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HomeMy WebLinkAboutBLD2013-00305 °BUILDING PERMIT APPLICAT'ON BLD13-00305 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00305 Received Date: 10/1/2013 SITE ADDRESS: 83 OLYMPIC BLVD# PORT TOWNSEND, 98368 OWNER: DONALD S MC DANIEL PHONE: ELLA L MCDANIEL 83 OLYMPIC BLVD PORT TOWNSEND WA 983689651 DISCOVERY BAY HEIGHTS DIV 1 SUBDIVISION: Block: Lot: PARCEL NUMBER: 947300003 Section: 32 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 INSTALL RANGE AND GAS PIPING 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 $228.00 MEB 09/26/13 145396 Total: $228.00 APPROVED OCT 012013 Jefferson County DCD \\firlcmer4\rlof�\fnrmc\C RI Il Ann Rlrl rn+ 111/1/9f\14 . - 535 1- ..., • ....m.."..- . . f2---; - • . •,...,,,,,-..,.r.,-. . I 1. ‘1& ' . li%-:;PW•el- ,. 6.t, -'1115t-47 ,,....?7_. t,^27;31,,:ir,zzr " . . . :Ft.g4","a=lir7.11g p.:41.:, . Di,,,,.5 'a, -.`•...-. - . . Z.../.4 .",.... .R:t'13:4V-j''.:i . . . . . ...,, IMN . . ,.. " - Date/10- 1,5 "time rec,eived 1/7. am _ Mon. TueS. _09 Thur. -Pri. —... BUD: , 13 * . Date: /e -/(... .- OWNER: . - • Contact Namer. . . ADDRESS: qe D . (9 Li Pkif ic- .ALvi) Contact Number.360 $'*-797 206 . a , 43- Notes: . . • - . . - . . Foundation Plumbing - Framing' Propane Tank _. . • Mechanical Setbacks Under-ground Framing Under-ground Furnace Footing _ Rough in Air seal Above ground - Gas .._ Sternwall Nydronic Exterior shear Exterior lines Oil Straps Interior shear Interior lines • Ducts f x Post Hole Ventilation Appliance " Underfloor Gas/wood stove Man-Homes • Setbacks - • Insulation. . Final Inspection Foundation- . . ,,. --.. Block&Tie floor wall ceiling. Address Posted i JEFFERSON COUNTY Villet NO. 14 5 6 DATE 117-7/ S RECEIVED FROM S kfr,,.. L...'..-e_ ( 0,t-g(3 DESCRIPTION BARS# AMOUNT r CURRENCY 1 C43� � �* COIN i I H ES the n ( ci._ - 2 0 , J ° 1 0 co C ten.. RECEIVED BY /'Yr '. TOTAL 2- `"`"' N r. • • '__Jib -t, JEFFERSON COUNTY I _ DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 . 360/379-4451 Fax C, www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include sgparate sheets as necessary): ' r'" S 6'4 P/;1/74 Tax Parcel Number: 9 V'7 3 0 0 © O 3 Property Size: (acres/square feet) Site Address and/or Directions to Property: .83 O Lyme,' c 8t P. z),, , Property Owner(s)of Record:8.S 400r) $ "LL/1" /0 d /0/fry�� Telephone: , 09 Fax: email: Mailing Address: .f/ P _ ApplicantlAgent(if different from owner): Telephone: Fax: email: Mailing Address: 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** )1aPropane ❑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 O 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 "Fic9tares 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 �/ .•ttoo act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE p/e4- a ��GL�u u^ Date: qJ— " 3 - /3 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 access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any requi 14+'later inspections. Staff' access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applica 07 hat he or she nts,rio tics. Signature: s��cL �C�Lvt�t/t Date: - / 3 . 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 yo re in compliance with the Je erson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe responsibility for adheling nd complying w' the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: /LA_ cu C�� Date: q.- O 3 - /-5 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • 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 MANUF CTURED HOME INSTALLER: PHONE: FAX: ..5" 7.'t-'-'041 r/il-1rp' — (340 38S'•S7 V ( ) MAILING ADDRESS: /O Fr) 244207 13.- EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: S 11 r JWi°X d 7�7e to 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 0 Community System ❑ Alteration/Remodel 0 Concrete Total: Height: 0 Individual System ❑ Repair 0 Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: 0 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 Underground Tank 1 Above ground Tank Size of Propane Tank: E X!J r/Al 0 I Heat Stov -I Cook Stov I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other &- Pl A Is this appliance beingTnstalled 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. v�tc]ti✓ ra i- n rq fit" 7' ' R r' /,a,: :114,,,, ,:14,:„,111,44,1 c S•uare Foota•e Current Proposed is� .sr(..� ./ 41, ,a . ; .r .� o . . 1, _. , Main Floor Heated EH Bld App Review: 2"O Floor Heated t i �1'z4 1 Consistency Review: Other Heated y 1 Base fee: i"Mezzanine - , Additional l Section:-. Heated Basement p-` Plan Check fee: Unheated Basement L . fi'� State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport �k ' "i �$° SUBTOTAL Decks • T 911/Rd Approach fee: Other ; x ,p: , ''„ „; TOTAL: $ .t Receipt Number: 1 " ' Cash/Check Number: ESTIMATED COST(REQUIRED) Date: 'Fair market value of all labor and materials foundation to finish Initials: ' G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc Contractors or Tradespeople liter Friendly Page • Page 1 of 1 Electrical Contractor A business licensed by LEI 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 CI) C.1) -I -b x -I -I CO x C_ c-) r+ x CO 0 -3 -o CO o — -o 's 's 0 OI C Cl CD CU 0 (D 3 3 CC -- m cc co 0 r3 o r+ o m - 0 7C X , E 's -- co v o o it cc o -• m c3 Iv �I -s Q o 0 o CO -+ 0 0 CO o 0 3 CO • �.1 c] -A x v w 0 0 0 N o 0 0 C co o W o r1- - CO 3 Co M v cD r+ n r v o o w r o o -0 C o I-I co r z 3 m co v -I cn o --I o a a v CO a n r r r co -I Z w o c1 >o -I -< r v m x I-I C o. m C7, 0 3 -I m X M v 3 X -0 3 cn m r vo w E- C, Z H c7 -I cn -C o cn c-3 v 3 v a o v rn M a co o x v -I co -- z o z o a o o a CO o 0 r I-I 0 7D CO Z -< ro m C m a M r a M • M D CO r z CO M r D 2 0 73 Q I-1 CO v CO m N -I M m m F-I -� X a r cn C7 -- H 2 3 D z -I n CI co o co r cn cn o Co o m -i E Gu = C 7 0 M Co n C I o c co o cn co m m CO 0 0 -1 -I -o v r o M o Z M co o Cr a -.I CO = S = C I Co Co I-I Cl r+ CO v o M H C v c7 D Z N r+ 0- 73 3 CL C7 -5 0 0 r C 1 - o- o M 7C N GJ - CD -+, m �I -- -- r RI Cn c_ r o o H o- m a co c CO I-1 CS) 70 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#: BLD13-00305 Received Date 10/1/2013 SITE ADDRESS: 83 OLYMPIC BLVD# Issue Date 10/1/2013 PORT TOWNSEND, 98368 APPLICANT: DONALD S MC DANIEL PHONE: ELLA L MCDANIEL 83 OLYMPIC BLVD PORT TOWNSEND WA 983689651 SUBDIVISION: DISCOVERY BAY HEIGHTS DIV 1 Block: Lot: PARCEL NUMBER: 947300003 Section: 32 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5 • 10853 RHODY DR PORT HADLOCK WA 98339 �l 3g5 '3c ST Contractor's License SUNSHP*077QP Expires 1?/((33 167/2 H-5:75 OWNER, DONALD S MC DANIEL PHONE: if different: ELLA L MCDANIEL 83 OLYMPIC BLVD PORT TOWNSEND WA 983689651 PROJECT DESCRIPTION: INSTALL RANGE AND GAS PIPING 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 10/1/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: g-Xi sTiN4, 144 G ��/2r c'•�' la>�� I rrce►o2L L'w f git J e or 10/i5/>g FinalApproval: di< Tcr I /O//s/. 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 10/1/2013