Loading...
HomeMy WebLinkAboutBLD2013-00386 IllkUILDING PERMIT APPLICAAN BLD13-00386 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00386 Received Date: 12/11/2013 SITE ADDRESS: 215 DUNSMUIR RD PORT LUDLOW, 98365 OWNER: SUSAN P MONROE PHONE: 360-774-6708 PO BOX 1090 PORT TOWNSEND WA 98368-1090 SOUTH BAY#3 SUBDIVISION: Block: Lot: PARCEL NUMBER: 995700018 Section: 21 Township: 28 N Range: 01 E CONTRACTOR: C H S INC PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**979OZ Expires 9/7/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION 120 gal Propane Tank Swap Out 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 12/11/13 145602 Total: $152.00 APPROVED DEC 1 1 2013 Jefferson County DCD \\4irinmor4\rin+o\fnrmc\F RI Il Ann Rlrl rn+ 17/11/7!114 a -1 * i fi 0) Cf) -1 fi x --I -1 CD 0) -- -- 01 v Cl) 01 X Cl C7 rt X 01 C) -3 -0 0) 0 - -0 -s -s C) 01 < O. CD 01 C) CD 3 3 CC -- CD CC CD CD O CD rl- O CD - 7 7C Z -3 E -3 -- CD Do O = # CC N — N CD C7 -` CO ) O. O O CJ1 CO - O -+ N - O �1 3 CO O O CO Z CJ1 73 -•.1 O N O O CJ1 C Cl) N CO O rF - 0) 3 CO CD - r+ O 1 Cl) G O O 0 CD -n C Z O O CD D3 Cl) 3 01 Cl) O -I C 0 -I O 37 - CO O -I O Z F- CD -I rn z c-) 77 -4 x m X CO 0_ M C) C) - -I 03 n X -• m Cl) a N I-- ID Z O 3 -I C -G CO Cl) CO O 3 3> Cl) N -D 0) rn O Z o ` X 37 It -1. 7D Z D3 CD 3> Z CA) N O O O 73 CO m m rn r- -o N m D cn m O aJ o_ CD y --I X N < 37 CA) -- H - 3 O Z D 0_ CO o C7 I- CO o CO 0 •• 0) -I E W C = rn CO O- -3O CO C, I 0 C O_ CO O CD CD CO O Cl O -I -I C7 ...... .. r o z o Z m c-) c) C) CT a �1 Cl) 3 3 3 C •• I CO CO 1-♦ Cl r+ C$) O 0 MI I-I 0 0 C7 : Z (1) r+ O- O 3 0- G) -s 0 0 r— w — o. o m c_ cn CA) - CD -b D • ■ CJ1 •• •- O cn C- CO O I-♦ O - T Z O- N T a O H CA D3 12/0'/2013 14:01 FAX 36037814111, GA 001/002 <=,ON n-N SS(0, ���' 0�,� JEFFERSON COUNTY ��� •. ��,,., , DEPARTMENT OF COMMUNITY DEVELOPMENT i . cq ,' , ,-. `' 621 Sheridan Street • Port Townsend •Washington 98368 ..... j"--"" - 360/379-4450• 360/379-4451 Fax www.co.jefferson,wa.us/commdevelo men; Master Permit Application MLA: Project Description(include separate sheets as necessary); . ern. ( I 7'0 .\ * • Tax Parcel Number: 0 1 _ Property Site: thi-ck c-F (acres/square feet) Site Address and/or Directions to Property; a 1._ _.....-_ 1 ii ?[s r-4,- f_u.ki,......_ 93S"..... Property Owner(s)of Record: sS - Actt i i. j r ',� Telephone:...3..r "-7 4•-•4 J7 c) y Fax: •':.•- '"': - .. ernail:S Qt.A 4t0 Mailing Address: .to:r 'Cie/0 t , f-i-" fQ 3 "", ttj / 5W .W, _es' c t yt.C,• C-014*.• Applicant/Agent(if different from owner): W" Telephone: .... ..Fax:_.__........_. . email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation f:OBuilding 0 Critical Areas Stewardship Plan LI Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) 0 Single Family 0 Garage Attached I Detached 0 Conditional Use[C(a),C(d),or C)" O Manufactured f-lnrne .0 PAodula • • 0 Discretionary"D"or Unnamed Use Classification o Cornmerc ia:• 0 Special Use(Essential Public Facilities)" I..l Criange of Use 0 Boundary Line Adjustment 0 Address _ 1.)Road Approach 0 Short Plat•' 1.1 Homo Business 0 Cottage Industry 0 Binding Site Plan'" %Propane C7 Long Plat"" LI sign • 0 Planned Rural Residential Development(PRRD)/Amendments" 0 Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration" F1 Stormwoter Management I-.J Shoreline Master Program Exemption/Permit Revisions" 0 Site Plan Approval Advance Determination(SPAAD)" 0 Shoreline Management Substantial Development" I;:i Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment l:J Forest Practices Act/Release of Six-Year Moratorium C)Jefferson County Shoreline Master Program Arnendinent ( "May require a Pre-Application Conference El Tree Vegetation Request — - _ "Requires a Pre.Appiication 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 comet to the bent of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with rasped 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 foes and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this pem,it, 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•?=tion that he or she ants prior notice. n _ --g_— ,' r Signature: Date: : 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 action_.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)Oven if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he.she or it holds individual are non-transfe bte responsibit',for adhering to and complying with they E„A The Applicant has read this disclaimer and signs and dates it below. ,;.,..R.,,,..,:,..,,,„,\i,,ttil,OR Ntt-:ft ft ti\DR E)Ft)irMS\Curreft l.)RI)t;unnr,\Nrantcr l'eimit Ap}:k.atiou 5 29.0ft.thk 12/09/2013 14:02 FAX 36037914 Aft 002/002 SLOWER STATEMENT The onn^/ *'*`y*m"on does*xmv certify that o`,r*.vIw:ownczu the,x'ux'r*reoxco herein.that they are not^,un.e0m^/'a*^y and that they writ wmmnednwieu sm'm,v,e: m \� Date. 1 7.-- /I l_________ GwE.A C —(_7..-)A�/� 0 � /| |��—��—�-----��� ---'-- _.2_ -- ` - `^`--' ~ '' `~^ � /'^x: kAL/woAoou*Sv• ~_� - - - -- -'—'-- -=�--~� -°�'��- Cow'wCro»'xLx�[wuc ---�--�-- -- r�'-�-e~ ~~,��-=�=�` ---' ----`-- ----'-__-_ VVAIITS mumoFn: NUMBER � AnofnEnnEw�m~x ---- � ------` ---- -' -- ---- '-`-----' �-- --' '---- =°°�, � ~____� _ ______ r1mwc ( ) FAX:{ ) Mm/mmxwmcos: Em�t --------- �---- ~--- Project Type: Frame Type; -�athroomu: -----' Shoreline: - Disposal: I' New o Wood 8o�� C Addition O Steel p} _ • Bank LIC*vmunxySystem u Alteration/Remodel o Concrete Total: Height: o Individual System 0 Repair 0 Masonry _-_.-.~ 8EPP :nit# ---- -/' Demolition u Other: Bedrooms: Water ~' Existing. - Setback; S Private well v� 17 Two pxdy Type*vHem� - Proposed: ___. . rPvb|`c Total: _�� __-- � Name W�mw `_ ~_ _'_- �___- .'_ _-_ .'_ -~-.. ..,_-_'�� If this kau Commercial following: � - ----�-� - Nrther of Parking Spaces: Current:. . Proposed: Number Parking Num� o[8��P^ Spaces: _ __ Number of occupants(includes owners.tenants,employees,etc) Current___ Proposed _ • :BC Occupancy: i�ClyP*Ofuon�nchmn: v@xyou have Food Service? v��L No -- If this is a Propane Tank andfor Appliance Installation permit mark all items below that apply: ' Underground'lank X 'bovc ground Tuox Size ot P Other i Heat Stove i Cook Stove. i woodr.-:tove fireplace Insert i Hot Water Tank i Pellet Stove i Other:TP.4. ,'.,;.“1.4C1-4) Is this p_p_pparice being installed in a Manufacturett,I.Mobile Home? Yes / No 13 1.A.A When applying tor a perrtut 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.tho reserve area. Square Footage Current ,_Proposed For Office Use Only. Amount Revision • Mnin Floor Heated EH aid App Review: i --724 13-1TOor Heated Consistency Review: '--' �}�����- --�------ --------� '�aoo����-----�- � -'' --'- - --'- -- ( - - -'--- — --- '---- - l2�Mezzanine MezMezzanine, - -- -Additional Section: .... ��»����__-___ __~-' -_ Heated Plan Check fee: Unheated Basement ----�-�- ' -``' -~ 8�a�c�-n �������--�-----� '�--'--- -`---- ----- | . Other Unheated -�- '---`-----�- � p�---' ^------ - �-----�----�- ' ------'--'VVater Garage/Carport SUBTOTAL - Decks --------~-----'--- '�-----� --'A11 : ~` ----�� `-^'--� . '~ --' -'~ _`- � Other Receipt Number� -- i�~���' cash/check mamb*c / A��' . i � -_ ____ ~� ° ESTIMATED COST(REQUIRED) Date: - --------- -Fair market vu�yv/ax��r and*mkx��6uuoupoonm»^�// / l^// | {ni�^/o: ' `�- --�----- -- �---� ------' '— �-------- ��-----�- - -' ''_____' -_____| / i� _ _ �__| • S 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#: BLD13-00386 Received Date 12/11/2013 SITE ADDRESS: 215 DUNSMUIR RD Issue Date 12/11/2013 PORT LUDLOW, 98365 APPLICANT: SUSAN P MONROE PHONE: 360-774-6708 PO BOX 1090 PORT TOWNSEND WA 98368-1090 SUBDIVISION: SOUTH BAY#3 Block: Lot: PARCEL NUMBER: 995700018 Section: 21 Township: 28N Range: 01E CONTRACTOR: C H S INC PHONE: (360)732-4585 PO BOX 518 AUBURN WA 98071-0518 Contractor's License CHSIN**979OZ Expires 9/7/2014 OWNER, SUSAN P MONROE PHONE: 360-774-6708 if different: PO BOX 1090 PORT TOWNSEND WA 98368-1090 PROJECT DESCRIPTION: 120 gal Propane Tank Swap Out 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 1211112014. REQUIRED INSPECTIONS: Tank/Line/Appliance: iA 3'J (4(O/ FinalApproval: P1613 71/bl� 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 12/11/2013 ce, °j JEFFERSON COUNTY / al DEPARTMENT OF COMMUNITY DEVELOPMENT ' 9 Date: p,..5—Time Received: /03& r11r/pm Mon. Tue. Wed. Thur. Fri. Date: (2,-T BLD: t.' ' •-?gb Contact Name: Owner: Contact Number: 360 -77({ 7e' Address: 2119- Do/vf,v r 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 . > _ : f 4 iu § \� ) [ \ ƒ C .47.■ 7 g . \6 p: ..� � � . R . E < © S § $ \ Cl) 41, >\_ . A� c \ � I ` 4 ±R } a o D � o_ 0_ . o @a ® > . & 2 $ § 0 _ _ \ o / a _ = o a. D 2 ..............-J � � k / =•c3 .� \f . § \ @ > O , E $ \ a i EV 'a ill-I 2 2 S W • \ £ � .1.1. . k § / CO � 7 � � Cl) O ` 4- ,, . � ( A / g.41 41) .._105 E © �, 2r ' . w CO / @ � \. � \ I- 43) / < f $ / § 2 I- Q / A q t 2 o CO CeZill m G \ / 0 § w ƒ 0 k � f k k d JEFFERSON COUNTY \ 67'1\ NO. 145002 DATE [2-/10/1 . RECEIVED FROM J5�`^" V ' ..z)&fie' DESCRIPTION BARS# AMOUNT CURRENCY 2 03 cC C SZ.. COIN I'. CHECK) x 0<c. 0 C n t 1) RECEIVED BY i � TOT, 1 / 5 2-'