HomeMy WebLinkAboutBLD2013-00278 *BUILDING PERMIT APPLIC N BLD13-00278
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00278 Received Date: 9/12/2013
SITE ADDRESS: 292 E ISLAND VIEW AVE
PORT TOWNSEND, 98368
OWNER: SKYLAR TRUST PHONE:
282 E ISLAND VIEW AVE
PORT TOWNSEND WA 98368
PROSPECT VIEW ESTATES
SUBDIVISION: Block: Lot: 5
PARCEL NUMBER: 989600005 Section: 35 Township: 30 N Range: 01 W
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 HEATER- PROPANE
TYPE OF WORK NON 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 2 0 JLA 09/12/13 142480 APP ROVED
Total: .00
16 SEP 12 2013
Jefferson County DCD
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CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX(360)379-4451
Carl Smith, Director/Building Official
PERMIT#: BLD13-00278
SITE ADDRESS: 292 E ISLAND VIEW AVE# Issue Date: 09/12/2013
PORT TOWNSEND, 98368 Final Date: 9/16/2013
APPLICANT: SKYLAR TRUST PHONE:
282 E ISLAND VIEW AVE
PORT TOWNSEND WA 98368
SUBDIVISION: PROSPECT VIEW ESTATES Block: Lot: 5
PARCEL NUMBER: 989600005 Section: 35 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: HEATER - PROPANE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/16/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/8/2013
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le- JEFFERSO�COUNTY 1 (L hit `�
` t DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Wash gtan I8 $,013
- ,, i,'- 360/379-4450 . 360/379-4451 Fax ttrr L
j +'+ www.co.jefferson.wa.us/commdevelopment
Master Permit Application A MMON COUl al
Project Description(include separate sheets as necessary):
Tax Parcel Number: Can(4c 0000 5- Property Size: (acres/square feet)
Site Address and/or Directions to Property:
aqa -- .s1--11JJ1�JL) V I)
Property Owners)of Record: 5T1\-1 C.la 17 rS /I-/n/•0/9 c R-00 FQ/TL-
Telephone: a.1 a- 3-t '1.) Fax: email:
Mailing Address-9a t y S C iJ 10 )/ l t.J 1 'PO IZ-T j 0 ' 1%-)S u. ( W I<1 q8 3(o6
Applicant/Agent(if different from owner): v5 tr...--r-Ls h,-r.e_,-Prop
Telephone: c3B S*--S.--/9 Fax: email:
Mailing Address: 10%S3 ein 0' Dr. Po r+ IMO
What kind of Permit?(Check each box that applies
❑Building ❑Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification
❑ 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 Request
*"Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
, DESIG ATION OF AGENT
I hereby designate J i c to act as my agent in matters relating to is ap ' • n ffo}rrpermit(s).
OWNER SIGNATURE A a A '�%� �' L Date: 1 ��7'V (
• V /
By signing this application form,the owner/agent attests that the info ation 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 attorneys 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 prow•e access and righ •f entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and an , .q ),d later i•'Ns •- s. Staff's a =ss and right of entry will be assumed unless the applicant i rms th ounty in writing at the
time of the applica-on,)jhat he•she wan : •rio •_ . . 7 /�I Signature: A , d I n d 4 Date: �j(J
The action or actions Applicant will unde ake as a re It 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 - = in co -pliance w • ' e Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trans - :• respon ,ility f• =dhe,ng taan•complying with the ESA. The Applicant has read this discla' er agd.signsa d dates it below.
Signature: I . * . Date: - S (//�j'
r' •1 O �J
G:\PermitCenter\###FORMS###\DRD FO w \Master Pat Application 5-29-08.doc
• S
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 assumin the responsibility of the General Contractor for the proposed pr, I
t
Signature: Date: " l 4, Kb
GENERAL CONTRACTOR
� OR MANUF TURE1D/HOME INSTALLER: PHONE: FAX:
�`^\-c_ T " 11'�...p . ( ) ( )
MAILING A R� 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 0 Masonry SEP Permit#
El Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well 0 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: 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 Under round Tank I Above ground Tank Size of Propane Tank:
CT at Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I 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''lan 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.
m , -77 sJ pi „i ` ^ x l •a d � A' �^ x �
� n � ' a, , _ �S.uare Foote;e Current Pro.osed , 4 ' , t _ -c•Main Floor Heated i" w ,� , w EH BId App Review:
2"°Floor Heated Consistency Review:
n
Other Heated ;, Base fee:
i
� � ti
Mezzanine '1' 1 Additional Section:
Heated Basement ,-MT a -TM Plan Check fee:
01 " Eft
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
4
•Garage/Carport 17„r SUBTOTAL
Decks KlmilivA 911/Rd Approach fee:
TOTAL:
Other �y W t p ' ,
W
r �
frv" Receipt Number:
riy "4 4� Cash/Check Number:
�h�
ESTIMATED COST(REQUIRED) Date:
.Fair market value of all labor and materials foundation to finish
Initials:
G.\PernvtCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
Contractors or Tradespeople*ter Friendly Page Page 1 of 1
Electrical Contractor
A business licensed by LW to contract electrical work within the scope of its specialty. Electrical
Contractors must maintain a surety bond or assignment of savings account.They also must have a
designated Electrical Administrator or Master Electrician who is a member of the firm or a full-time
supervisory employee.
Business and Licensing Information
Name SUNSHINE PROPANE UBI No. 600342368
Phone 3603855797 Status Active
Address 10853 Rhody Drive License No. SUNSHP*984B3
Suite/Apt. License Type Electrical Contractor
City Port Hadlock Effective Date 1/23/2002
State WA Expiration Date 1/23/2014
Zip 98339 Suspend Date
County Jefferson Specialty 1 Hvac/Rfrg Ltd Energy
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
Specialty Effective Expiration
License Name Type Specialty 1 2 Date Date Status
ENVIRHI004D9 ENVIRONMENTAL Electrical Hvac/Rfrg Ltd Unused 3/29/2000 3/29/2002 Archived
HOUSING INC Contractor Energy
Master Electrician INFORMATION
License CHAWER*954JE
Name CHAWES, RICHARD
Status Active
Business Owner Information
Name Role Effective Date Expiration Date
ROSS, LEVI K Agent 01/23/2002
PETERSEN,JAMES F President 01/23/2002
EWING,MICHAEL H Secretary 01/23/2002
YOURISH, ROBERT Treasurer 01/23/2002
BISHOP, RON M Vice President 01/23/2002
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
1 RELIANCE SURETY CO 6086432 03/20/2000 Until Cancelled $4,000.00 01/23/2002
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information No records found for the previous 6 year period
Summons/Complaint Information Summons and Complaints are not filed with the department for this contractor type
Warrant Information Warrants are not filed with the department for this contractor type
Infractions/Citations Information No records found for the previous 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx 3/12/2013
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#: BLD13-00278 Received Date 9/12/2013
SITE ADDRESS: 292 E ISLAND VIEW AVE Issue Date 9/12/2013
PORT TOWNSEND, 98368
APPLICANT: SKYLAR TRUST PHONE:
282 E ISLAND VIEW AVE
PORT TOWNSEND WA 98368
5
SUBDIVISION: PROSPECT VIEW ESTATES Block: Lot:
PARCEL NUMBER: 989600005 Section: 35 Township: 30N Range: 01W
CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797
10853 RHODY DR
PORT HADLOCK WA 98339
�� 385
Contractor's License SUNSHP*077QP Expires 1 17/6/ 013-5875
OWNER, SKYLAR TRUST PHONE:
if different: 282 E ISLAND VIEW AVE
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION: HEATER- PROPANE
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 9/12/2014.
REQUIRED INSPECTIONS:
Tank/Line/Appliance: �1 9/14//3 =v
Apia-FinalApproval: Ok -car A pia, 9 1 c /13 if
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 9/12/2013
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OWNER: __________ --- Contact tiame.
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Contact Number.360 7,4c5-57f 3.
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Notes: -- C.-. 1/( - • 13.- "
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Foundation P lLn___ELDIClg. - Framing' . Pro at__p_. 1 -_1-wik - - -
------- MechaniCal
Setbacks — Under-ground Framing _ Under ground Furnace
Footing ____ Rough in Air seal Above ground Gas _
Sternwall _ Hydronic Exterior shear Exterior lines 0 Oil
Straps — Interior shear Interior lines • Ducts
:t•, -
Post Hole ____ Ventilation . Appliance _CZ
Underfloor _ Gas/wood stove
4-Rn"nes
. •
Setbacks _ - Insulation. Final Inspection
Foundation-_____ . *'•,: •-s:i
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Block&Tie _____ floor wall ceiling. Address Posted
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