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HomeMy WebLinkAboutBLD2013-00058 • BUILDING PERMIT APPLI ION B 005 Ree view view Type; Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00058 Received Date: 2/20/2013 SITE ADDRESS: 62 BARN SWALLOW RD CHIMACUM, 98325 OWNER: KEITH L KISLER PHONE: CRYSTIE KISLER 62 BARN SWALLOW RD CHIMACUM WA 98325-7719 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901263020 Section: 26 Township: 29 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 DESCRIPTIOI PROPANE, TANK,PIPES TO EXISTING KILN TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION 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 Total: APPROVED FEB 2 0 2013 Jefferson County DCD \\+ir7emar4\rh+e\fnrmc\F RI n Ann Ri,+rn+ '7ronn11+� 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#: BLD13-00058 SITE ADDRESS: 62 BARN SWALLOW RD Issue Date: 02/20/2013 CHIMACUM, 98325 Final Date: 3/12/2013 APPLICANT: KEITH L KISLER PHONE: CRYSTIE KISLER 62 BARN SWALLOW RD CHIMACUM WA 98325-7719 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901263020 Section: 26 Township: 29 N Range: 01 W PROJECT DESCRIPTION: PROPANE, TANK, PIPES TO EXISTING KILN 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 3/12/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 3/20/2013 1 0 • 4,>`I. JEFFERS©N COUNTY , • kik,. ' • DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Por ownsend "Washjngton '8368 36©/379-4450 . 360/379 54 Fax R . www.co.jefferson.wa..t sfcomnidevetopment Master Perm A.p it 1 lication MLA: Project Description(include separate sheets as necessary): r Tax Parcel Number.: .g o C for .0 C) Property.•'ze:r.�C • (acres/sgware feet)- Site Address.and/or Diitions to Property; r•• Property Owners)of Record: , ; . (` !I �x .••Telephone: Fax:- i` . f ���� ��nn , mail:••Mailing Address: O. _. ,�/5? y. S-Ccl/9L'C'C) /e- '' / �� ' Appiicant(Agent(if different from owner): `¢ ^0-- — i` /P i of-,—....e...„_.---- Telephone: 385 X 7 9 7 . . Fax:; . B S-�.8 75 `c4`4A`"``/p, ?�'"e .c..o- MailingAddress: . ./08.53 kg. 4y_ QP . / ///>'-Oc.oc�c,. . /t . email: S What.;kind of Permit (Check eact�-box that applies , • 0 Lot or Road S•,gre a ation DBuiidin' ' 9 0 Cnticai Areas . rdsttip Plait i " . O Demolition Permit ❑1/ariarricie(Mire•r or or Reasonable Enomic Use)•❑Single Family ❑Garage Attached/-Detached• 0 Conditi real U e[c:01.,,,,C(d),or C]** ❑ Manufactured Home. O �r odular •• . • 0 Discretionary °•o Unnamed t se Classification. o Commercial D:Speaatt/se �e tial Public racillties) • 0 Change of Use .: •, © oundat L'in A j stment O Address . . 0 Road Approach 0 Short Plat*" • O Home Business • 0 Cottage industry Cl Binding Site P art , Propane O Lori f at** o Sign " 0 PlannetdRur, Res dentiai i' eveiopmeht(PRRD)/Amendments**•O Allowed Ayes Use"Consistency Analysis ' 0 Plat Vacation/ Ile lion".*-41 Q Stormwater Management o Shoreline er er P ogram Exemption/Perrnit.Revisions'"" • •Phan prowl Advance Deter►iiination(SPAAD)* 0 Shoreline,Ma r: a eat Substantial Development** p 0.Shorel gala age ant,Varrance Q relees�Telecommrtunication* .;.' 0-Comp a risi a PI 0/U0C/Land Use.District Map Amendment `: O Forest Practices Ac t/Release 0-f..,., f Six-Year Moratorium 0 Jefferson`ou S ore ine Maas fY i ter F?.rogram Amendment May require a°Pro-Application Conference ;x. . :0 Tree"Ve eta "..`R'°quest **R ul Application Conference Please • Identify any the tocalr state fedeiai permits require fo th p osal, f known:• ` ,J,►�t#1 . ..: . ,& SIGNATION OF AGENT .Iy ereby.designate 4 to act as my agent in .-tt. re relating,to. 'is application far permit(e). '� •V1rNER SIGNATURE Date:.INS � i� By signing this application form,the caner/agent.attests that the information provided herein, rid 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. e;o' erlage.nt'Wit, h re..speet.to•this appiica iq packet, may result in this permit being•null and void. • I further agree to•save,indemnity and hold'harmless"JeffersontCounty against all liabilities,ju Me s,court Costs,reasonable attorneysfees and expenses which may in any way accrue against.Jefferson County as a result of or in cpnsegt! pe.• the granting.of this permit. -1 further•agree.to`provide access and right of entry to'J rerson County and Its employees,reti s.,en atives or agents for the sole purpose of application ' review and any requi ter inspections. Staffs access and right:of entry will be assrlmed+U ass he-a lioant irr orris he Coun' in writing at.the. .Mime cf the application h he or .e wa E prior cot pp ty •nature: .L �/ ���''�"."i �_ .. I• I Dated- • The action or actions Appiica u1 ill undertake as a result of the issuance of thie::permit rnayne ativ ly impact upon one•or,more threatened or endangered species and could lead to a•potential."`take of an endangered species as those to Pr a a a defined.in•thhe federal law known as the "Endangered Species Act"or"ESA,"Jefferson County make no assurances to:the applicantft•et.th-.actions that,will be undertaken because this.. :permit:has been>issued will not violate the ESA. Any!,individual,group or agency can file a Ia uit-o 'behalf,of an en`dangered species regarding your action(si even if you : e in com liarice ,pith the Jefferson County development code. the f�ppli ,nt- pkrtovvledgas that:he,she or it holds individual • and non-transferab .-ponsibi ly for adhering to,end complying with the'ESA The Applicant has read this disclaim 'r=nd--igns and dates it below: Sign tune > � , i _ Date: St t� . C:•\Pr„,;,('roar\###F(1RM.C###\DRn hoRMc\r,,.",rr1RTl p.....,e\144•r..v....,:.A...,,:,...w.., c'1n n• u parcel?The signer of this statement does herehY ear*that theY are the()wriers of the e- - General responsibility et a e = I GENERAL • O' Q' e 4 • MAILING ADDRESS: 0 ; re.: , ® I r P. ( L: , e . CONTRACTOR'S LICENSE 1, NUIvt6ER: S. k 5- ARCHITECT/ENGINEER: a MAILING ADDRESS: Project Type: : Frame Type: Bathrooms: { . Shorelin : Type of Sewage Disposal: 0 New ' 0 Wood Existing: 0 Sewer 0 Addition 0 Steel Proposed: Bank . 0 Community System 0 Alteration/Remodel 0 Concrete Total: - Height: • 0 Individual System 0 Repair 0 Masonry SEP Permit#y 0 Demolition 0 Other: Bedrooms: f ` Water Su BXistin ppiy. A Setback: •Type"of4 Heata Proposed; 0; Private wait ❑ Two Party. Total: N; , 0' Public =-_ Name of System . If this.is.a Commercial Prolectt you must?answer the,following: Number of Parking Spaces: Current: ` Proposed: Number of A A Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current. Proposed - . IBC Occupancy: ; IBC Type of construction: ,, . ill you have Fo.d'Service? Yes / No' 'If this is;a Profane Tank and/or Abbti-1• o installation .rm ma all to = ®e o that aw.y: t Underground Tank °bove ground Tan Size of Propane ank:, , r t Heat Stove t Cook •ve ,;.e.®:e a'e t FireplaceIsert .H .ttWater -5 k 1:=Pellet:Stov- Other 4 f - Is this.ar)ollatnce,beinu installed in a Manufactured/Mobile Home? Yes /,.,O / ' When applying for a pernilt to Install a ploparne tank you must also submit - site plan sho, ng all of the buildings,all property . -lints, tank location-and size, distances'f om he propane tank to all-prope ;line's,building and Septic system components, ncludin e the reserve area t` i�" b y>.9 7.Yy;S;,. i �� t'` ° two „',:r Yi- Ni t .t:& .,`!,r 1 Mstsr k ,h r x• x.eg a uare Foots a Current 'Pro owed s; ; i d 4 : i �8t. ief > ? 1x,�k dr}„``rS} to}"f 1�, .wrS tf)'1�;1 irz °' s�.v3:Main:Floor Heated . ! 4. EH Bid App R 4 .'^5yx 2`Floor Heated . � . Consistency RIMINI! ; ,' v' u o N,,,.., .,. _ 4 t n o ''4 +i =a .- - - „5, e'p - =e iiI£ ,w t e..; n Other. eate• Other {; ,,�1-ay w:.•,;0,;1111111101•EMIL11111 1111101111111111/11 ' I7:4,-4...t ' I Receipt 114Mb s k.„ Cash/Chock N mbert; AP I�`M�', �. ;jam ESTIMAT JI:COST;(REQUIRED) -. ' :Date • •Fair market value of all labor and materials foundation'to fish; Initials: G:\PernutCenter\###FORMS###\DRD FORMS\Ciurerit bRD Pomms\Ma ter`Perrnir rkw.41■14....,s_,Sb_ne a... • S • SITE VISIT REPORT (PLOT PLAN) JOB Ze.. -\tyf l).So gt aa.VN-R---V t u..\0 in DATE: 2` CONTACT: ADDRESS te. 'i C.,t SW \camel PHONE #: DIRECTIONS o ,....a N G¢nn R. Or FAX #: . L'cur rrR... D ouJ To F\v.-11z 9...v-0:.-Y "t •\ of,' f—\--; Email PLANNER: T) t& L. . Include all street names adjacent to property,property lines,tank,appliance&piping locations,distances of tank to property lines and buildings,septic,wells,wetland areas,distance to water bodies. 1 40 40 ,g;1, 40 O 12.------""N 4—i 14' zoi° 1 ST6.1 k.."'" , r�9 .,„ Z SO YV\ Se--7- 21 14 T o k rt1 IND.04).K -ro 2.N°5Ta�5-e, ` v is , • • \\Sunshinel\E\BUSINESS\FORMS\PROJECT PLANNING\SITE VISIT REPORT-PLOT PLAN.doc Contractors or Tradespeople Printer Friendly Page Page 1 of 1 • • Electrical Contractor A business licensed by L&I 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"98483 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 License Name Type Specialty 1 Specialty Effective Expiration Status 2 Date Date 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 2/20/2013 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#: BLD13-00058 Received Date 2/20/2013 SITE ADDRESS: 62 BARN SWALLOW RD Issue Date 2/20/2013 CHIMACUM, 98325 APPLICANT: KEITH L KISLER PHONE: CRYSTIE KISLER 62 BARN SWALLOW RD CHIMACUM WA 98325-7719 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901263020 Section: 26 Township: 29N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 ((33 Contractor's License SUNSHP*077QP Expires 1'f/167%3 -5875 OWNER, KEITH L KISLER PHONE: if different: CRYSTIE KISLER 62 BARN SWALLOW RD CHIMACUM WA 98325-7719 PROJECT DESCRIPTION: PROPANE,TANK, PIPES TO EXISTING KILN 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 2/20/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: a . '/1///.3 i� 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 2/20/2013