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HomeMy WebLinkAboutBLD2014-00391 OJILDING PERMIT APPLICA BLD14-00391 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00391 Received Date: 10/22/2014 SITE ADDRESS: 70 PINE WAY PORT LUDLOW, 98365 OWNER: CHARLES COURTNEY PHONE: 360-437-9875 CHARLES H COURTNEY TRUSTEE 113 GOLIAH LN PORT LUDLOW WA 98365-9641 9840 SUBDIVISION: Block: Lot: PARCEL NUMBER: 984000311 Section: 22 Township: 28 N Range: 1E CONTRACTOR: FRANSON TRUCKING AND EXCAVATING PHONE: 360-821-9262 430 NO NAME RD PORT LUDLOW WA 98365 Contractor's License FRANSTE949QG Expires 11/7/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP DEMO EXISTING 1971 MOBILE HOME SEPBCP TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP DEM 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 State Building Code $4.50 SRE 10/22/14 151702 n Permit $76.00 SRE 10/22/14 151702 f ' PROVED Total: $80.50 DEC 1 p 2014 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/22/2014 fox c_ � JEFFERSON RUNTY LDI • YIA DEPARTMENT OF COMMUNITY DEVELOPMENT "' ` ` 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ‘19$IN Cs www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: NO fin LA Project Description(include separate sheets as necessary): fX s n i 1q 71 WH Tax Parcel Number: 9 Fif--pop3 I I lggq-,pp©--3D? Property Size: (acres/square feet) Site Address and/or Directions to Property: 70 P/ di: Lv.D L.ze.s> 4J� 98 3 6 Property Owner(s)of Record: CA'(' e-c (4. Ctxl lrr'n e f .4-Tw 1M Co ..5 e,' -1-71vc' Telephone: 3,6 0 x137 Fax: email: "flu, kkC.111 uc/�oD 11 .+,a{r 1'- 'y Mailing Address: /i 3 GeLI A rl >(. 4 F'©'2 r Lt)�t.tx�% I W A} 9g 36:3 Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation I'is ilding ❑Critical Areas Stewardship Plan ►, Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) Q Single Family__ _ [Garage Attached_/Detached p Conditional Use[C(a)m C.(0)or Cj*"_ and a ure• 'ome - • osu ar • - • 'Isere Ionary If or Unnamed Use Classification I ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑ Binding Site Plan** ❑ 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 Requs�- **Requires a Pre-Appll > •n r A Please identify any other local,state or federal permits required for this proposal,if known: - ----� I DESIGNATION OF AGENT OL'1 2 2 2014 I hereby designate to act as my agent in matters relating to this application for perr�Iti (s OWNER SIGNATURE Date: J- y IViY By signing this application form,the owner/agent attests that the information provided herein,and in any attachments is-true-and a. lithe b st 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,reasonallle 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 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 application that he pr she wants prior notice. Signature: - _ Gam` _ Date: /�51 oI L( 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 compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf able responsi f for herig to and complying with the ESA. The Applicant has read this disclaimpr and signs and/dates it below. Signature: Date: ID//5 ,5-� `7' G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc III • 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: Date: -GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: F Rikkt Sa Al. f e--r�t r 0— ti- E 544r—AVA-Ti el 4) ( ) -ge.l6...— ( ) MAILING ADDRESS: 4 3© l\tC:, r.IPoMe le 0 Pr Lop Lou, 4 EMAIL: CONTRACTOR'S LICENSE '19365— WAINS NUMBER: f',v Aw r C 9L(q q&. NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition Li 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 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: "'I I you ave oo: ervice. • -s ,o If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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 Off ice Use Only OrilY Anfoont Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: _ Other Heated - Base fee: 1 — — Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: 1 50 Other Unheated Pot Water Review fee: —i Garage/Carport '— SUBTOTAL 10 Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: i 5( -02 Cash/Check Number: i 025 ESTIMATED COST(REQUIRED) Date: top-wig •Fair market value of all labor and materials foundation to finish �j Initials: 5 '/ G.\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc ' IP ' ' ' . C'r ,..r, ..., , 4, .. , ,. . 1 Cam- _ \o‘ \..- -".-s `to `L'+e.-+SAC \ \ K \ \\ \ i, \ \ �\ 1S\ 0 ® ,,5\ \ 1 di ir X G V ' Lei , 3 \ \ (, \ , $ .., 103 0 ; !. \ \ cb ,► ' f' v r.r 'fir, ` E :. ,[_,_.„_,_.,_ ,, , i.„..., rivE ; V. f � t OCT Z 2014 .,...0..saz4( ..--.9 am° \n friFInPNIENT . 2)6 - 11--3- •-•1•N\ c-mo-b's.9-as \...,` S•-� F-v.- bo. i't n V10 W\e 1'O Den-,0 f r Ext.'4-i( Q.P eh'L. S c4-c 1'reei- Cur re-n+ coc\e Rr A_v(2 to vct.'n �,el',mc� s C.,t,-,,,_A,i, c_. /6,1 /, ,431)i • • ti.koc0 4 8 2940-B Limited Lane NW ..J °� � ' Olympia,WA 98502 ,, ORCAA � : � 1-800-422-5623 • (360) 539-7610 k t; 'f Fax: (360)491-6308 ORCAA Permit Application Status Permit Status o Approved ❑ Disapproved Notes Related to ASB004582 10/29/2014 Conditional Approval to remove ACM roofing.Once removed,submit completion notice and ORCAA will issue permit for the remaining structure. 10/29/2014 Recd signed statement from Demolition Contractor 10/22/2014 First Amendment change start and end dates and to include work plan for simultanous demo/abatement of roof containing ACM.Need demo contractor to sign workplan. 10/17/2014 Approved--Owner Occupied,Confirmed with Owner.No ten-day wait 10/13/2014 On Hold.Waiting for Asbestos Survey.Related to 14DEM003901 Survey received incomplete need project description and lab anyalysis 10/22/2014 First Amendment change start and end dates and to include work plan for simultanous demo/abatement. 10/29/2014 P F M Review Date Reviewed by 14DEM003901 10/08/14 Permit# Expiration Date Application Received Amount Due $35.00 10/08/14 Li Cash ❑ Check 0 Credit card Additional notes or permit conditions t , !Arlg,a'L',, f+c'.lt9 c)t;is,-; 114 '1, 1 8 ,,,�;f_. ',1;tit, 11"1, t's�a"t a��,x:'lsku,,,W.y'`=a r,,), ,?r,O 41, I,=,G `n �, v w,orcaa.or qSGoqa„” it -47-, (a,,1,a)110i .c=idf.)1 ic: ',O1 ()ie', €�Av .., f�,y?nigld, tik'\,)F,z,': . t'st,t7,sa-zs ,11" lytpfit,Region Clean Air Agency(OO 2940-B Limited Lane NW Olympias WA 98502 360-539-76101 F `3818.. port Angeles Office 360-417 1466 ReAA Raymond O#f'ice 360-942-2137 www orcaa arg DE OLITIN PERMIT APPLICATION Demolition and renovation projects within Clallam,Grays Harbor,Jefferson, Mason, Pacific and Thurston counties REQUIRE A PERMIT and require that the following permit conditions be met prior to demolition or renovation. Olympic Region Clean Air Agency(ORCAA)regulations define a demolition project as the wrecking, razing, leveling, dismantling or burning(by a fire department for training purposes)of a structure making the structure permanently uninhabitable or unusable. Renovations include the removing of load bearing structural members, but not to the extent to make the structure uninhabitable. The following information is merely a reference guide and not a substitute for agency regulations. 1.A good faith asbestos survey must be conducted by a certified Asbestos Hazardous Emergency Response Act(AHERA) building inspector. Qualified contractors and inspectors may be found in your local Yellow Pages,through the Washington State Department of Labor and Industries, or on ORCAA's website. 2.Asbestos samples must be sent to an NVLAP laboratory(National Voluntary Laboratory Accreditation Program)per 40 CFR 763.87. A list of labs can be found on ORCAA's website. 3.The start date on other structure demolition must be at least 10 working days from the submission date of the complete application and payment. 4. It is the responsibility of the property owner and/or demolition contractor to ensure there is no asbestos-containing material present in the structure to be demolished. 5.Any and all structures on the same parcel of property that are not proposed to be demolished must be identified as such. 6.A copy of the asbestos survey and approved Demolition Permit, as well as any subsequent amendments, must be kept on site and available for review by Agency inspection personnel. 7.The original demolition permit will expire on the Completion Date. Under no circumstances will a project be extended beyond 1 year from original start date. ADDITIONAL REQUIREMENTS In addition to Agency requirements, most building departments require a demolition permit(separate from ORCAA's Demolition Permit).The Washington State Department of Labor& Industries may also require notification for asbestos removal projects. "Owner Occupied Residential Dwelling"means any single family housing unit which is permanently or seasonally occupied by the owner of the unit.This term includes houses, mobile homes,trailers, houseboats, and houses with'mother-in-law apartment'or a'guest room.'This term does not include structures that are demolished or renovated as part of a commercial or public project; nor does this term include any mixed-use building, structure, or installation that contains a residential unit, or any building that is leased or use as a rental, or for commercial purposes. PROPERTY OWNER • • Name Mailing address charles courtney 113 goliah lane City ZIP State port ludlow 98365 wa Site address City ZIP 70 pine st port ludlow 98365 FAX Phone number Other contact number Email 360 437 9875 360 531 0877 twilachuck @hotmail.com DEMOLITION CONTRACTOR ❑ check the box if same as property owner information Business/Contractor Name On-site contact franson trucking and excavating derek franson E-mail Mailing address City ZIP derekfranson @embargmail.com 430 no name rd port ludlow 98365 Phone number Other contact number 360 821 9262 DEMOLITION PROJECT INFORMATION Number of structures being demolished 1 Start date Completion date Is asbestos present? 10/20/14 10/20/14 Yes Attach your asbestos survey below Has all identified asbestos been removed No DEMOLITION PROJECT CATEGORY ® Complete demolition ❑ Training fire-(complete fields below) ❑ Renovation, alternation, remodeling, maintenance or other construction If training fire, provide fire protection agency name, point of contact and telephone number • Owner occupied residential dwelling-Permit fee: $35.00- Prior Notice-Nonrefundable ❑ Other Structures-Permit fee: $60.00- 10 working day wait period- Nonrefundable ❑ Emergency Fee$50.00-must be accompanied by Government Ordered Declaration (other structures only) Attach declaration below PLEASE MAKE A NOTE OF YOUR FEE. Applicant name Date charles courtney 10/08/14 I do certify that I am the owner, authorized agent of the owner, or authorized contractor for the property subject to this ORCAA application/permit. I authorize ORCAA staff to enter the property listed in this application at reasonable times for purposes of inspecting the work that is the subject of this application/permit and to ensure compliance with permit conditions, applicable laws and regulations. I understand that granting of this permit by ORCAA does not authorize anyone to violate federal, state, or local laws or regulation pertaining to activities associated with this permit. I have read and will abide by the conditions set forth in this permit and any addendum thereto. I do certify under penalty of perjury under the laws of the state of Washington that the information in this application and supplemental data is,to the best of my knowledge true, accurate and complete. ® I agree Olympic Region Clean Air Agency(ORCA • 2940 Limited Lane NW Olympia,WA 98502 F.—. 360-539-7610 FAX 360-491-6308 r'f Port Townsend Office 360-338-6419 Raymond Office 360-942-2137 www.orcaa.org ASBESTOS COMPLETION NOTIFICATION and AMENDMENT Use this form to notify Olympic Region Clean Air Agency of completion of the asbestos project.The completion notification is not considered an amendment and does not require a fee. Use this form to make changes to the original asbestos permit. You may submit 2 amendments at no cost. Each additional amendment is$25.Amendments must be filed by the original applicant. The amendment form applies to changes to the following information: 1. Contractor contact information. 2. Project Start or Completion Dates. The original asbestos permit will expire on the Completion Date at close of business(4:30pm).To change the completion date,this form must be received PRIOR to expiration. If the permit expires and the project is not complete,you must submit and pay for another asbestos permit. Under no circumstances will a project be extended beyond 1 year from original start date. 3. If the project goes"on hold"or"off hold." Note:"on hold"and"off hold"notices together are considered one amendment. If project will be on hold past the Completion date, the new completion date must be updated. 4.Work shift days or hours. 5.Additional amount of asbestos identified and abated. If the job category changes,the appropriate non-refundable fee must also be paid. 6.Only original applicant may amend the original permit. Asbestos Permit number Amendment or Notification type Actual completion date (e.g. 13ASB001234) 1st Amendment(no fee) 14ASB004582 Project Information-choose applicable fields Is there a new New completion New start date On-hold date Off-hold date? Off-hold date date 10/24/14 ❑ 10/29/14 Additional square feet Additional linear feet New disposal site New work shift days New work shift hours ❑ Mon ❑ Tues ❑ Wed ❑Thurs ❑ Fri ❑ Sat ❑ Sun /� Additional documentation (e.g. receipts and/or images) 1 ! L C F V E-mail address(where we will send an application receipt) OCT 2 2 2014 'i I li jtaylorkcb @yahoo.com Property Owner J[ v t;r^ C:COUNTY nr.'1 CO PNUNIT`'DFVELONENT Name Phone FAX Charles Courtney 360.437.9875 • • Site address City 70 Pine Way Port Ludlow Contractor Business name Phone FAX K C B 360.830.5022 360.830.5020 Onsite contact Phone FAX Mobile phone Lan Taylor 360.710.1992 360.830.5020 Additional comments Because of hazards of having technicians on an old mobile home roof,we are simultaneously coordinating with the demolition contractor(Franson Excavating)to lay the mobile on its side to remove the silverseal coating(contains asbestos). It will then be wrapped and transported for disposal by K C B. I do hereby certify that all information contained on this form and any supplemental data described herein is,to the best of my knowledge,accurate and complete. Name Jeanie Taylor Upon clicking submit you will be redirected to Point and Pay,our 3rd party payment vendor. fivE ` { I OCT 2 2 2014 ! r� J1Y !TY Parcel Details Page 1 of 2 • • - erson ouniy Home County Info Departments Search I Parcel Number: 984000311 SEARCH Parcel Number: 984000311 Printer Friendly Owner Mailing Address: CHARLES COURTNEY CHARLES H COURTNEY TRUSTEE 113 GOLIAH LN PORT LUDLOW WA98365-9641 Site Address: 70 PINE ST PORT LUDLOW 98365 Section: 22 School District:Chimacum (49) Qtr Section: SE1/4 Fire Dist: Port Ludlow (3) Township: 28N Tax Status: Taxable Range: 1E Tax Code: 0232 Planning area: Paradise Bay (8) Sub Division: 9840 - PARADISE VIEW ESTATES Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: PARADISE VIEW ESTATES BLK C LOT 12 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info m', _= Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH .. Best viewed with Microsoft Internet Explorer 6.0 or later ie Windows- Mac OCT 2 2 2014 fi i� Y http://www.coj efferson.wa.us/assessors/parcel/parceldetail.asp?Parcel_NO=984000311 10/22/2014 FRANSON TRUCKING& EXCAVATING Page 1 of 2 • Washington State Department of Labor & industries FRANSON TRUCKING & EXCAVATING Owner or tradesperson 430 NO NAME RD FRANSON, DEREK J PORT LUDLOW, WA 98365 360-732-6899 Principals JEFFERSON County FRANSON, DEREK J, OWNER WA UBI No. Business type 602 475 484 Individual 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. FRANSTE949QG Effective—expiration 11/07/2006—11/07/2014 Bond RLI INS CO $12,000.00 Bond account no. LSM0021559 Received by L&I Effective date 10/21/2008 10/10/2008 Expiration date _ Until Canceled -L aU `✓ Cg Insurance OCTL 2 2014 I' Atlantic Cas Ins Co $300,000.00 Policy no. L179000598-4 WAN uP'lF?!n°rIFNT Received by L&I Effective date 09/30/2014 10/10/2014 Expiration date 10/10/2015 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602475484&LIC=FRANSTE949QG&SAW= 10/22/2014 FRANSON TRUCKING& EXCAVATING Page 2 of 2 L&I Tax debts No L&I tax debts are recorded for this ntractor license during the previous 6 ye eriod, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp No active workers'comp accounts during the previous 6 year period. Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington Accas Wallington* i 7",\\ F.. n F., V E I 1 OCT 2 2 2014 ,t) i __. ,;C l NTY C 4'1N!T'I `rl07 7NT https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602475484&LIC=FRANSTE949QG&SAW= 10/22/2014 I DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00391 Received Date 10/22/2014 SITE ADDRESS: 70 PINE WAY Issue Date 12/10/2014 PORT LUDLOW, 98365 APPLICANT: CHARLES COURTNEY PHONE: 360-437-9875 CHARLES H COURTNEY TRUSTEE 113 GOLIAH LN PORT LUDLOW WA 98365-9641 SUBDIVISION: 9840 Block: Lot: PARCEL NUMBER: 984000311 Section: 22 Township: 28N Range: 1E CONTRACTOR: FRANSON TRUCKING AND EXCAVATING PHONE: 360-821-9262 430 NO NAME RD PORT LUDLOW WA 98365 Contractor's License FRANSTE949QG Expires 11/7/2015 OWNER, CHARLES COURTNEY PHONE: 360-437-9875 if different: CHARLES H COURTNEY TRUSTEE 113 GOLIAH LN PORT LUDLOW WA 98365-9641 PROJECT DESCRIPTION: DEMO EXISTING 1971 MOBILE HOME 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 12/10/2015. REQUIRED INSPECTION: FinalApproval: 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 SPECIAL CONDITIONS APPLY- SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CASE# BLD14-00391: 1.) This approval for demolishing the residence does not ensure future building approval. Any future onsite sewage system shall meet code in effect at the time of application. \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 12/10/2014 �kw¢SO k c, JEFFERSON COUNTY l` DEPARTMENT OF COMMUNITY DEVELOPMENT Ngy 1 NQ��� Date: i a q //I. 'Time Received: /0:4"? (31pm Mon. 451 Wed. hur. Fri. Date: d BLD: I — 013 ' I Contact Name: Yr ., 0 Owner: ,a • VA_ Ill , , Contact Number: 360 ' , S Address: "7O Pr i'- � )1/01.0 Ulm 206 Notes: �l� � / UU � JJ� m" " l % S b _ a ra ;/� /6 ,h,e / l // _ 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 / ■ I J /0)/ Foundation Wall Address posted Block&Tile Ceiling