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Home My WebLink AboutBLD2014-00292 - MECHANICAL BUILDING PERMIT APPLICAitN BLDI4-00292 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00292 Received Date: 8/13/2014 SITE ADDRESS: 8595 FLAGLER RD NORDLAND, 98358 OWNER: DEAN C STRAUB TRUSTEE PHONE: J JEANNE STRAUB TRUSTEE 130 PIPER COURT RICHLAND WA 99352 SUBDIVISION: Block: Lot: PARCEL NUMBER: 021294008 Section: 29 Township: 30 N Range: 1E 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 DESCRIPTIOI' New Propane lines to existing 120 gallon tank. TYPE OF WORK NO N SQU ARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: PRO 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: IRouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $152.00 SRE 08/13/14 151377 APPROVED Total: $152.00 AUG 13 2014 Jefferson County DCD 1 \\tidemark\data\forms\F_BLD_App_Bld.rpt 8/13/2014 4eV.soi� c JEFFERSO[ OUNTY IIII �' � DEPARTMENT OF COMMUNi T Y DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 41,s 0 www.co.jefferson.wa.us/commdevelopment �41NG Master Permit Application MLA: Project Des '• ion(include separate sheets as necessary): r�r,Line 4-Ci,mot 1 ‘res o 120 /Lica& . Tax Parcel Number: Property Size: (acres/square feet) Site Address and/or Directions to Property: g • 9 5 ---r- tocc teir WA , Nix-clActicl, Property Owner(s)of Record: DecexTh 5-1--rcc., ,6 -3-; 3 -.%c r 61-y- -t- Telephone: ,5ttpq 420 c3?01 I Pola Fax: email: M�M.�a`� lA-e (t C�ced�,�.a1efi Mailing Address: if - • - \ _,J 1 0� q R 35 Z Applicant/Agent(if different from owner): i`C1Ct_.Y'� S l t LL*iA-es(\ Telephone: 50 I-I2d 370c I Fax: email: tv\v�VOct-ld. .fe'..�ei'" Mailing Address: 13O P Qe- c.---V. T, �� 9 e5: ail: kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Building ❑ Critical Areas Stewardship Plan G Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family ❑Garage Attached/Detached ❑ Conditional Use[C(a),C(d),or q.. ❑ Manufactured Home .❑ Modular V ❑ Discretionary"D"or Unnamed Use Classification C' Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑Road Approach_ ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** ❑ Propane ❑ Long Plat** ❑ Sign ❑ Plannea Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference _ Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: 1 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 agree 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. Z1 T Signature: 1111■4- `li_S- . ,_;1Y ■ 0 4115 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 nd compl ing with t e ESA. The Applicant has read this disclaimer and s' ns ind dates it below. Signature: Date: 8 \ 12 r l L G:\PermitCenter\###FORMS###\DRD FORMS\Current 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: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: I Shoreline: Type of Sewage Disposal: r New 0 Wood Existing: ❑ Sewer C Addition ❑ Steel Proposed: Bank 0 Community System C Alteration/Remodel 0 Concrete Total: Height: 0 Individual System 0 Repair ❑ Masonry — SEP Permit# Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: 0 Private well 0 Two Party Type of Heat: Proposed: 0 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 Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / Na - If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: Underground Tank Above ground Tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace Insert 1 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. Square Footage Current Proposed For Office Use Only ;; _ Amount Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: Other Heated Base fee: 5 c.)o Mezzanine • Additional Section: � Heated Basement Plan Check fee: n UV Unheated Basement State Surcharge fee: `l Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL u o Decks 911/Rd Approach fee: Other TOTAL: $ "l . U 0 Receipt Number: « 1 3 3- Cash/Check Number: iJ� ESTIMATED COST(REQUIRED) Date: l 'Fair market value of all labor and materials foundation to finish E I 'a )/ I Initials: C G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc , 0 - 0 •, : , , ...,_...... , - i ---- I 0 i 1 ; r---- ... cts ' / ... , I . .. . „,„...N. / . , _ . i t ,. .. '.. -...3 , (Zit . _ , . . . , , ,it* (,.'.? ,,, io*. tr----it P i ,,...- . r 7 .° „.... 5 ''('-'--------'' 3 . ., .".„., I .°9 .. . I ill . , , •"•,,A --..4 Cil . ' '--,'„., . , • cc hh -L60 1,(:;t;- 4- SUNSHINE PROPANE Page 1 of 3 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, 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) 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 ENVIRONMENTAL HOUSING INC 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 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 5/8/2014 Parcel Details • • Page 1 of 2 %-t, Jefferson C J e x ounty;.� ,r .,,,, .x .u. mss'..a. ^-:,:-.-7-:-.. ::e ram „..,:,' . ' _ J =17� .- .,mD . //.,... .6 1 .— � i�`--,--.+u-+>xa:-.wit....,*_ _a� mow.). i k' 7 y Home County Info to Deportments - Seorch z3,<<5. .. .iiai.. tab, tru . Parcel Number: 021294008 SEARCH Parcel Number: 021294008 Printer Friendly Owner Mailing Address: DEAN C STRAUB TRUSTEE J JEANNE STRAUB TRUSTEE STRAUB FAMILY TRUST 130 PIPER COURT RICHLAND WA99352 Site Address: 8595 FLAGLER RD NORDLAND 98358 Section: 29 School District:Chimacum (49) Qtr Section: SE1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1E Tax Code: 0211 Planning area: Marrowstone (3) Sub Division: Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: S29 T30 R1E TAX 1 (S 82 1/2') TL TAX Q(S1.30 CH) W/PTN VAC NOLTON AVE ADJ Tax,A/V, Sales, Photos,and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info .................... ' , Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6M or later Windows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?PARCEL NO=021294008 8/13/2014 Cases Associated with a Parcel • Page 1 of 1 g �Liefferson County '` Home Lounty into Departments Search Cases Associated with Parcel No: 021294008 This may not be a complete listing of information that exists for this parcel. There may be other information pertinent to the property on file. Please contact the Department of Community Development for additional information. *Parcel Tags Case Number SOM77-00317 Description Last Name STRAUB TRUSTEE Received Date 7/10/2012 4:08:24 PM No Images Case Number SDP05-00011 Description MOORING BUOY Last Name STRAUB TRUSTEE Received Date 3/22/2005 No Images Case Number BLD97-00443 Description PROPANE TANK INSTALLATION Last Name STRAUB Received Date 7/9/1997 No Images Case Number SEP77-00317 Description Last Name STRAUB TRUSTEE Received Date 7/12/1977 Images Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH y ilOrY Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.jefferson.wa.us/commdevelopment/ppquery/cm.asp?value=021294008 8/13/2014 (sON JEFFERSON COUNTY lc jo ls,,,„No., DEPARTME•OF COMMUNITY DEVELOPSNT 1 Date: gidiTime Received: P-4� am/pm Mon. Tue. W d. Fri. Date: q--1 BLD: (C-- Z g2__ Contact Name: `` Owner: Contact Number: 360 („ - Address: a 206 4 Notes: e ;, '�� 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 -------------------—-------I..I.•..••..1.I.11.li•..Ilo • 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#: BLD14-00292 Received Date 8/13/2014 SITE ADDRESS: 8595 FLAGLER RD Issue Date 8/13/2014 NORDLAND, 98358 APPLICANT: DEAN C STRAUB TRUSTEE PHONE: J JEANNE STRAUB TRUSTEE 130 PIPER COURT RICHLAND WA 99352 SUBDIVISION: Block: Lot: PARCEL NUMBER: 021294008 Section: 29 Township: 30N Range: 1E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (36 385 Contractor's License SUNSHP*077QP Expires 11/17//2014-5875 OWNER, DEAN C STRAUB TRUSTEE - PHONE: if different: J JEANNE STRAUB TRUSTEE 130 PIPER COURT RICHLAND WA 99352 PROJECT DESCRIPTION: New Propane lines to existing 120 gallon tank. 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 8/13/2015. REQUIRED INSPECTIONS: 2: Tank/Line/Appliance: Final Approval: ),:i.... -1 -Iq 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 8/13/2014