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HomeMy WebLinkAboutBLD2013-00338 BUILDING PERMIT APPLICA DN B 0338 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00338 Received Date: 10/24/2013 SITE ADDRESS: 5831 OLD GARDINER RD PORT TOWNSEND, 98368 OWNER: JEFFREY A HEISTAND PHONE: KARI C HEISTAND 5831 OLD GARDINER RD PORT TOWNSEND WA 983689779 OLSEN SHORT PLAT#2 SUBDIVISION: Block: Lot: PARCEL NUMBER: 902133011 Section: 13 Township: 29 N Range: 02 W CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr INSTALL VMS,- HEAT PUMP SYSTEM 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 10/24/13 145493 Total: $152.00 APPROVED OCT 24 2013 Jefferson County DCD \\firlcm.r4\rhfo\fnrme\I= RI Il Ann PIA rn+ 1!1/9A/WW2 14 tsj, 1:2_, .• S lit.95TPi t 9--S • 4. 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H- UD G 0 M H C v C7 D Z U) r+ O. 70 3 Q C7 7 0 0 r- — C1 - O. o m c_ 0 — CD O O c - O H o ` -n z I- N m .0 0 C --' H C) 7O ��g:. 0© JEFFEON COUNTY • a DEPARTMENT OF COMMUNITY DEVELOPMENT e "1 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax a • '81x1•0' www.co.jefferson.wa.us/commdevelopment ( A \� Master Permit "�� ermtt Appltcatlon MLA: Project Description(include separate heets as necessary): Tax Parcel Number: g 0 a 1 33 p 1 1 Property Size: (acres/square feet) Site Address and/or Directions to Property: 5e3! Q1J C3a raft ne-r Res .fvftl WnSkcNci lr4. 6%314 Property Owner(s)of Record: etc 1..,4, -4- -4'1 • " S Telephone: la-I- '141 Fax: email: Mailing Address: S .Me, Applicant/Agent(if different from owner): Al r % o Hear}j r�j Telephone: ata0^Web-$P101 Fax: to B3- 3cr11" email:ette„rl a1r-F%oheat Mailing Address: 221 W. cedar- S`k ` sA i W'� eA1$,M$a- c�.GOM 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)* 0 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: n DESIGNATION OF AGENT I hereby designate {"11 r'i-t O 7at 1 n to act as m a ent in matters relatin to this a permit(s). / Y 9 g J pplication for OWNER SIGNATURE kr Date: /)/cr / 3 By signing this appiOtion 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 an right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any requi• • late //ons. Staffs access and right of entry will be assumed unless the applicant inf rms the County in writing at the time of the appl' e r e wants prior notice. Signature: Oe Date: /a l(r'( The action ractions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endange • 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 n4 violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if ;are' ., phance with the Jefferson County development code.The Applicant acknowledges th he,she or it holds individual and non-transf ' ibltity for adhering to and complying with the ESA. The di,Signature: Applicant has read this disjla' ��ncsigns and dates it below, Date: fr" l/3 G:\Penn ter\###FORMS###\DRD FORMS\Master Permit.Application 5-29-08.do • I 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#: BLD13-00338 Received Date 10/24/2013 SITE ADDRESS: 5831 OLD GARDINER RD Issue Date 10/24/2013 PORT TOWNSEND, 98368 APPLICANT: JEFFREYA HEISTAND PHONE: KARI C HEISTAND 5831 OLD GARDINER RD PORT TOWNSEND WA 983689779 SUBDIVISION: OLSEN SHORT PLAT#2 Block: Lot: PARCEL NUMBER: 902133011 Section: 13 Township: 29N Range: 02W CONTRACTOR: OWNER, JEFFREYA HEISTAND PHONE: if different: KARI C HEISTAND 5831 OLD GARDINER RD PORT TOWNSEND WA 983689779 PROJECT DESCRIPTION: INSTALL DN� HEAT PUMP SYSTEM Directions C.4) 'CW` 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 10/24/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 9/L- ) ) 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 10/24/2013 :v: rVwyc //// • • , R:12-Cii- 371 - - Date [1 — 13 time received 1 a i / pm Mon. Tue . Wed. Thur. -"Fii. BLD: 13- -33 g Date: 1 C—2 0 • OWNER: p Contact Name: `^� �1 7 ADDRESS: 0 3 I Q t.,0 (y�vOv.c/ Contact Number 360 ( 2_1 9 7 6 _ • I Notes: 206 . 4 Foundation Plumbing - Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground . Furnace _ Footing Rough in Air seal Above ground Gas Sternwall __ Hydronic Exterior shear Exterior lines Oil A_ Straps Interior shear Interior lines . Ducts T. Post Hole Ventilation — Appliance Underfloor Gas/wood stove Man•Honies • Setbacks " Insulation. Final inspection Foundation . • Bieck&Te floor _wall ceiling. - Address Posted r AIR FLO HEATING COMPANY • ck Number: 41413 41413 Jefferson County Building Department Date Description Amount 10/22/2013 Permit for Heistand 152.00 / ■ JEFFERSON COON ( s 9 145493 DATE LO/l-t-l1 t r< RECEIVED FROM / )\(__ , r DESCRIPTION BARS# AMOUNT CURRENCY Q �� l S � COIN 11� CHECK 1: 0L 1 0 m n 0 e 0 . gy m. — , RECEIVED BY " TOTAL 1'5-2..