HomeMy WebLinkAboutBLD2014-00202 - MECHANICAL 413UILDING PERMIT APPLICAON BLD14-00202
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00202 Received Date: 6/11/2014
SITE ADDRESS: 5211 CAPE GEORGE RD
PORT TOWNSEND, 98368
OWNER: JENNY JORDAN PHONE: 928-342-3139
12417 E VIA FELIZ
YUMAAZ 85367-7389
OCEAN GROVE ESTATES
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 977100302 Section: 24 Township: 30 N Range: 02 W
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 DESCRIPTIOP TANK, PIPE, AND FS STOVE
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC
VALUATION MAIN:
CODE EDITION: 2012 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
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: Approved/Date
Permit $228.00 JLA 06/10/14 148772
Total: $228.00 APPROVED
JUN 112014
Jefferson County DCD
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11 Cad JEFFERSON COUNTY ' V %.
` DEPARTMENT OF COMMUNITY DEVELOPMENT,
;� 621 Sheridan Street• Port Townsend•Washington 98368
z 360/379-4450 . 360/379-4451 Fax
' • www.co effefson.wa.uslcoi`nmdevelo ment
Master Permit Application MLA:
Projec cription p ude separate s is as necessary):
Tax Parcel Number: 11 1 503 02— ] Property size, (acres/square feet)
Site Address and/or Directions to Property:
4-:)-.9/t CA4 la-.5, G � .
Property Owner(s)of Record: . iJ1 `i ol�DA
Telephone: Gla1:— '4z, . - Fax:, n email:
Mailing Address: 1 - 9 1. i A Fe,Lrt. G rifi . /A .,
ApplicantlAgent(if different from owner):
Telephone: Fax: email:
Mailing Address
What kind of Permit?(Check each box that applies
❑Building ❑Critical Area"Ste ardship Plan
❑ Demolition Permit ❑Variance(Minor, ajor or Reasonable Economic Use)
❑Single Family ❑Garage Attached!Detached -❑Conditional jUse[i(a it• •
❑ Manufactured Home ❑ Modular ❑Discretionai!y'"D' "r`J - , - . 'on
❑ Commercial* 0 Special Used(Essen tvw
O Change of Use 0 Boundary Line Adju- I , . . Q
❑ Address ❑Road Approach ❑Short Plat** i
❑Home Business ❑Cottage Industry 0 Binding Site Plan I1
0 Propane SUN. ,0
Sign 1. L:1 Planned Rural R.-.1.. =I Devel.pmeril(P I' . -sits**
O Allowed,'Yes"Use Consistency Analysis_ ❑Plat Vacatic n/Alt ration
O Stormwater Management ❑Shoreline Maste Prog • E_xe • • ••' evis',
0 Site Plan Approval Advance Determination'(SPAAD)* 0 Shoreline Manage r i i•; `-_ .. en
0 Temporary Use 1 '. ❑Shoreline Management Varia, REVF OE
0 Wireless Telecommunication* 1 0 Coinprehen ive.Plan/UDC/Land se Di ndment
Ala are a pre_ Six-Year Moratorium 0 Jefferson C 'nty Shoreline Mas =r Program Amendment
p Forest Practices Act/Release icationiConference - E, ❑Tree�Vege tion Request
Requires a Pre-Application onference
Please identify any other local,state or federal permits required for his proposal,If k own:
DESIGNATION OF AGENT
I I hereby design - r . ' to act as my agent in matters relating to this application for permit(s).
OWNER-SICw► - � a..[�M, .. m
....., i Date: tP
--0/- !
By signing this appli , ., form,t er/- attests that the information provided herei and.in any attachments,is.true and correct to the best.of
his her or its know-•r- Any mat- •- fals od or anyomis$ion`of a material fact made b' the with respect to this application packet
may result in this pe being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabiljties, udgments,court costs,reasonable attorneys fees and
expenses which may in any way accrue against Jefferson County as a result of or in conse uence of the granting of this permit
I further agree to provide access and right of entry to Jefferson County and its employees, presentatives or agents for the sole purpose of application
review and -• equired let- ctions.. -1=ft's access and right of entry will be assume unless the applicant informs the County in writing at the
time of the •• y,o is • or notice.
Signatures..�®,fit's' :/' Date:
The action or a• • s Apo!,,-nt dertake as a result of th issuance of this permit may egatively impact upon one or more threatened or
endangered s• s and could-to a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endangered • -= Act'or - Jefferson County makes no assurances to the applica ti 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 I�wsuit on behalf of an endangered species regarding your
actions)eve A.u are „., ...Ilan ' the Jefferson County development code.The Applicant acknowledges that he,she or it holds Individual
and non-tra ; - - e . - nsib •x fo = -ring to and complying with the ESA. The Applicant has read this disda' er and slip,ns and d p� I
Signature: '®� A' Og- "' Cal'
G:\PemitCenter\•;IS , .
.'•• - RD 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 refer$nced herein,that they are not licensed contractors and that
they will be a- uming he responsibility of the eneral Contractor for the proposed prof
Signature: i"� �� . �i� Date:
C`I I
GENERAL.CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
/. ( ) ( );
MAILING ADDRESS: EMI�IL7
CONTRACTOR'S LICENSE WP INS
NUMBER: NUMBER
ARCHITECT(ENGINEER: PHONE E ( ) FAX:( )
•
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
D New 0 Wood _ Existing; 0 Sewer
• Addition o Steel Proposed: Bank ❑ Community System
,0 Alteration/Remodel ❑ Concrete Total: I Height: ❑ Individual System
O .Repair ❑ Masonry SEP Permit#
O Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well ❑ Two Party
Type of Heat: Proposed: 0 Public
Total: _
-T Name of System: ..
If this is a Commercial Prolect 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 nd/or A Ii nee Installation permit.mark all items below that apply:
Underground Tank ove round T Size of Propane T nk:
•
=at Stove I Cook Stove i Woodstove i Fireplace Insert 1 Hot Water Tank' I Pellet Stove 1 Other,
thin a..li;nc- bean, installed I aMn act red/Mo•11= Ho =? Yes / Io
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 reserve area.
iF',•r•t+h I •
S•uareFoota•e Current Pro•osed ai� ...�.� ,� ,�,k� .•a79i,�! .. 'r i h s � � [ qm € '�
Main Floor Heated EH Bid App Review:
�t�xti
2"0 Floor Heated Consistency Review:
Other Heated
a:. Base fee:
Mezzanine Additional Section:
•
Heated Basement x Plan Chsck fee
Unheated Basement 4 s `, State Surcharge fee:
Other Unheated i r Pot Water Review fee:
Garage/Carport . M44; SUBTOTAL
Decks 'e^
91 t/Rd Approah fee'
Other • TOTAL $
Receipt Number:,
'4,14 4-,5 • Cash/Check N�rmber:
ESTIMATED COST(REQUIRED) , Date:
.Fair market value of all labor and materials foundation to finish
Initials:
G:\PeimhCenter\###FORMS###\DRD FORMS\Master Parnit Application 5-29-08.doc
SUNSHINE PROPANE Page 1 of 3
01 Washington State Department of
Labor & Industries
ISUNSHINE PROPANE
Owner or tradesperson 10853 RHODY DR
CHAWES, RICHARD HENRY PORT HADLOCK, WA 98339
360-385-5797
Principals JEFFERSON County
CHAWES, RICHARD HENRY, PRESIDENT
LEMLEY, DAVID BARRY, VICE PRESIDENT
SIMPSON, LAURA ANNE, SECRETARY
YOURISH, ROBERT B, TREASURER
FLANDERS, RONALD LEE, MEMBER
EWING, MICHAEL HOYT, MEMBER
ROSS, LEVI K
(End: 01/01/1980)
ILicense
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
Expiration date
Until Canceled
Insurance
FEDERATED SERVICE INS CO $1,000,000.00
Policy no.
633829
Received by L&I Effective date
11/09/2006 11/17/2006
Expiration date
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 6/11/2014
Screen: 01 REAL PROPERTY MASTER Mode: INQUIRY
•
Parcel # 0009771003024,o Cd 300224402111 Auto Roll : OFF
OCEAN GROVE ESTATES Nbhd Cd 5560
BLK 3 LOT 9 (ALL) , 10 (W 20' )
Loc ID
* Taxpayer Cd JORD 2300 JORDAN, JENNY T/P Chg Dt 9/10/1997
* Title Owner T/P Chg Usr JODI
Tax Code 0111 Status TX TAXABLE Land Use 1100 RES-SINGLE
Affidavit 82631 Vol/Page / C/U Code
COMPLETE ADDRESS WINDOW
Taxpayer
JORD2300 JENNY JORDAN
12417 E VIA FELIZ
YUMA AZ 85367-7389
Search Key
CMD 6: End Window CMD 7: End of Job
• 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#: BLD14-00202 Received Date 6/11/2014
SITE ADDRESS: 5211 CAPE GEORGE RD Issue Date 6/11/2014
PORT TOWNSEND, 98368
APPLICANT: JENNY JORDAN PHONE: 928-342-3139
12417 E VIA FELIZ
YUMAAZ 85367-7389
SUBDIVISION: OCEAN GROVE ESTATES Block: Lot:
PARCEL NUMBER: 977100302 Section: 24 Township: 30N Range: 02W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339 (3g�1 385
Contractor's License SUNSHP"077QP Expires 11/17/2014-5875
OWNER, JENNY JORDAN PHONE: 928-342-3139
if different: 12417 E VIA FELIZ
YUMAAZ 85367-7389
PROJECT DESCRIPTION: TANK, PIPE,AND FS STOVE
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 6/11/2015.
REQUIRED INSPECTIONS:
Installation per Manufacturer Specifications/CO2:
Tank/Line/Appliance:
Final Approval:
),(1 11/x/
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_Permit_Propane.rpt 6/11/2014
Q¢ s°7 e,OG2 JEFFERSON COUNTY
''-4.; *"` DEPARTMENT OF COMMUNITY DEVELOPMENT
Q'SRI i4; °} S
Date: 6736 Time Received: /•4 amL Mon. 0113 Wed. Thur. Fri.
Date: 7////t
BLD: /I/ - 01,c)1 Contact Name:
Owner: Contact Number: 360 3 y5 5797
Address: <Zit e gPig r,;,dvgag rb 206
Notes:
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
• Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to
staffing issues,at this time,we cannot guarantee that you will receive an inspection the next day.
day. Unless you receive a call from us,assume we will arrive on your requested inspection day.
• You may leave an inspection request 24 hours a day, and Inspections are available from
Monday through Friday.
We cannot determine the time we will arrive in advance. However, if you call our office the
morning of your inspection, around 9:00 a.m.,we can give an estimate of when the inspector will
arrive. Our general office phone number is 360 379-4450.
• An approved set of plans are to be on site with building permit for all inspections. If permit and
plans are not on site at time of inspection,a re-inspection fee must be paid prior to re-scheduling
another inspection.
If no access, no inspections will be performed, and a re-inspection fee must be paid prior to
re-scheduling another inspection.
• Inspectors will not access a home that has personal affects inside when the owner is not present.
• Commercial projects require 24 hour notice for inspection.
JEFFERSON COUNTY c3C4) NO. 148772
r
DATE 69-1‘D-----1 L
RECEIVED FROM ( 1.- A)v--1.. PlibiC-7\-4.---
DESCRIPTION BARS# AMOUNT
CURRENCY /J 2;Z �
COIN 19_(x)
i
1
ECKS
� 01- 1 lo Tz cor 2
co
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a� d, , m
y w 13
1,,,,,l, IP ii, qtivil o
,4t-X. aN.-.,4,. ate:.
RECEIVED BY TOTAL / / `°-.°