote!e Current Pro•osed- E,l,. �`, 5»,� m;„IiiI t r .-1,,,'aiai['' r,X ,iI.97' . E ...E..: Main Floor Heated - ” -_ ' r' ;:1�uEHBId App Review:., ,_ � ,. 2' Floor Heated Y Consistency Review a . . , Other Heated, Base few Mezzanine -Additional Section: Heated Basement`` ,0' -Plan Check fee: Unheated Basement Y ' , State Surcharge fee:' Other:Unheated ', t r .Pot water Review fee: .- Garage/Carport .1 ,:- ;,°. SUBTOTAL., Decks '"i. i `: 911/Rd Approach fee: 'Other 1 7 I : TOTAL $ Receipt Number. J "l S 14 b nr CashlCheck Number: ESTIMATED COST(REQUIRED) Date: •Pairmarket value of ail.labor and:materials foundation to finish ,f Initials: _l. t G:\PetmitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc SUNSHINE PROPANE Page 1 of 2 • • 0 Washington State Department of Labor & Industries SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DR CHAWES, RICHARD HENRY PORT HADLOCK, WA98339 360-385-5797 Principals JEFFERSON County CHAWES, RICHARD HENRY LEMLEY, DAVID BARRY SIMPSON, LAURA ANNE YOURISH, ROBERT B FLANDERS, RONALD LEE EWING, MICHAEL HOYT ROSS, LEVI K (End: 01/01/1980) CHAWES, RICHARD (End: 01/01/1980) YOUNT,JO (End: 01/01/1980) SPRING, PERRY (End: 11/05/2010) PETERSEN,JAMES (End: 11/05/2010) Doing business as SUNSHINE PROPANE WA UBI No. Business type 600 342 368 Corporation Parent company Governing persons ENVIRONMENTAL HOUSING INC BILLBISHOP License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no SUNSHP*077QP Effective—expiration 11/17/1993—11/17/2014 Bond TRAVELERS CAS&SURETY $12,000.00 Bond account no. 206086406 Received by L&I Effective date 10/23/2001 11/17/2001 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 3/18/2014 SUNSHINE PROPANE Page 2 of 2 Insurance United States Fire Insurance C $1,000,000.00 Policy no. 506-8751013 Received by L&I Effective date 11/13/2013 11/17/2013 Expiration date 11/17/2014 Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings during the previous 6 year period. Tax debts No tax debts during the previous 6 year period. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 422,171-00 Doing business as SUNSHINE PROPANE Estimated workers reported Quarter 4 of Year 2013"11 to 20 Workers" L&I account representative TO/CAROLYN CRAWFORD(360)902-4715-Email: CRAI235 @Ini.wa.gov Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept.of Labor&Industries,Use of this site is subject to the laws of the state of Washington Access https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 3/18/2014 0 0 MECHANICAL AND DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00094 Received Date 3/18/2014 SITE ADDRESS: 481 THORNDYKE RD Issue Date 3/18/2014 PORT LUDLOW, 98365 APPLICANT: JANET A DE DONATO PHONE: 360-437-8054 ROBERT W GRINDELAND 481 THORNDYKE RD PORT LUDLOW WA 98365-9568 8 SUBDIVISION: ADMIRAL'S ROW Block: Lot: PARCEL NUMBER: 721095008 Section: 9 Township: 27N Range: 01E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3g� 385-5875 Contractor's License SUNSHP*077QP Expires 1'f/17/2014 OWNER, JANETADE DONATO PHONE: 360-437-8054 if different: ROBERT W GRINDELAND 481 THORNDYKE RD PORT LUDLOW WA 98365-9568 PROJECT DESCRIPTION: REPLACE BOILER 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 3/18/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance: Final Approval: . 2 /1 BUILDING INSPECTION HOT-LINE 379-4455. REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED. Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday HOT LINE AVAILABLE 24 HOURS A DAY \\tidemark\data\forms\F_BLD_Perm it_Propane.rpt 3/18/2014 /' .e-s°\ c% JEFFERSON COUNTY ti 7 `' ' DEPARTMENT OF COMMUNITY DEVELOPMENT Date: 4.2D Time Received: (OQ a Imo Mon. Tue. ! Thur. Fri. Date: 5---/Z BLD: ( 1-1--- CtLf Contact Name: Owner: Contact Number: 360 Address: 42q -z- or (c,.. 206 -7V 2.,0Z19 Notes: k sL-s- Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling