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HomeMy WebLinkAboutBLD2014-00370 - MECHANICAL itUILDING PERMIT APPLICAI N BR D14-00370 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00370 Received Date: 10/14/2014 SITE ADDRESS: 270 HARRINGTON DR QUILCENE, 98376 OWNER: TOM N EASTGARD PHONE: 206-245-7795 REBECCA L EASTGARD 3967 EL CIMO LN NE BAINBRIDGE ISLAND WA 98110-4049 SUBDIVISION: Block: Lot: TX 17 PARCEL NUMBER: 601343013 Section: 34 Township: 26 N Range: 1V1 CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP INSTALL 2 120 GALLON PROPANE TANKS 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 SRE 10/14/14 151652 APPROVED Total: $152.00 OCT 1 4 2614 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/14/2014 W�w45ON Luc. �F R90N COUNTY BLD I '.S--v DL ARTMENT OF COMM ITS' DEVELOPMENT .,. ),e110+ 621 Sheidan Street I Port Towisend,WA 93368 I Web:www.oDiefferson.wauscorrrrultV ooment 5 Tel:360.379.4450 I Fax:360.379.4451 I Email:dcrigoo.jefferson.waus Building Permits&Inspections I Deuelopnuit Consistency Peview I Long Range Planning I VVatershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate sheets as necessary): / fotsiaii fro c l\-e_ 44145 Gf,f►! / t?Gwj Tax Parcel Number: 46/3 3 013 Property S1 e: ^'S4v (acres/square feet) Site Address and/or Directions to Property: 270 / /'tin 710 2 Or CQw/cer)e- Property Owner(s)of Record: �tvt Ea St/a h� Telephone: ?Qb 245 7795 Fax: email:'"/r'►')e--eS a rd,07 Mailing Address: SR1r)e" 1 Applicant/Agent(if different from owner): i-//4 Telephone: Fax: Mailing Address: What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation ❑Building ❑ Critical Areas Stewardship Plan ❑ Demolition Permit ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family ❑ Garage Attached/Detached ❑ Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑ Special Use(Essential Public Facilities)** ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑ Road Approach ❑ Short Plat** ❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan** ;Eff Propane ❑ Long Plat** ❑ Sign ❑ Planned 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: 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 attomey'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 = :r ins•-ction . Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicati', hat he c/he w�!is prior •tice. Signature: r—./i ',/,-./h'4r Date:��� Z� The action or actions Applicant will u,,%ertake 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 in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe a respo ility f'r adhering.;to and complying with the ESA. The Applicant has read this disci n and signs and dates it below. 19 Signature: 01/1401/14., r � I ' . # Date: / 9/y- / 07/24/2013 BUILDER STATEMENT The signer of this statem oes hereb certify at they are the Owners of the parcel referenced her ,that they are not licensed contractors and that they will be assume a respo ability if the Gen:ral Contractor for the proposed project. Signature: /o' �L^ ' Date: 1d�9// GENERAL CONTRACTOR OR MANU CTURED HOME INSTALLER: PHONE: FAX: - ' Comes r0FLI'le ' — — ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New 0 Wood Existing: ❑ Sewer O Addition 0 Steel Proposed: Bank 0 Community System O Alteration/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 0 Two Party Type of Heat: Proposed: 0 Public Total: Name of System: If this is a Commercial Proiect 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: Underground Tanke ground tank Size of Propane Tank: 2-)4/20 a/ lat Stove Cook Stove Woodstove Fireplace.nsert rehtO I evotS telleP I knaT retaW toH I Is this appliance being installed in a Manufactured/Mobile Home? Yes 40 When applying for a permit to install a ••• •.- • - ,• • 11 st also submit a site plan showing all of the buildings,all property lines, tank location and si , =" ,,nces from the propane tank to a • —- •1 lines,buildings and septic system components, includin• the reserve areal;j 1 fl e. ,/ se. 6 Li)r - 0.9.3 Square Footage Cur : Proposed or • .. se •nay Amount Revision Main Floor Heated EH Bid App Review: 2"0 Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: ] 5/ 6.5 ,? Cash/Check Number: .2 p7 ESTIMATED COST(REQUIRED) Date: O�j��1 I [Fair market value of all labor and materials foundation to finish / / Initials: 11/,/ &L 07/24/2013 OINT"A" EX. 5/8" REBAR YPC �`0AN .iL I,,,, "A WOOD PLS 23911" `FC FF� u� & NEW 2" X 2" STAKE AT ,Fj. --�, CIO 0.74' NORTHWESTERLY OF LINE �`/. -�- '22, IT AND FOOTING DRAINS �� ,` �, tLj UATELY SIZED S! IN ADE ATE Q `/ EX. STAIRS - StDEYARD I TO%PRIVATE SETBACK _ ' !D B BEACH ACCESS / s/ �% 4�A� O \ 4 N PIPE ON LINE , i€ 1% `�`, NTS "A" AND "B" )RTHWESTERLY ,/ „„-- ` CK ^` � ♦ OF THEO. LINE �,,; �c \ ;,�``��. `` N. �,,. *. ,./4,410”, Ii.:,o•/..Nke ■ SITE BENCHMARK\ /\ TOP OF PIPE w." --(/- PORCH` /�� EX MF'ft. E 22' • _ EX. 92' 2q EL=17.78' M LLW I / (DEM 92_' 4 -' -� X. DRIVEWAY _ _-- / ; 3. ,� (GRAVEL) .7 �` ``� .7 v7 �• tow Ptofif,.. 'Ay J-; , 4r,*, No. -1,-----j------' ‘ i , ,0 4 • Aili '', -4-.0.,,,,Is4,,c, '''' • * ,,- Di I., AI r''' - ':' 4i, MEDIUM DENSE TO VERY D GARAGE,.1"-------' 11" - �Y7 (DEMO) SF� B N� // °l NS r � oA � � \c ,S,I 0 ` X. WELL / � \ S ` O„ 0 SAO toA ` NOTE: EXISTING DRAINFIELD , ,c, ` AND SEPTIC TANK ARE TO \tiQ , BE DECOMMISIONED \'?'}A TANK&TRANSPORT SETBACK \ ,' \ , ---?/,__________ /- V.--"Lz, O DRAIN J' F ',^ ��j`�r / ('� /�' 1 / J '/ VEGITATION 4 r-og ✓'tJe. ?l.D0I-�( ,3 5 -, ���r�/YL I / TAX# 6S 343S13 // // / Z / / / ss'p 0. ` �' FA sb EX. 112" REBAR • • 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#: BLD14-00370 Received Date 10/14/2014 SITE ADDRESS: 270 HARRINGTON DR Issue Date 10/14/2014 QUILCENE, 98376 APPLICANT: TOM N EASTGARD PHONE: 206-245-7795 REBECCA L EASTGARD 270 HARRINGTON QUILCENE WA 98376 TX 17 SUBDIVISION: Block: Lot: PARCEL NUMBER: 601343013 Section: 34 Township: 26N Range: 1W CONTRACTOR: CENEX PHONE: 360-732-4585 P.O. BOX 248 CHIMACUM WA 98325 OWNER, TOM N EASTGARD PHONE: 206-245-7795 if different: REBECCA L EASTGARD 270 HARRINGTON QUILCENE WA 98376 PROJECT DESCRIPTION: INSTALL 2 120 GALLON PROPANE TANKS L-'1'—€ 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 10/14/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specifications/CO2: Tank/Line/Appliance:-7 ) r u. , /E '36 j7 Final Approval: 11'ict-(ify 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 10/14/2014 ,,_SON co �� °y 2 JEFFERSON COUNTY 4. DEPARTMENT OF COMMUNITY DEVELOPMENT Date: /O-Zc, Time Received: ©g am/6 Mon. Tue. Wed. 0 Fri. Date: /t7 -3c BLD: /14--- 70' Contact Name: Owner: Contact Number: ' .�5 77? Address: 2,,0 14 w,a7SvpJ �d°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 „,45O” coG JEFFERSON COUNTY Alitt\ '*'-� DEPARTMENT OF COMMUNITY DEVELOPMENT 1S'K7Ndc /� m Mon. Tue. Wed. Thur. Fri. >ate: Time Received: –t am/p Date: kt- k Contact Name: ,; 3LD: Contact Number: 360 , .'"`"` owner: �.. 206 �rvr. . ddress: ‘c"4.0„„ 0 Notes: Foundation Plumbing Framing Propane Tank Mechanical Framin g Under ground Furance Footing Setbacks Under-ground Air Seal Above ground Gas Rough In pil Stemwall Hydronic Exterior shear Exterior lines _ Ducts Hot Water Htr Interior shear Interior lines D Straps -- Appliance Post Hole Ventilation Gas/Wood stove Underfloor Insulation Man-Homes Final Inspection Floor Setbacks — Wall Address Posted Foundation__ Ceiling Block&Tile