HomeMy WebLinkAboutBLD2014-00270 - MECHANICAL BUILDING PERMIT APPLICATI BLD14-00270
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD14-00270 Received Date: 7/28/2014
SITE ADDRESS: 181 WINDROSE PL
PORT LUDLOW, 98365
OWNER: ALEX SALINAS PHONE: 360-333-1020
181 WINDROSE DR
PORT LUDLOW WA 98365-9552
9319
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 931900033 Section: 16 Township: 28 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 DESCRIPTIOP NEW 120 GALLON PROPANE TANK
FIREPLACE, TANK, AND GAS PIPING
TYPE OF WORK NON SQUARE 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:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $228.00 SRE 07/28/14 151311 APPROVED
Total: $228.00 JUL 2 8 2014
Jefferson County DCD
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\\tidemark\data\forms\F_BLD_App_Bld.rpt 7/28/2014
I
ON : JEFFERSON COUNTY
' !A DEPARTMENT OF COMMUNITY DEVELOPMENT_ '
621 Sheridan Street• Port Townsend •Washington 98368 I'
....a„ 360/379-4450 . 360/379-4451 Fax
-t www.co.jefferson.wa.us/commdevelopment
",�lI'I�T�.
Master Permit Application MLA:
Project Description jtndude separate sheets as n ssary):
0 Tax Parcel Number. -j [ b O 0 ' Property Size: (acres/sq i;are feet)
Site Address and/or Directions to Property:
X 1 Gt)1,040 _ 13 2, .`Pd - �.- pz 7)t-J, G� l i
Property Owner(s)<of Record: L_E)C cS L-1 13. }S {f
Telephone: 5LpI - 33 -- 1 v 1- Fax: email:
Mailing - W fl / ��
9ApP licant/A ant(i f different from Q ) C IL / PI• s.:
Telephone: '�S.----, 19.-1 Fax: <3%5— .c----`i'. ----- email: '
Mailing Address: 1,=,
What kind of Permit?(Check each box that applies
OBuilding 0 Critical Areas Stewardship Plan 1
0 Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) '1''
0 Single Family 0 Garage Attached:/Detached 0 Conditional Use[C(a),C(d),or Cj** j. -
O Manufactured Home 0 Modular 0 Discretionary'D"or Unnamed Us= -_••• /J[
O Commercial* 0 Special Use(Essential Public Fa e it' (^► t" `.I 1 ■ ,
O Change of Use 0 Boundary Line Adjustment
❑ Address ❑Road Approach ❑Short Plat"
O Home Business 0 Cottage Industry 0 Binding'Site Plan*" r n ',
❑Propane . /n!" JUL.
❑°Sign 0 Planned Rural'Residential Develo• 1 RRD)/Amend l ents**'
0 Allowed'Yes"Use Consistency Analysis 0 Plat Vacation/Alteration"*
O Stormwater Management 0 Shoreline Master Program Exemp •n/Pe i eyitrotiv 1_ 01.1;\Ill
O Site Plan
Approval Advance Determination(SPAAD)' 0 Shoreline Management Substantial Deviet)pttlpn^iiNa"
O Temporary Use 0 Shorelirie Management Variance
0 Wireless Telecommunication* 0 Comprehensive;Plan/UDC/Land Use District Map Amen'',tnent
❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Arnendmen.',
*May require a Pre-Application Conference 0 Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if knownr !
DESIGNATION OF AGENT f—+
OWNER SIGNATURE Date: 4�/ `
all
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to t,a 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 acket
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 attorneys fee`sand
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 a•plication
review and any required later inspections. s access and right of entry will be assumed unless the applicant informs the County in writing,at the pc
time of the ap.11catlon t' t he ore wan•- •ri• . ol-
Signature: - i►
ile Date: / • A
The action or.actions Applicant will undertake as a result of the issuance of this permit maynegatively Impact upon one or more threatened of , V
endangered species and could lead to a potential"take'of an°endangered species as those terms are defined in the federal law known as thl.,! i
"Endangered Species Acr or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken becaus this
permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered ered s cies
Y 9 9 cY g lie rage ing your
action(s)even if you are In compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds ind p"idual —
and non-transfe respo sibility for adhering an co ply g with the ESA. The Applicant has read this discla r and a gns and da- • • low.
Signature: l � Date: o t 4
G:\PerrnitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc ft
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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 contracto and that
they will be assumin the responsibil f the neral Contractor for the proposed proj4. /
Signature:9 Date: /. L ,
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( ) i,
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER i
ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) I
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disp• al:
• New 0 Wood Existing:. ❑ Sewer ,
• Addition ❑ Steel Proposed: Bank ❑ Community System,
O Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
O .Repair 0 Masonry SEP Permit#
O Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 o Party
Type of Heat Proposed: ❑ Public
Total: Name of System:
{..
If this is a Commercial Protect 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 i
if s is a Propane Wank and/orAo Iip ance Installation permit,mark all items below that apply ,1
I Underground Tatk 1 g and Tan Size of Propane Tank: Q
I Heat Stove i Cook Stove i Woodstove i Fire lace Ins I Hot Water Tank I Pellet Stove I Other 11
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No I,•
When applying for permit to install a propane tank you must also submit a site plan showing all of the buildings,all I.roperty
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic s 1-14-- • .,.nents,.
including the reserve area. _ e , r• I Ilk
�
i
r
r
Square Footage Current Pro•used ( �4� ��r���ld �re. I ��! ,dy1';n L:4.L�
+' ,,.I ,,° �' ' '
Main Floor Heated `r ,- ,' ys EH Bld App Revie 111 _ 11111111111 ill
Consistency Review` i iiiiyilliiiiii
2�Floor Heated � � '�' �`�° j�
Other Heated d Base fee:_ a.;►
' mom
Mezzanine a :3.. ,
Additional Section: • OEPT Of CO�r1MUN1T`i II _
Heated Basement" 4{
' ' Plan Check fee:
*wi y
Unheated Basement ' - a State Surcharge fee:
Other Unheated
,�";71',, { g- T1 Pot Water Review fee:
, . :1 ,
Garage/Carport
A S =TOTAL i.
Decks 4.
911/Rd Approach fee:
Other =ge.} n
TOTAL: $ 4, /
�4 , )5. 1 31
'[ j "': Receipt Number:
,` , f s4- Cash/Check Number
ESTIMATED COST(REQUIRED) Date: p I
.Fair market value of all labor and materials foundation to finish v 7 ;D l
Initials:
1
.
G:\Petmitanter\###FORMS###\DRD FORMS\Master Pumit Application 5-29-08.doc
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SITE VISIT REPORiT'
(PLOT PLAN)
JOB / IsZ�C< d`\1Y`0\--5
DATE: , ;� b 1:.� . CONTACT:
ADDRESS \?\ WI oz f'D S-Q "D.(`\ PHONE I#4
DIRECTIONS QAIZ TA (Z4.1-0 Qo�ra4,1"S-e,Ba. �,FAX #i
'TU W 1 No'a:O:SA. 0 rl. —"T, Email :S® LA,na,s u7�%.v e_..Ciri'vl
PI, c, R:' �.. ��ii ,
Include all street names adjacent to property,property lines,_tank,appliance&pipin c ons, distances of tank to property lines and
buildings,septic,wells,wetland areas, distance to water bodies.
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JUL 28 2014
JEFFERSON COUNTYn-'
DEPT OF COMMUMTY DEVELOPMENT :'
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Parcel Details � • Page 1 of 2 n
e erso ou
t
m � County Info : Departments S
n earch
Parcel Number: 931900033 SEARCH
Parcel Number: 931900033 Printer Friendly
Owner Mailing Address:
ALEX SALINAS
181 WINDROSE DR
PORT LUDLOW WA98365-9552
Site Address:
181 WINDROSE DR
PORT LUDLOW 98365
Section: 16 School District:Chimacum (49)
Qtr Section: SE1/4 Fire Dist: Port Ludlow (3)
Township: 28N Tax Status: Taxable
Range: 1E Tax Code: 0231
Planning area: Port Ludlow (7)
Sub Division: 9319 - BAYVIEW VILLAGE DIV 1-3
Assessor's Land Use Code: 1100 - Residential - Single Unit
Property Description:
BAYVIEW VILLAGE DIV 1 LOT 33
Tax,A/V, Sales, Photos, and
Permit Data Bldg Data Map Parcel Plats&Surveys
Septic Monitoring Info
ya`
Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH
Best viewed with Microsoft Internet Explorer 6.0 or later
le Windows - Mac
http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel N0=931900033 7/28/2014
SUNSHINE PROPANE Page 1 of 3
• •
01 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
License
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://securelni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 5/8/2014
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#: BLD14-00270 Received Date 7/28/2014
SITE ADDRESS: 181 WINDROSE PL Issue Date 7/28/2014
PORT LUDLOW, 98365
APPLICANT: ALEX SALINAS PHONE: 360-333-1020
181 WINDROSE DR
PORT LUDLOW WA 98365-9552
SUBDIVISION: 9319 Block: Lot:
PARCEL NUMBER: 931900033 Section: 16 Township: 28N Range: 1E
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339 (3601 385
Contractor's License SUNSHP*077QP Expires 1?/17/2014-5875
OWNER, ALEX SALINAS PHONE: 360-333-1020
if different: 181 WINDROSE DR
PORT LUDLOW WA 98365-9552
PROJECT DESCRIPTION: NEW 120 GALLON PROPANE TANK
Directions FIREPLACE,TANK,AND GAS PIPING
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 7/28/2015.
REQUIRED INSPECTIONS:
Installation per Manufacturer Specifications/CO2:
Tank/Line/Appliance: 4?6CV t 2.014N1) -TAI*. IKYTE2,1 Og Pke)P41.s t
pievipA RAte- OK_ izjirn
Final Approval: K 2.IZ7/
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 7/28/2014
,,,,i °? JEFFERSON COUNTY
,A,, --V DEPARTMENT OF COMMUNITY DEVELOPMENT
Date: l _- __Time Received: ,/ 70Sr 0/pm Mon. Wed. Thur. Fri.
Date: /2—Z.
-
BLD: l { Q Contact Name:
Owner: Contact Number: 360 579'7
Address: /'I fA)/l-fi)Aele.. De- 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 � C
Final Inspection
Setbacks Floor
Foundation Wall Address Posted
Block &Tile Ceiling
JEFFERSON COUNTY DaD NO. 151311
DATE / T
0
RECEIVED FROM Ala 411 A 't MIir/s�, l
DESCRIPTION BARS# AMOUNT
CURRENCY LIMON • by
$ A:��
2 IIII
I
■
O
e.r. q ,1 I m
,,,,,„. _.,„ sir,t
4�41 1,. , '<
• /
RECEIVED BY '4444 TOTAL '