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HomeMy WebLinkAboutBLD2012-00218 THIS BUILDING IS NOT FINALED . PERMIT WAS CANCELLED PRIOR TO RECEIVING ALL INSPECTIONS AND HAS NOT BEEN ISSUED A CERTIFICATE OF OCCUPANCY. ILDING PERMIT APPLICA1N BRD1e 00218 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00218 Received Date: 7/16/2012 SITE ADDRESS: 1493 IRONDALE RD PORT HADLOCK, 98339 OWNER: MICHAEL 0 SHANNON PHONE: 206-769-9805 JAN M SHANNON PO BOX 806 PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: TX 24 PARCEL NUMBER: 901021007 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr A/G 120 GAL PROP TANK, LINES & HEAT STOVE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 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: ii FteiV Propane Tanks/Stoves $222.00 LYK 07/16/12 134990 A Total: $222.00 JUL 10 2012 Jefferson County Planninc & Building Department \\+irlcmerle\rh+ \+• rme\G RI ll Ann PIA rn+ 7/1R/W11') .eLSON cod JEFFERSON NTY • � 'V DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �• www.co.jefferson.wa.us/commdevelopment G Permit Application MLA: tad 1 aC►" e' 1 Master Pe pp 7 Project Description(incl de separate sheets as ne sary): p Rio pxi,I fr ' ‘,010/- F 4/1)6 7�'A /,tiSi L Q, ,mot Property Size: (acres/square feet) _ Tax Parcel Number: 9 0'l d a t o 1 t Site Address and/or Directions to Property,: 9O 7 //40 / A �� 3' Property Owner(s)of Record: m/eH �L 0. '5�a?titiO� e il:/ /f'l`•S�l/4� ✓� Q Telephone: 9�'�6 c —c- Cs,. " Fax: Mailing Address: Po oX g0 pow/ ,Qt/ k w4 'g33�3 - Applicant/Agent(if different from owner): S�47- Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 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)111,',:l, ,-. � r ❑ Manufactured Home -❑ Modular , . - ❑Discretionary"0"or a y,: - r, ❑ Commercial* ❑Special Use(Essentig I; ' II:- ❑ Change of Use ❑Boundary Line Adjust, ❑Short Plat** ❑ Address 0 Road Approach I j(1� � J U L 1 6 2012 ❑Home Business ❑Cottage Industry ❑Binding Site Plan** ! I ❑Long Plat** I Li IA .gn ❑Planned Rural Resid ntial 1-, - • •t--- ' •men s** ❑ to ❑Plat Vacation/Alteratibn** ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program! 1- t ki.'''•' 1.'! _----1/ 1.-A ❑Stormwater Management ❑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 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 acres- -nd right of entry to fferson County and its employees,representatives or agents for the sole purpose of application review and any requiater pections to ss and right of entry will be assumed unless the applicant informs the County writing at the :::: tt r s �pr - --:i `t. ` Date:d 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 Co -ty makes no assurances to the applicant that the actions that will be undertaken because this permit has been issu-• wi1 of vi• :to t edES'. 'y individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)ev-n if yo i-re f co ■i. ith t y J fferson County development code.The Applicant acknowledges that he,she or it holds individual r ire-•ons'•i • adh- it. o and complying with the ESA. The Applicant has read this d'- me)r a Rio nd dates it below. and non-tr•�- =�=-�- � �, / ��� � +` Date: i Signature: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc I • BUILDER STATEMENT • • The signer of this stat ment es h- b -/,' that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be in the re po • . ty.f General Contractor for the proposed project. Signature: Date: /���--- 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: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ 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 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: i UndergroundsTank Above ground Tank Size of Propane Tank: 1?-0" ( 92.2e7/Ir/ Heat Stove i 'Cook ave Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i Other lance being installed in a Manufactured/Mobile Home? Yes / o When applying for a 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 .Offtce.Use Only ;., , Amount . . ,lvision Main Floor Heated EH BId App Review: 2"°Floor Heated Consistency Review: Other Heated Base fee: as 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: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish Initials: G:\PemutCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 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#: BLD12-00218 Received Date 7/16/2012 SITE ADDRESS: 1493 IRONDALE RD Issue Date 7/16/2012 PORT HADLOCK, 98339 APPLICANT: MICHAEL 0 SHANNON PHONE: 206-769-9805 JAN M SHANNON PO BOX 806 PORT HADLOCK WA 98339 TX 24 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901021007 Section: 2 Township: 29N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, MICHAEL 0 SHANNON PHONE: 206-769-9805 if different: JAN M SHANNON PO BOX 806 PORT HADLOCK WA 98339 PROJECT DESCRIPTION: A/G 120 GAL PROP TANK, LINES& HEAT STOVE 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 7/16/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 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 \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 7/16/2012 I"LASIIC CAP SIAMF'W A 5% 1 WOOD PLS 23911", SET BY 4 ARNOLD WOOD IN VOL. 13 N OF SURVEYS, 'PG. 84 � RECORDS OF JEFFERSON 2 o°, COUNTY, WASHINGTON. �°S Z �" VOL. 13, SURVEYS, PG. 84 : (A. WOOD) 1.14' LOT 1 i1'i V o p Li D MONUMENT WAS FOUND N 1.0' EAST OF THE JUL 1 6 I��HELD�NUEU OF � iz VOL. 34, �IURVEYS, G. (SEE (F. BREWER) LONG TIME USE. N JEFFERSON SURVEY NARRATIVE) °p DEPT.OF COMMUNITY a FOUND A 1/2" IRON PIPE WITH ——'"`—— --1 g A 1 1/2" IRON PIPE WITNESS • cc; POST AND ORANGE AND WHITE APN 901+021-007 FLAGGING, S 23' W, 0.62' MONUMENT WAS FOUND FROM THE SET BREWER 1.5' EAST OF THE w MONUMENT. 0 CALCULATED DEED LINE. IT WAS HELD'IN UEU OF LONG TIME USE. (SEE � SHOLIy'S ADD. TO H • SURVEY NARRATIVE) h VOL. 4, LONG PLAT SEE DETAIL, ■ DECK TH13 PAGE O le 5,1' IIIIIIII HOUSE 1.1' 8 o 0 LOr 2 VOL. 34, SURVEYS, PG. 49-50 (F. BREWER) 3 N 4' WIDE E.., MONUMENT WAS FOUND HEDGE O �'1 N 26'5O'18" E, 4.68' 0.1.9' 4,` FR M THE SE BREWER t �,y'h A.03'45'34" RE . i t R=984.8 ' a\l" L=64.62' �`" PP •G MONUMENT WAS FOUND DETAIL / S 8T E, 0422' FROM SCALE 1"..26' GUY ANCHOR FOR E SET BREWER 1---- —_,-- ---, --J POWER POLE / MONUMENT. ENCROACHES 3.5'; / 70 MONUMENT SET 0.1' BELOW SURFACE OF `�� GRAVEL PARKING e t / �. SPACE 4) / a / it/ / CENTER OF SEC. 2: ,o / FOUND A 6 x6" C / ti SANDSTONE MONUMENT / ft FLUSH WITH THE * / • \--- GROUND AT THE NORTH ' END OF A FENCE. / 1/16 COR. SEC. 2: (TIED 7-16-2000) / FOUND A 4"x4" CONCRETE (RE-TIED 8-18- 008) MONUMENT WITH BRASS WIRE, ..s.1 STANDING 0.2' ABOVE GROUND. © ' (TIED 8-18-2008) �. N 86'54'09" P 1326.05' 1 VIP S 86'54'09" E 1325.98' 14-J INDEX GRAPH .2 1 EAST 1/4 COR. SEC. 21 FOUND A SANDSTONE MONUMENT 1.,3' DEEP IN SIC REFERENCE SURVEYS: AN ALUMINIUM MONUMENT * VOL. 4, LONG PLATS, P. 2, "SHOW'S ADD. TO HADLOCK" FOUND WELL. INE THE NORTH SIDE * VOL 13, SURVEYS, P. 84, "A. WOOD" YARD OF HOUSE #71, C GL. 1, S.2, T29N, R1W, W,M. * VOL 34, SURVEYS, P. 27, "F. BREWER" RANDOLPH ST. 2011 * VOL 34, SURVEYS, P. 49-50, "F. BREWER" (TIED 8-4-2008) JOB NO.: 11007 THIS SURVEY WAS PERFORMED IN FILE: 11007_SHANNON JEFFERSON COUNTY, WASHINGTON FOR: ; : 0 AMERICAN LAND SCIENCE FIELD 8K: 44, PG. 66-68 MIKE SHANNON PROF 'SSION IL LAND SURVtYI SUPVVEYED: DC/CLH a.—- LOCATION: 211 W. PATISON Sr DROWN BY: KF?S O 40 80 i ZO Z`'w PORT HADLO tK, WA. 98336 4.1•1=111�- ~ MAILING: P08T OFFICE BOX 547 CHK'D BY: FHB �.,,. CHIMACUM, WA. 98325 SCALE: i"=4D` (ORIGINAL) \► ran(360) 385-9851 FAX:(360) 38598