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Home My WebLink AboutBLD2014-00036 0 011 BUILDING PERMIT APPLICATION BLD14-00036 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00036 Received Date: 1/29/2014 SITE ADDRESS: 234 POND RD PORT TOWNSEND, 98368 OWNER: JACQUELINE D LEVIN PHONE: 360-774-0040 i PO BOX 877 PORT TOWNSEND WA 98368-0877 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002121012 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt Install 120 gal propane tank TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW 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 01/29/14 145739 APPROVED Total: $228.00 Jefferson County DCD \\+iricmer4\dn+e\fnrrnc\C RI fl Ann PI,l rn+ 7/Z/9f11A lb A i-c---f-c- /- ce ,rif - -7A L, calac e .(.? wq5 ,x1--- or 4 7. 71 1 , 1 / /fr15t,-11 74-ct P*-- i 1, /7,:E_ -- - /,7 ,, e, te , (a ,A,,, (:>‘ 7-e . / IILLL.:2; r2iFriviEi,-7-, JAN 1 2 203 Ili I // 1 L; ( a frx„, ' : - ---- . ......i --) LEFERSON COUNTY DPI CF COMKONTIY DEVELOPMENT 1-( 3 ‘ 0 37 ? 4207 r- 3o 7700 $/ c) Di / R1201S kOme-tii/un CatLe_at . AM e-cuet -W -Fir\&\ ackr ceb 10th StA,Y\SA; v\I--Pr6p aik-c t e,o\Y-Yki . i nsfridal?x) 01 CZ/tells It ii r oN�S �C� DEPARTMENT OF COMMUNITY DEVELOPMENT { 621 Sheridan Street,Port Townsend,WA 98368 Tel 360.379.4450 Fax 360.379.4451 ��1 y�� /� Web:www.co.jefferson.wa.us/communitydevelopment l, v 4,,, toctster-1 ,C0 E-mail:dcdaco.jefferson.wa.us January 02, 2015 JACQUELINE D LEVIN PO BOX 877 PORT TOWNSEND WA 98368-0877 RE: SUBJECT: PERMIT TO EXPIRE - NOT RENEWABLE SITE ADDRESS: 234 POND RD PERMIT#: BLD14-00036 1 LEGAL DESCRIPTION: BLOCK: LOT: PROJECT DESCRIPTION: Install 120 gal propane tank DEAR JACQUELINE LEVIN PERMIT# BLD14-00036 WAS ISSUED BY THIS DEPARTMENT ON 2/3/2014 , WAS VALID FOR ONE YEAR AND IS NOT RENEWABLE. According to our records, a final inspection has either not been scheduled or has not been passed. TO SCHEDULE-A FINAL INSPECTION, CONTACT THE DEPARTMENT OF COMMUNITY DEVELOPMENT INSPECTION HOTLINE AT 379-4455 and leave your request after the recorded message. In the event a final inspection is not passed, the inspector will give you a written notice of required corrections. You must call for a re-inspection to receive final approval. A FINAL INSPECTION MUST BE SCHEDULED BY 2/212015. Please contact the Department of Community Development(360) 379-4450 with any questions. Sincerely, Permit Technician cc: file 2,"-e \\tidemark\data\forms\F_BLD_pro_exp_ntc.rpt 1/2/2015 °'rok- �Oa JEFFERSON cJNTY t " 3(0 , r'��' 'j DE PARTMENT OF COMMUNITY DEVELOPMENT 'w ` PC 621 Sheridan Street • Port Townsend •Washington 98368 ` 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment BIND Master Permit Application MLA: Project Description(include se?agate sheets a necessary): s,' �.cges eIA S e 6 r t 1 -� / .Tax Parcel Number: . 1 L D roperty Size: C a e S (acre s�/ quare feet) Site Address and/or Direction o Propert : } 3 "v.47 , fi,E . -' 3.3 Property Owner(s)of Record: r , _ ' , i e . /Inc S t+t-t( r , €4_ n Telephone: • .,a J / /Faux: email: .-rata-e t—" eV A ,a �'c .g`onvk Mailing Address: 4'6 e )( • 77 l O.f d 7w,is Pll,W1. _ 9f." S‘e Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation email: ❑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 Cj** ❑ Manufactured Home .❑ Modular - ❑ Discretionary"D"or Unnamed Use Classification 1 0 Commercial* ❑Special Use(Essential Public Facilities)** • Change of Use ❑Boundary Line Adjustment ❑ Address ❑ Road Approach . ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑Binding Site Plan** jit Propane ❑Long Plat** ❑ Sign -. ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program ExemptioNPermit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive PIaNUDC/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: 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 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 arid right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appliJ &L-j"that he or she ants pri e. Signature: V' 1 lL_-' ✓ �"' Date: / O ( 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-transferable responsibility for a hering to and complying with the ESA. The Applicant has read this disclai -r and s''ns • d dates it below. Signature: ..Jo-f2) Date: f ?el G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 0 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: X ( ) ( ) MAILING ADDRESS: 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 C Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# O 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 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 i Above ground Tank Size of Propane Tank: i H• eat Stove I Cook Stove 1 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 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 Office Use Only Amount I .Rion Main Floor Heated EH BId App Review: 2-Y Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: _ Other TOTAL: $ Receipt Number: i Y Cash/Check Number: vi ESTIMATED COST(REQUIRED) Date: `(1 •Fair market value of all labor and materials foundation to finish Z' ` _l Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc I ' s . • • s Site Plan Checklist A Site Plan. All site plans shall be drawn with a straight edge &features shall be to scale using an engineer scale. For Residential Applications A site plan printed on 11 X 17 to scale. Please show the following on all site plans. ❑ North arrow ❑ Title block with the project name, address, drawing title, tax parcel number, &the name/address/phone of the person preparing the drawing. ❑ All Property boundaries, dimensions, total parcel acreage or square footage dimensions. ❑ Building footprint square footage for all proposed &existing structures [for Site Plan Approval Advance Determination (SPAAD) applications show buildable area rather than building footprint] ❑ Environmentally sensitive areas such as ravines, seasonal creeks, bodies of water, wetlands, steep slopes, etc. ❑ On-site septic system location or sewer lines (existing or proposed). Show measurement from foundation to septic tank, drainfield, & reserve area. Show transport line. ❑ Well locations, water lines &water meters. Show 100' radius around wells. ❑ Impervious surfaces such as driveways or patios. Show driveways all the way to access road, not just to the property boundary. ❑ Setback distances from: o property boundaries to structures or use o distance between structures o distances from structures to environmentally sensitive areas such as wetland, shorelines, top and toe of steep banks or slopes, etc. ❑ Location of any easements &encumbrances such as utility or access easements. ❑ Method & location of stormwater disposal facilitates such as drainage swales, tightlines, dry wells, curtain drains, etc. ❑ For applications on marine or river shorelines show ordinary high water mark, top of banks & heights of banks. ❑ Locate the Propane Tank, Size of tank, A/G or U/G &distance from nearest building. For Commercial, Industrial, Multifamily &Small-scale Recreational &Tourist Uses as listed in Table 3-1 A site plan prepared by a licensed civil engineer, architect, or landscape architect containing the following information in addition to the general information required above (in these instances, site plans may be printed on larger paper). ❑ All existing & proposed development or use areas. ❑ Existing structures & significant features on the subject property &on adjacent properties. ❑ Property lines, adjoining street, & immediately adjoining properties &their ownership. ❑ The layout of an internal vehicular& pedestrian circulation system, including location &dimensions of existing & proposed improvements on public right-of—way such as roads, sidewalks, & curbs. ❑ Corner grades & existing contours of topography at five-foot contour intervals. ❑ Existing & proposed grades&volume &disposition of excavated material, if applicable ❑ Natural drainage direction &storm drainage facilities & improvements. ❑ Locations of all existing & proposed utility connections. ❑ On-site septic system location or sewer lines (existing or proposed). Show measurement from foundation to septic tank, drainfield, & reserve area. Show transport line. ❑ Well locations, water lines &water meters. Show 100' radius around wells. ❑ Parking spaces & driveways. ❑ Proposed landscaping. i #-- / 0 iz , _______4p.a .,...t-is i • l V 5 24-7-v 5 W 2IOl24 V9Q P ^ 7rj ` ,,,./..4 ii. t/,5i_•N ,Q.s.b D4401a 5 04/ 1 ohd zz. QI a . 4 . • � � 711H�d �n9 � L/IA 21'741,1'4 5 ‘091A1° 1 60g/z t eoc� -44-y-y 1�°c�c� 5 rillrf ot V,/ f '''d .5-4ernvz _71-v aj s", , 7-192 s „.1.,11 69 # jso j 14 Q 6 i_7.- i(4 p1.49i /- N , i ?7gity7-e_p f k .L...4 ?s,/,_,--- . ,7 . ____, i 12 63P( '-e--, 1 --e-0 0 4 1 D-e3r10 a )c, __1_ • • 4S° C 4, Y a JEFFERSON COUNTY . DEPARTMENIOF COMMUNITY DEVELOPM s xI a ( ) Date: a tOTime Received: rtgct Mon. Tue. Wed. Thur. Fri. Date: 2 BLD: I It" 3(a Contact Name: Owner: Contact Number: 360 7 ?LA NO Address: A3`i POi.)U 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 -1. ck&Tile Ceiling Inspections are required to be cal by 3:00 pm to receive an inspection theft day. Do to staffing issues, at this time,we ca guarantee that you will receive an inspe the next day. day. Unless you receive a call from us,assume we will arrive on your requested inspection day. You may leave an inspection request 24 hours a day, and Inspections are available from Monday through Friday. We cannot determine the time we will arrive in advance. However, if you call our office the morning of your inspection,around 9:00 a.m.,we can give an estimate of when the inspector will arrive. Our general office phone number is 360 379-4450. An approved set of plans are to be on site with building permit for all inspections. If permit and plans are not on site at time of inspection, a re-inspection fee must be paid prior to re-scheduling another inspection. If no access, no inspections will be performed, and a re-inspection fee must be paid prior to re-scheduling another inspection. Inspectors will not access a home that has personal affects inside when the owner is not present. • Commercial projects require 24 hour notice for inspection. • • 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#: BLD14-00036 Received Date 1/29/2014 SITE ADDRESS: 234 POND RD Issue Date 2/3/2014 PORT TOWNSEND, 98368 APPLICANT: JACQUELINE D LEVIN PHONE: 360-774-0040 PO BOX 877 PORT TOWNSEND WA 98368-0877 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002121012 Section: 12 Township: 30N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 �l 3g5 Contractor's License SUNSHP*077QP Expires 1'f/167/2014-5875 OWNER, JACQUELINE D LEVIN PHONE: 360-774-0040 if different: PO BOX 877 PORT TOWNSEND WA 98368-0877 PROJECT DESCRIPTION: Install 120 gal propane tank 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 2/3/2015. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: /uJ1 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 2/3/2014