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Home My WebLink AboutBLD2013-00366 143 UILDING PERMIT APPLIC MON BLDI3-00366 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00366 Received Date: 11/18/2013 SITE ADDRESS: 42 THUNDER RD PORT TOWNSEND, 98368 OWNER: GARY FREDRICK PHONE: NANCY FREDRICK 42 THUNDER RD PORT TOWNSEND WA 983689455 MARIAH HEIGHTS SUBDIVISION: Block: Lot: PARCEL NUMBER: 002125011 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION INSTALL WOOD BURNING STOVE. (permit for previously installed wood stove, installed 2007) TYPE OF WORK RES 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 MEB 11/18/13 145559 Total: $152.00 APPROVED NOV 18 2013 Jefferson County DCD \\+ir7umorL\rh+e\+nrmc\C RI 11 Ann PH rn+ 11/1 R/9ni Jefferson Co Dept of Comm D,WA - Online Payments Page 1 0 4114 = t Jefferson County H11 rommunittoitmentotot�' Step 1:Select Payments Step 2:Review and Submit Step 3:Confirmation and Receipt Step 3: Confirmation and Receipt Result: Payment Authorized Confirmation Number: 11942994 Your payment has been authorized successfully and payment will be processed. Jefferson County Department of Community Development thanks you for your payment.For questions about your account,please call 360-379-4452 Thank you for using our bill payment services. Please save or print a copy of this receipt for record keeping purposes. My Bills Description Amount Duel Residential Applications payment of$152.00 on Parcel Number 002125011 $152.00 Subtotal: $152.00 Customer Information Convenience Fee: $5.00 First Name: Gary Total Payment: $157.00 Last Name: Fredrick Address Line 1: 42 Thunder Rd Address Line 2: City: Port Townsend State: Washington Zip Code: 98368 Phone Number: 360-379-9065 Email Address: gfredrick @baymoon.com Payment Information Card Number: *'^ --4-•5767 Expiration Date: **/** Print https://client.pointandpay.net/web/JeffersonCoDeptofCommDevWA 11/18/2013 ,� \+3, JEFFERScOUNTY , - 36 "f' DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 . 360/379-4451 Fax 4„ www.Co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate s eets as necessary): - .■ ..---, . ( !, "..,1-- (tl, QhA,' Tax Parcel Property Number: L -Z / L 7 C ( \ Size: acres/square feet) Site Address and/or Directions to Property: (- 7,,.1,+.,1 c .c C� _ Property Owner(s)of Record: u I"t Telephone:3 e„C --:--z, ? ci — cl C S Fa : email: 1 +- * c , ../.\ Mailing Address: LsI -2-- .ML c•,,^. l Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: at kind of Permit?(Check each box that applies) uildin l I Variance(Minor, Major or Reasonable Economic Use) i Conditional Use C a ,C d ,or C]** I Demolition Permit [ ( ) ( ) ] I Single Family t Discretionary"D"or Unnamed Use Classification I Garage Attached/Detached i Special Use(Essential Public Facilities)** 1 Manufactured Home i Boundary Line Adjustment Modular i Short Plat** I Commercial* I Binding Site Plan** I Change of Use i Long Plat** I Address i Road Approach i Planned Rural Residential Development(PRRD)/Amendments** I Propane I Plat Vacation/Alteration** i Allowed"Yes"Use Consistency Analysis I Shoreline Master Program Exemption/Permit Revisions** I Stormwater Management t Shoreline Management Substantial Development** I Site Plan Approval Advance Determination(SPAAD)* I Shoreline Management Variance I Temporary Use i Comprehensive Plan/UDC/Land Use District Map Amendment i Wireless Telecommunication* t Jefferson County Shoreline Master Program Amendment I Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **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: 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 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 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._Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli -ti. tha ;ors ;w- t pCl_or nAtice. Signature: - - •y /) Date: 1/l ( /C:%- ti i it 3 as a result of the issuance of this permit may negatively impact upon one or more threa ened or The action or actions Ap scant will undertake P Y 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 re in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe y • respon r for.dhe note-and complying with the ESA. The Applicant has read this disclaimer and signs and/d 1 a es it b ow. ---�1 ( / 1 (l // Signat : Date: // ! 1 f .5 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc 0 BUILDER STATEMENT • _drier of this st- -ment does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that will b- ---,- v' a the res...--'.ility oft General Contractor for the proposed project. gnature: Date: l l/1 / —1 f , GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL ABathP oject Type: Frame Type: rooms: Shoreline: Type of Sewage Disposal: New ❑ Wood Existing: ❑ Sewer ❑ ddition ❑ Steel Proposed: Bank ❑ Community System ❑ Aeration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ 'Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type,of Heat: Proposed: ❑ Public L c. Ci Total: Name of System: If this is a Commercial Project you must an swer 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 • e Tank and/or Appliance Installation permit.mark all items below that apply: i Undergr' nd Tan I Above ground Tank Size of Propane Tank: i Heat St%, i Co k Stove)(Woodstove i Fireplace Insert i Hot Water ,=d Pellet Stove I Other Is this ap being ins of Iled in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also subm - 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 , '* . , - bz ,,_, T 4 A!'011'41,1 Main Floor Heated rN EH Bld App Review: 2"0 Floor Heated Consistency Review: Other Heated ' Base fee: 4'/ d Mezzanine .t" ` �'�� '�� Additional Section: Heated Basement - Plan Check fee: - — Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport r° SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: 1 u) t5 p �� Cash/Check Number: lv �aN2�� ESTIMATED COST(REQUIRED) Date: 1 •Fair market value of all labor and materials foundation to finish Initials: G:\PemvtCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc ii CQ 0 TG { + {. . JEFFERSON COUNTY n .E Q DEPARTME. OF COMMUNITY DEVELOOENT a Dk. a1 Date: /D /5 Time Received: / 57 am� Mon. Tue. Wed. ' Fri. Date: f29.-7(.' BLD: i?-_9440, Contact Name: Owner: Contact Number: 360 y79 Address: 24$'Z 71?U aCA' - "'77Y. ./5—t7 Notes: S.--Dc/ 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 • 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#: BLD13-00366 Received Date 11/18/2013 SITE ADDRESS: 42 THUNDER RD Issue Date 11/18/2013 PORT TOWNSEND, 98368 APPLICANT: GARY FREDRICK PHONE: NANCY FREDRICK 42 THUNDER RD PORT TOWNSEND WA 983689455 SUBDIVISION: MARIAN HEIGHTS Block: Lot: PARCEL NUMBER: 002125011 Section: 12 Township: 30N Range: 02W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, GARY FREDRICK PHONE: if different: NANCY FREDRICK 42 THUNDER RD PORT TOWNSEND WA 983689455 PROJECT DESCRIPTION: INSTALL WOOD BURNING STOVE. (permit for previously installed Directions wood stove, installed 2007) 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 11/18/2014. REQUIRED INSPECTIONS: U1 �+, /17/t Tie�, T is r�f� =s"fG�(� [ I.�Sf Q L.lJ�.`t'i G� v � FinalApproval: 01( 41' 41 u.i( t /l7 1 ' G 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 11/18/2013