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Home My WebLink AboutBLD2013-00353 0UILDING PERMIT APPLICJON BLD13-00353 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00353 Received Date: 11/6/2013 SITE ADDRESS: 2965 PARADISE BAY RD PORT LUDLOW, 98365 OWNER: CHARLES E NATION PHONE: PATRICIA E HAWKINS PO BOX 934 PORT HADLOCK WA 983390934 TALA SHORES#1 SUBDIVISION: Block: Lot: PARCEL NUMBER: 998200133 Section: 22 Township: 28 N Range: 01 E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION INSTALL 120 GAL PROPANE TANK, PIPING AND INSERT TYPE OF WORK RES 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 MEB 11/06/13 145532 Total: $228.00 \\firlcmer4\rief.m\fnrmc\F RI Il Ann Rid rnf 11/f:/)!11'2 v tti -1,b 3 •-- . .3 t JEFFERSON NOUNTY f 4 kki, DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 . 360/379-4451 Fax lisztrisTee l' www.co.jefferson.wa.us/commdeveiopment Master Permit Application MLA: Project Description(include separate sheets as ne ssary): t c , t R-�+.�°a wee Tax Parcel Number: 9,Q,2) a-O Q(33 Property Size: (acres/square feet) Site Address and/or Directions to Property: ?-CI t o `PAP-P10L 13 LI (LP - �j, • Property Owner(s)of Record:,(?,h4 r/ 6 f 41-/ rr Y) �A_1/2J Lt 9 L.i- / 65 TelephoneQ1I,- 6c---1, j / Fax: l e ail:: Mailing Address: -S - - P o, • IA m - 0 3 -,, MAI1Mirf ft 31 ApplicantlAgent(if different from owner): o 5UaJ.5Hir`Jtr -8 Telephone:! '33`S-SZFI-1 Fax: email: Mailing Address: \c'555'6 P2 M\ EJ2 -i:'0Q-1-. IAA01..b(4, ,V3 F d33 k What kind of Permit?(Check each box that applies OBuilding ❑Critical Areas Stewardship Plan ❑ Demolition.Permit ❑Variance(Minor,Major or Reasonable _ ,"1•••• - ❑Single Family ❑Garage Attached!Detached ❑Conditional Use[C(a) -c•J, n- ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or U 1:-•- ioi I IIE O Commercial* ❑Special Use(Essentia • • • - - O Change of Use ❑Boundary Line Adjus ❑ Address ❑ Road Approach ❑Short Plat** e ,:mq ❑Home Business ❑Cottage Industry ❑Binding Site Plan** NOV 4;ropane ❑Long Plat** ign ❑Planned Rural Reside i- s= e•f,i -e , ' ents ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteratio ** JEFFERSON CO NTY ❑Stormwater Management ❑Shoreline Master Prog =m r . •C•r i' ,,, -r.1%1-,i i;CI Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Managemen -•• F a •evelopment** O Temporary Use ❑Shoreline Management Variance O Wireless Telecommunication* 0 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 designat; i Ifita.1 iial I • ' o act as my agent in matters relating to this appiicatio or permits). OWNER SIGNATURE `I ��f/—� Date: 001-45 / By signing this application form,the owner/agen attests t•-t the information provided herein,and in any attachments,is true a d 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 e , o rson County and its employees,representatives or agents for the sole purpose of application review and any required late spe •l;. 'affs a- -- and right of entry will be assumed unless the applicant informs the County i writing at the time of the applica4 h orT•rAi,= pn• •� I _ y� �� Signature: � ,✓% Date / 5 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 '- ce th •: eff=rson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe -•**ib" •• d r•• •.=nd complying with the ESA. The Applicant has read thi laimer and sig a to d e Signature: ��il �" �41 Data it G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-0B.doc GGG 0 • \a 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: CF-Q.L( Date: it— -13 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: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing:. 0 Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System 0 .Repair ❑ Masonry SEP Permit# 0 Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two 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 If this is a Propane Tank and/o , r .Hance Installation permit,mark all items betgw that apply: I Underground Tank -at;..ve ground T.. Size of Propane Tank: L' D ' I Heat Stove i Cook Stove I Woodstove fireplace InS-1, I Hot Water Tank I Pellet Stove t Other p fi�'J n Is this appliance being installed in a Manufactured/Mobile Home? Yes o ®o property lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. �,e z p , ,,, ,- 0 3 ,7 s 2°, f r : r�s.� 1 j,� FS 7 is + !'V'1' ' : .y 14 °4:41.1' F ' �F S uare Foota!a Current Pro•osed � w i 4�� 'til i41k'r ,.. ,p,-a ;„; .; aAz � fx fv, .�',.,_ t ,,. ,-, ' 1 Main Floor Heated '1, N.Y�-a,T,Ae EH Bld App Review: 2"0 Floor Heated „,,,',,--4.. a 4, ,, y r Consistency Review: Other Heated ' , ,, r=” e I Base fee: t ,1 , : Mezzanine '�.'I ' ', 1 Additional Section: Heated Basement '7 ' # Plan Check fee: 4 A., t. &. Unheated Basement M 1';: } 3. State Surcharge fee: Other Unheated ' , 7 Pot Water Review fee: a ,,„ h Garage/Carport PP:':r 7�°'4L SUBTOTAL Decks '''''I 911/Rd Approach fee: Other ' TOTAL: $ tl ■ Receipt Number: k(4�c3 rt s. Cash/Check Number: ' �-- ESTIMATED COST(REQUIRED) Date: `( / •Fair market value of all labor and materials foundation to finish ! b �� Initials: • G:\PemvtCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc r • 0 4' SITE VISIT REPORT (PLOT PLAN) • JOB 6c4- l'ACION &\ \S DATE: /D l 251,[I CONTACT: ADDRESS 9 61;g- '0.,'a S-2)NI �C�., PHONE #: D CTIONS d/A lL o�.f 1 S-C, FAX #: � .`� . "rb AGI(e C Email ✓ PLANNER: 1)0.%14-L.-_ Include all street names adjacent to property,property lines,tank,appliance&piping locations,distances of tank to property lines and buildings,septic,wells,wetland areas,distance to water bodies. I to 42 C----Zo --- IVIC\ a 1 ' • 2O OEfVE i�_ 0„,-(4 IN - NOV O 2013 k bt. -Q JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT T------------- /00 off-o v Q a1\ t 4) `( ., 1 V'.S--e r 1 • • I 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#: BLD13-00353 Received Date 11/6/2013 SITE ADDRESS: 2965 PARADISE BAY RD Issue Date 11/6/2013 PORT LUDLOW, 98365 APPLICANT: CHARLES E NATION PHONE: PATRICIA E HAWKINS PO BOX 934 PORT HADLOCK WA 983390934 SUBDIVISION: TALA SHORES#1 Block: Lot: PARCEL NUMBER: 998200133 Section: 22 Township: 28N Range: 01E CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3 3 Contractor's License SUNSHP*077QP Expires 1?/167/013 85 -5875 OWNER, CHARLES E NATION PHONE: if different: PATRICIA E HAWKINS PO BOX 934 PORT HADLOCK WA 983390934 PROJECT DESCRIPTION: INSTALL 120 GAL PROPANE TANK, PIPING AND INSERT 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 11/6/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: L 11—t?---‘3 FinalApproval: `l C tl—t' L 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_Perm it_Propane.rpt 11/6/2013 .e.1.*--,,,,W-.. . it'll: ' . b.,L''o•L'rk='F 47t - - . . - • - - Date time r -eceived ,2..3 c am 1 pm Mon. Tues. Wed: Thur. -CD BLD: t3 - 35-3 Date: 114 . OWNER: Contact Name i ADDRESS: FOLV4 ...., 6 47 . Contact Number:360 , 1 ? LI _ 206 r, Notes:_ , • Foundation - Framing ramin Pluming g . ro n ' • Mechanical Setbacks Under-ground Framing Under ground Furnace Footing Rough in Air seal Above ground PGas Sternwall Nydronic Exterior shear Exterior lines -X- Oil Straps Interior shear Interior lines • Ducts ------- Post Hole Ventilation Appliance Underfloor _ Gas/wood stove Man-Homes - . • Setbacks Insulation. Final Inspection ,..= :so Foundation- • . -,,:- :.? ...i. Block&Tie floor wall ceiling. Address Posted s • ---- . JKUNI;UUNIY (\ )) DEPARTMENT OF COMMUNITY DEVELOPMENT Date: W-2.1 Time Received: 2; 22-1. am/0 Mon. Tue. v-•. " Fri. Date: BLD: -r- 1/U3 J-3 Contact Name: Owner: - „ Contact Number: 360 43-7,6-- q, Address: /� �� 206 Notes: ([ 1`."1 �,, 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 4Q45F % JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT /4gSRZ ` o� J Date: // 143/l4-Time Received: 7• /5 6;pm Mon. Tue. /Ned) TThur. Date: /4' BLD: !' j- . 5Th3 3 Contact Name: /U4^ Owner: N Contact Number: 360 `7_s j 9 c Address: ,2%11.5' grad i 1a2P >a- Notes: pAi4--eji A \at-V-N-ie, /Y1 kca po p 'l Vg at 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 inal Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling i