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Home My WebLink AboutBLD2012-00041 • 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#: BLD12-00041 Received Date 2/13/2012 SITE ADDRESS: 231 S PALMER DR Issue Date 2/13/2012 PORT TOWNSEND, 98368 APPLICANT: JAMES J HILL TRUSTEE PHONE: 360-379-9128 JAMES J HILL TRUST 231 S PALMER DR PORT TOWNSEND WA 98368-9497 6 SUBDIVISION: CAPE GEORGE COLONY DIV 4 Block: 11 Lot: PARCEL NUMBER: 938701106 Section: 12 Township: 30N Range: 02W 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, JAMES J HILL TRUSTEE PHONE: 360-379-9128 if different: JAMES J HILL TRUST 231 S PALMER DR PORT TOWNSEND WA 98368-9497 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 2/13/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: Q((7 1 114 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 I:\F_BLD_Permit_Propane.rpt 10/29/19 IIIPIJILDING PERMIT APPLICA1N BLD12-00041 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00041 Received Date: 2/13/2012 SITE ADDRESS: 231 S PALMER DR PORT TOWNSEND, 98368 OWNER: JAMES J HILL TRUSTEE PHONE: 360-379-9128 JAMES J HILL TRUST 231 S PALMER DR PORT TOWNSEND WA 98368-9497 CAPE GEORGE COLONY DIV 4 SUBDIVISION: Block: 11 Lot: 6 PARCEL NUMBER: 938701106 Section: 12 Township: 30 N Range: 02 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 DESCRIPTIOP REPLACE ELECTRIC WATER HEATER TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 1,032.00 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 $37.30 LYK 02/13/12 131441 Plan Check $27.17 LYK 02/13/12 131441 State Building Code $4.50 LYK 02/13/12 131441 Total: $68.97 569770 III 4110 C0 JEFFERSON COUNTY a ' `l�1 k DEPARTMENT OF COMMUNITY DEVELOPMENT `' '`, ( 621 Sheridan Street• Port Townsend•Washington 98368 360/379-4450• 360/379-4451 Fax q a, ' www.co.jetferson.wa.us/commdeveiopment e Master Permit Application MLA: N JV 1I1(.1q PA, rih. Project Description(Include separate sheets as necessary): Remove/Replace Electric Water Heater Tax Parcel 938701106 Property Number Size: (acres/square feet) Site Address and/or Directions to Property: 231 S PALMER DR Property Owner(s)of Record: HILL, JAMES &JANE Telephone: (360)379-9128 Fax: email: Mailing Address: 231 S PALMER DR PORT TOWNSI_ND, WA 98 Applicant/Agent(if different from wner): FAST WA ' • , 0 V ' A I Telephone: 425-636-70` Fax: 425-636-�t73� emaii i tastwaterheatet.corn Mailing Address: What kind of Permit?(Check each box that applies IHuilding ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use jC(a),C(d),or C]*" KI Single Family ❑Garage Attached/Detached ❑Discretionary°D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular LI Special Use(Essential Public Facilities)*"' ❑ Commercial* ❑Boundary Line Adjustment ❑ Change of Use ❑Short Plat** ❑ Address ❑Road Approach ❑Binding Site Plan"`* ❑Home Business ❑Cottagelndustry ❑Long Plat** ❑Propane ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑Plat Vacation/Alteration** ❑Allowed"Yes°Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** O Stomiwater Management ❑Shoreline Management Substantial Development-- El Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Va ❑Temporary Use ❑Comprehensive Plan/UDC/ 'iidt sl�i i „ .ieV \1 ❑Wireless Telecommunication* ❑Jefferson County Shoreline Mes r,Program Amcndmej rt i ❑Forest Practices Act/Release of Six-Year Moratorium D Tree Vegetaion Request ,J I *May require a Pre Application Conference **Requires a Pre-Applic Conference Please identify any other local,state or federal permits required for this proposalt P k igwnFE B 1 3 2012 `1 rJ DESIGNATION OF AGENT _, I hereby designate to act as my agent in matters relating to this appilW s) OWNER SIGNATURE See attached DEPT.OF COPJIMUNI DEVELOPMENT Date: Sy aigraing 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 it's 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 4 9 g p 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 ry will be assumed unless the a pp licant informs the County y in writing at the time of the application that he or she wants prior notice. Signature: Date: 2/8/12 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: 2/8/12 CADocuments and Settings\card\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-14-2006.dac \I AVidt \ 002_, 1 peic Ls 1A- c ass S (a,51.-- • 0 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: FAST WATER HEATER COMPANY ( ) 425-636-7054 ( )425-636-7055 MAIUNGADDRESS: 12601 132ND AVE NEjZIKKLAND,WA 96034 EMAIL: carnlr fastwatPrhPatPr corn CONTRACTOR'S LICENSE WAINS NUMBER: FASTWWH948BC NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New 0 Wood Existing: 0 Sewer O Addition 0 Steel Proposed: Bank O Community System OXAlteration/Remodel 0 Concrete Total: Height: 0 Individual System O Repair 0 Masonry SEP Permit# O Demolition 0 Other. Bedrooms: Water Supply: Existing: Setback: 0 Private well G 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 / No If this is a Propane Tank and/or Appliance Installation permit,mark all Items below that apply: 0 Underground Tank IjAbove ground Tank Size of Propane Tank: I 0 Heat Stove El Cook Stove ❑Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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. Square Footage Current Proposed For Office Use Only:. Amount Revision Main Floor Heated EH Bld App Review: 2/°Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: ^i. `i Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other ater Heater 1 TOTAL: $ Cog i 1 Receipt Number: Cash/Check Number: r-- , L 1 V I ESTIMATED COST(REQUIRED) Date: I` ' .Fair market value of all labor and materials foundation to finish ,,.." 13-12 b Initials: 44 71111111 C:\Docuntenta and Settings\carol\Local Settings\Temporuy Internet FleAOLK86\Master Permit Application 12-19-2 G.doc JEFFERSON COUNTY DEPT.OF COtIMUNITY DEVELOPMENT