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HomeMy WebLinkAboutBLD2014-00081 BUILDING PERMIT APPLICOON BRLD1e 000p8f Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00081 Received Date: 3/5/2014 SITE ADDRESS: 63 OAK SHORE DR PORT TOWNSEND, 98368 OWNER: GRETCHEN G THOMPSON TRUSTE PHONE: 360-379-9883 RAYMOND G THOMPSON TRSTEE 63 OAK SHORE DR PORT TOWNSEND WA 983689534 KALA POINT#5 SUBDIVISION: Block: Lot: PARCEL NUMBER: 965000183 Section: 27 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 11/17/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt On Demand water heater and piping - H2O and gas 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 $152.00 JLA 03/05/14 148425 �9 Total: $152.00 APPROVED Jefferson ity DOD \\tidemark\data\forms\F_BLD_App_Bld.rpt 3/5/2014 ii �`'S0N Ca JEFFERSQIIl�OUNTY • wow 4\ DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax WIp$ www.co.jefferson.wa.us/commdevelopment c)7�� Master Permit Application _ ,1 ' MLA: Project Description(include separate sheets as necessary): 2:9A—.40,"z/V.0 12 74-"Z e`�'E. 7 ° .�✓�,riu�� d' /425 Tax Parcel Number: qc.6. op,7l X . Property Size: (acres/square feet) Site Address and/or Directions to Property: /<1 E 141 '34Y Property Owner(s)of Record: ,A2. / d�IJ 4''/',/>f/r,2,c7s...ew Telephone: o579-- 4-616._ ' Fax: email: . g s Li`;, Mailing Address: 7,37ck„."rv✓"" -A427j Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation wilding 19,,x;/ y� ❑Critical Areas Stewardship Plan ❑ Demolition Permit �• 11�r ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home .❑ Mcdular - • - ❑ 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** I4Propane ❑Long Plat** ,iyn ❑ 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: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). �� Date: ' `"°i OWNER SIGNATURE �.�r.�i/%L1� i/i' �r• ' %' �` By signing this application fo ,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 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 applicaaff. that he or she wants prior notice. Signature: L f„«.r1��� ..f- _ � � Date: — 5 .2 e/lj� The action or action-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-transfera�,;ac ••nsibility for adhe ing and and com with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: —.2e79.y G:\PermitCenter\###FORMS###\DRD FORMS\Current 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 assumin. the responsibility of the General Contractor for the proposed project. i Signature: �.+: ��. ,i Al' /iii ._._�� Date: _..S. . .-..6--^ ,..2.e,/ / / GENERAL CONTRACTOR OR MANUFACT RED HOME INST LER: PHONE: FAX: ,� C 5/`Y~j 11-1. 0 ‘1/1" /,'2"`e ( ) ( ) 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: Li New ❑ Wood Existing: I ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank D Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair U Masonry — SEP Permit# 0 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 • ;BC Occupancy: IBC Type of construction: Will you have FoodService? Yes / No If this is a Propane Tank and/or Appliance Installationpermit,mark all items below that apply: 1 Underground Tank Above ground Tank Size of Propane Tank: > 1 Heat Stove i Cook Stove i Woodstove i Fireplace Insert Hot Water Tank' i Pellet Stove i Other . Is this appliance being installed in a Manufactured/Mobile Home? Yes /66 . o- dls „ 40 !, ,_. 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- Revision Main Floor Heated EH BId App Review: 2`d 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 y •Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ — Receipt Number: Cash/Check Number: ESTIMATED COST(REQUIRED) Date: 'Fair market value of all labor and materials foundation to finish Initials: j G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc SUNSHINE PROPANE Page 1 of 2 • • 0 Washington State Department of Labor & Industries I SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DR CHAWES, PORT HADLOCK, WA 98339 HAWES, RICHARD HENRY 360-385-5797 Principals JEFFERSON County CHAWES, RICHARD HENRY LEMLEY, DAVID BARRY SIMPSON, LAURA ANNE YOURISH, ROBERT B FLANDERS, RONALD LEE EWING, MICHAEL HOYT ROSS, LEVI K (End: 01/01/1980) CHAWES, RICHARD (End: 01/01/1980) YOUNT,JO (End: 01/01/1980) SPRING, PERRY (End: 11/05/2010) PETERSEN,JAMES (End: 11/05/2010) Doing business as SUNSHINE PROPANE WA UBI No. Business type 600 342 368 Corporation Parent company Governing persons ENVIRONMENTAL HOUSING INC BILL BISHOP ILicense 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. SUNSHP*077QP Effective—expiration 11/17/1993—11/17/2014 Bond TRAVELERS CAS&SURETY $12,000.00 Bond account no. 206086406 Received by L&I Effective date 10/23/2001 11/17/2001 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 3/5/2014 SUNSHINE PROPANE • Page 2 of 2 Insurance • United States Fire Insurance C $1,000,000.00 Policy no. 506-8751013 Received by L&I Effective date 11/13/2013 11/17/2013 Expiration date 11/17/2014 Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings during the previous 6 year period. Tax debts No tax debts during the previous 6 year period. License Violations No license violations during the previous 6 year period. IWorkers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 422,171-00 Doing business as SUNSHINE PROPANE Estimated workers reported Quarter 4 of Year 2013 "11 to 20 Workers" L&I account representative TO/CAROLYN CRAWFORD(360)902-4715-Email: CRA1235©Ini.wa.gov IWorkplace 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. Access Washingtoniw iM+.;ial i 'a#a-. rrzinarAe kSa+&#t,. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*077QP&SAW= 3/5/2014 Jefferson County Building Division Permit Number: Applicant: BUILDING PERMIT INSPECTION APPROVALS Applicable Code: International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION 2- (3 1 c i FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00081 Received Date: 3/5/2014 SITE ADDRESS: 63 OAK SHORE DR Issue Date 3/5/2014 PORT TOWNSEND, 98368 Expiration Date 3/5/2015 OWNER: GRETCHEN G THOMPSON TRUSTE PHONE: 360-379-9883 RAYMOND G THOMPSON TRSTEE 63 OAK SHORE DR PORT TOWNSEND WA 983689534 KALA POINT#5 SUBDIVISION: Block: Lot: PARCEL NUMBER: 965000183 Section: 27 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 11/17/2014 PROJECT DESCRIPTION: On Demand water heater and piping - H2O and gas 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: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $152.00 JLA 03/05/14 148425 Exist: Exist: Total: $152.00 Prop: Prop: Total: Total: Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY i,- N 3 L N n N N N O co F Cl) C C G 2 (8i a M Z co � ' _ Z CA . N U N o .71 Z O c g o_ , Z a v- ` I= o ++ • m b m ,& U) CI.Ts m � a 2 7 Y c C f- • = a ' f° b o u) ✓ Q N 2 CI .∎ $ t A o I-0. L C v ° co i t 3 c W L 'A- 3 O v m O O N 1 L U V y 0 U M U 00_ M s 4110 CA m Z O , • I- N N « O H CD D O m I o Z inl Z Q. °' -a in N w0 7 -0 " 25 I- 2 o m c m CC > 00 } a) 2 m CL 0 0 -c _o o m 4,o- ? k53 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ��/� 9Sy7NGK0, e l Date: t 16( Time Received: ' �� 1 r Fri. 31 rr/pm Mon. Tue. r' Date: 1 ' BLD: I r"I -- 0 0 0 8 Contact Name: f s Owner: S Contact Number: 360 �-ici q 0,93 Address: Co 3 OQ }[S(tia-e. Dc; r,j p„- 206 Notes: v,A-Vd141 &v1/4.,01,1A-v 41‘i) f- ' i--0---q'St L y . 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 Block&Tile Ceiling • Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to staffing issues, at this time,we cannot guarantee that you will receive an inspection 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. k,4 c 4 gON b �'"7 JEFFERSON COUNTY ,�-+ 4. DEPARTMENT OF COMMUNITY DEVELOPMENT 9SRI N' ,/�/ Date: 2 i(-I�1Time Received: am/pm Mon. Tue. Wed. Thur. _ ' ` Date: BLD: dote g1 Contact Name: _ Owner: te4-rAA Contact Number: 360 i� Address: �2J pak�--' 6(e,J ( 206 �`� I 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 Block&Tile Ceiling - Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to staffing issues, at this time,we cannot guarantee that you will receive an inspection 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. 460; ?6,iti 4w4sox ooG� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT N,sH.JNG�O Date: ('Time Received: 40 rp/pm Mo Tue. Wed. Thur. Fri. Date: ! l 1 BLD: I4'--" I Contact Name: Owner: 1tior-h,-- 50,/l_ Contact Number: 360 7 Address: I j • II 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance v Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines l./ l 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 Block&Tile Ceiling