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Home My WebLink AboutBLD2013-00047 • BUILDING PERMIT APPLIARION BRLD13-000047 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00047 Received Date: 2/6/2013 SITE ADDRESS: 216 GREENVIEW LN PORT LUDLOW, 98365 OWNER: CHARLES S HYNDEN TRUSTEE PHONE: 360-301-3063 VENITA M HYNDEN TRUSTEE 216 GREENVIEW LN PORT LUDLOW WA 98365-8750 GREENVIEW VILLAGE SUBDIVISION: Block: Lot: 6 PARCEL NUMBER: 955600006 Section: 21 Township: 28 N Range: 01 E CONTRACTOR: BRENNAN HTG &NC LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 12/29/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION HEAT PUMP REPLACEMENT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 2,400.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 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 LYK 02/06/13 139979 APPROVED Total: $228.00 I� G FEB -62013 Jefferson County DCD \\+irJmmnrIArin+n\franc\G PI Il Ann PIr1 rn+ 7/RP7l14R 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#: BLD13-00047 SITE ADDRESS: 216 GREENVIEW LN Issue Date: 02/6/2013 PORT LUDLOW, 98365 Final Date: 3/14/2013 APPLICANT: CHARLES S HYNDEN TRUSTEE PHONE: 360-301-3063 VENITA M HYNDEN TRUSTEE 216 GREENVIEW LN PORT LUDLOW WA 98365-8750 SUBDIVISION: GREENVIEW VILLAGE Block: Lot: 6 PARCEL NUMBER: 955600006 Section: 21 Township: 28 N Range: 01 E PROJECT DESCRIPTION: HEAT PUMP REPLACEMENT THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 3/14/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 3/20/2013 • • ,11. g?) I iki6,,„,, 1 QN A JEFFERSON COUNTY ART COME 621 DEPSheridan TMEN StreetOF O. Port MUNITY Townsend DEV•WashingLOPMENT ton 98368 360/379-4450 • 360/379-4451 Fax "f" ^i0 www.co.jefferson.wa.us/commdevelopment �ZiTN Master Permit Application MLA: 1'______M___ _____ P I D■eicription(include separate - eets as n- -ssary): . i L/, L'1 It t L‘ , LU L, Tax Parcel Number.4...ff 5(o III Property Size: (acres/square feet) Site Address and/or Directions to Property: ' 11.0 Cct-Cnv.l L c Lua Li) ,LD Property Owner(s)of Record: ' 1 r� — 2 Telephone:`:.DP0 . 'j 0\ , , Me Fax: email: Mailing Address: A.- Applicant/Aaen (if different lb —from o__wner): o, A&.4�_ � s ---__ i Telephone: . ° .. t)* x: . ,��.'I i j email•_ II y�.1 44�t -f1 l' Mailing Address: 140 ' V L C1 i 1. �g-q__ a t � ° What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) .....Iiii=8ingle Family ❑Garage Attached/Detached ❑Conditional Use C a C • • ** ❑ Manufactured Home ❑ Modular O Discretion ." U r -% ❑ Commercial* ❑Special Use a, e -11 ,._1.1,' - id ) O Change of Use ❑Boundary Line Adjustt ent l O Address ❑Road Approach ❑Short Plat*E d O Home Business 0 Cottage Industry 0 Binding Site Plan** i ❑Propane ❑Long Plat'**`' - F E -'- I O Sign ❑Planned Rural Residential Development(PRRD)/ ' d ents** O Allowed"Yes"Use Consistency Analysis ❑Plat Vacatioii/Alterauioa'* i O Stormwater Management ❑Shoreline-Master Program Iiieni06iiiiiiThaifnit Revisions * O Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management S` 'betatitldQlDetle16,a, P* O Temporary Use ❑Shoreline Management Variance O Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium 0 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 A to act as my agent in matters relating to this application for permit(s). S OWNER SIGNATURE ' L. J q VLLe 01-1) _ Date: -By signing this application form,the owner/agent attests tha 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. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior notice. Signature: Date: The action or actions Applicant will undertake as a result of the issuance of this permit may legatively 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 adhering to and complying with the ESA. The Appicant has read this disclaimer and signs and dates it below. Signature: Date: G:\Pem itCenter\###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: ENERAL CONTRACTOR OR ANUFACTURED HOME INSTALLER: PHONE: PM: " (c)* d 4 —A MI ( a� `�1 3 q„.31,5„._ MAILING ADDRESS:`, 3 �i, �1 b 1 J 1 T bta..`H`'(.. EMa.IL �t i rt -e.Vb rt.n.t'■A.Aida/.9,-41 y‘ CONTRACTOR'S LICENSE b"(,t�y\ (c"a,A \ q iNS NUMBER: "-��, NUMBER rn ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New ❑ Wood Existing: ❑ Sewer 0 Addition ❑ Steel Proposed: Bank 0 Community System Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# 0 Demolition 0 Other:ry Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: 0 Public El CC, Total: Name of System: If this is a Commercial Protect 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: n 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 pit; t^ e v I Is this appliance being installed in a Manufactured/Mobile Home? Yes / No ? 1 j■ 1 When applying for a permit to install a propane tank you must also submit a site pet hawing all of the bui • gs, ri •perty lines,tank location and size,distances from the propane tank to all property lines,buildings fif eptiejsy;�co •• -nts, including the reserve area. S•uare Foota!e Current Pro posed I' r 1 r , x4!-"xk I9f.E 11 p y3 r Main Floor Heated Y s 1 EH Bid App Review: ' a DrnT OF COMMUNITY)E�IELOPMEM .nil Floor Heated Consistency Review: Other Heated Base fee: Mezzanine �" ` v Additional Section: r , 1 Heated Basement �' ,� E �� Plan Check fee: Unheated Basement •., ,, .' State Surcharge fee: Other Unheated ,,�?t x Pot Water Review fee: Garage/Carport SUBTOTAL l' `` Decks : u 911/Rd Approach fee: Other TOTAL: $ `J([) Receipt Number: 1' 6 �� Cash/Check Number: ESTIMATED COST(REQUIRED)' 4 m . Date: .Fair mantel value of all labor and materi�undation to finish - Initials: • G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • 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#: BLD13-00047 Received Date 2/6/2013 SITE ADDRESS: 216 GREENVIEW LN Issue Date 2/6/2013 PORT LUDLOW, 98365 APPLICANT: CHARLES S HYNDEN TRUSTEE PHONE: 360-301-3063 VENITA M HYNDEN TRUSTEE 216 GREENVIEW LN PORT LUDLOW WA 98365-8750 6 SUBDIVISION: GREENVIEW VILLAGE Block: Lot: PARCEL NUMBER: 955600006 Section: 21 Township: 28N Range: 01E CONTRACTOR: BRENNAN HTG &NC LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971 R9 Expires 12/29/2013 OWNER, CHARLES S HYNDEN TRUSTEE PHONE: 360-301-3063 if different: VENITA M HYNDEN TRUSTEE 216 GREENVIEW LN PORT LUDLOW WA 98365-8750 PROJECT DESCRIPTION: HEAT PUMP REPLACEMENT 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 2/6/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval. 14***--- 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 2/6/2013