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HomeMy WebLinkAboutBLD2013-00059 BUILDING PERMIT APPLIcION BLDI3-00059 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00059 Received Date: 2/20/2013 SITE ADDRESS: 372 MEADOW RD PORT TOWNSEND, 98368 OWNER: STEPHEN P NORDINE TRSTEE PHONE: 360-385-3220 SUSAN D REID TRSTEE 372 MEADOW RD PORT TOWNSEND WA 98368-9426 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 002121022 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 11/17/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION WATER HEATER REPLACEMENT 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: IRouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Total: APPROVED FEB 2 0 2013 Jefferson County DOD \\tidemark\data\forms\F_BLD_App_Bld.rpt 2/20/2013 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#: BLD13-00059 SITE ADDRESS: 372 MEADOW RD Issue Date: 02/20/2013 PORT TOWNSEND, 98368 Final Date: 4/16/2013 APPLICANT: STEPHEN P NORDINE TRSTEE PHONE: 360-385-3220 SUSAN D REID TRSTEE 372 MEADOW RD PORT TOWNSEND WA 98368-9426 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 002121022 Section: 12 Township: 30 N Range: 02 W PROJECT DESCRIPTION:WATER HEATER 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 4/16/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 5/22/2013 JEFFER N COUNTY.. 1 ON. ,• if er DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port ToWnsend;•Washington 98368 .A, t . 360/ 379-44S0 • 360/379.4461'F Fax www.co.jeffersori.wa..uslcommdevetopment. Master Permit •Applicatiion :, MLA;;: . Project Doscrip•.n(include separate sheets as necessar/): ._ 2Tax ParoelNumber ., O 0.0.2, /aZ, 7 a c2 -- Property Ski' (acres/square feet) Site Address.andlor Directions to Property: /mil . Property Owner(s)of Records "S ' o > - � 3 ` J e4 �t O . • Telephone: 3 it-3.2,__ _'0 Fax: --- r email: Mailing Address: Applicant/Agent(if different from owner): Telephone: ��5.- S7.97 Fax J8 S" 5 7.5 , `�,-e ,cam, ii.maily.o. s' df* i".- Mailing Address: . . c cY ,3 ,,/c,A LJp /r.`t)i-OLO c./ ,,,)A What kind of Permit?;(Check each--box that applies- 0 Lot or oad Segregation . OBulldin` : : , g ❑Cntica�Areas Stewardship Plan Q Demolition Permit - Cl Variange(Minor,Major.or Reasonable Economic Use) 0 Single Fainily - 0 Garage..Attached/Detached Q Conditional,Use GC(a),,;C(d).,or C]** 0 Manufactured Home. • .0 Modular' 0 Discretionary"D"or Unnamed Use Classification 0 Commercial* O Special Use(Essential Public`Facilities)." Change of Use .0 Boundary i*ine'-Adjustritent 0 Address 0 Road Approach . 0 Short flat** 0 Nome Business Q Cottage Industry . 0 Binding Site Plan" . • ,kK'(? n ane :0 Long plat** C Planned Rural Residential Development(PRRD)/Arnendrnents** i�,Allowed"Ye's"Use Consistency Analysis 0 Plat Vap ationlAlferation** 0 Stormwater Management - d Shoreline Master Program Exemption/Perinit Revisions"• O Site Plan:Approval Advance Determination(�SPAAD)* 0 Shore ltne Manegement Substantial Development" 1"i •Terip©ra y Usek:;, , :'0 Shoie i4 a Management Variance 4 Wireless°l eiet tunicatiori*' :' 0 Cornpl hert.stye:Plan/llDC/{and Use Distnc ap Amendmen t 0 Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre Application Conference a Tree Vegetati n Request `*77e i_. a Pre•A licatJPn Conference Please identify any other local,-state or federal perrtai> re.4uire ife ails proposal, If known: ' . DESIGNATION OF AGENT - -- '"-- - I, ereby.designate to - •as my-a.0eflt In Matters relating.to this-application for permits)44 -` OWNER SIGNATURE .� J gate: /3 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 of a mater'ial fact made-by the owher/igent with respect to•this applica'ttan packet this permit'being`null and void. . , may result int ;. 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=cpnsequence'ofthe granting.Of this permit. I further agree`.to provide access and right of entry to jeffereerr County and.its employees,representatives or agents for the sole purpose of el). pplication review and anyrequired•later inspections. Stafraaccess ant right will=be assumed unless the-,applicant informs.the County in wilting-at•the.. r . :time ofthe appilca •• •- he:or she .ants astir , r^� •nature:. a��- t -fiatit' �. pate 3 • (3 • Tneangered r actin s Applicen will ad undertake to a naiai"take"of atn endangered species as those termtis are defined in the federal law known as the "Endangered Species Act"or"BSA,"Jefferson County makes no assurances to the applicantthet the.actions that will t?e.undertakenbecause this. • permit has been issued will not violate the ESA. Any[ndivldual,group or agency"can file a lawsuit':on behalf of an endangered species tegardingwyour. action(s)even if you are in compliance with the Jefferson County development code,The.Applicant acknowledgess that:he,-she of Wholds°individual and non transferable res. sibility for =• • -n comply with-the ESA. The Applicant has read`this disclaimer a sig and dates'f bet ow: Sign,'t, e: ®. ,3 /3 `�r r. _ r.\A rt.rnir(inter\e rrrPnRM..c###\r1Rn non MR\C3„YMrTlRn F.,.,.,.\T.f.,.r..,n-- :r A.,.,1:...,,4,,.c In no a,,., S BUILDER„STA� M tl fit The signer of this statement tlbes harsh ce . • • . ..,.-.-.. ''• . , :: : .:;..,„,„•:,„,,,,,•,:v.,,,,i,,,,,.,... - H...„..„ .....„,47.!:,-.7,,,... ::::. . 40.- . . . ....... . . .• . . • . . .. „ . .. .. .. .... .... . .. ., . . ,.. ... ..., ....,,.. •,,• . , . .•y rtify'fF1*t•they re the Owners Of the kcir t,r t r�n t herelb,thatitl ey'are.Itof ilcensed oontt�sctorsi4nd'titat they•4411::be as,surntng.the respohsib�t�ty ctthe Ge e ( f(ir iiibi dirks pi4poser3 je, a,x -. Signature: . • 64f�,r;:t , 1 �; � ��S�y }lsi� y t 1.�•GENERAL 6:ON1MCTO4.2 e ., s tm ER; of4•0 Y. F FM. AX $.c4.t i ra e,...,,,,--.e . .S' ` �`7 tcir4c AoorESS 3 (3.64 3 p'75 CONTRACTOR'S LIOEN8t - T . NUMBER U4 4/l MB l , AFi�HI`['EC�'f"�.�ri�G�ME'ER: ��y����'� of rr. j r FAX:t.•MAILING AbOREes: L. Project Type. • Prarne Type t3athrooms: Cl .flew D .Viii PSIS#rng ••,.: ,. Sharelir Typaofev�age i)isposalr d Addition F] $teal ` Proposed:.. 1 Bank 0 Alteration/Remodet d = of orete Total ;' t idurilty Systefn ewe Ci Som kleight d Individual Systetti 0 Repair a asonr i. sSF5 permit# 0 Demolition 0 r : t i jnoms; • , y `, r ”' �iciatet:Suppf 3 s .. •rSfp brie ai't: ,;n: 5 ..:4....1•,• talApoSodr .Y ett;,ack t D Private NOl! a •wo att tote} :t (� I, bl4c . •� ;. S: Narrte of System �- If this;Is a Commerciaj Project N.Qt#'111,t+tttattrilikci't q tlo i/itlt�,<' Number of 1?eraking Spates Caren.o . rt posed F JJumber of s , Parking 8:''adee Number of occupants.(includes d*tiiit ;t ti ts)e plojveee,etc) Cunsn'f 1 P► ° •o. ecl lBS Occupancy I4. 1'yp4;;# rnstrrtc iorir _ ii, ou have Poo 5 -, 4 �- i ;r�• • 1 ,-n. 411. 9e` y �'� ice •' ery 7 Yes':/°No : tangy a rm men 111_ weowt at •• f t/ndergroune rdnk 1 Above ground "an Size of Pr :, f?'1,-:. ..•fi -f-teat Steve• 1 Cook Stove ip1t . . V o:dt fotie f It p1 "I trert I la llateri ' k.�z - •-: • t> is ' 1:::.Other•1 this:a••I enc e rietalfe• ®a u`'.11...fa t! a r/e. 11e** iii** 1 i# Il0 i, / �T a>� k-1 ,.�si0 so4:u rt1 sre 116 are # •;hnas,tank locai'ton and'sfza.,.010.0fr a ® a i • <lncludlr 'th'arxe '$'a e� �' " .tf, r: i~ln tf�tl n soPflt: ] > m cc mportertts, .� a farik to atal pf�p�e ,!r a d • • 4 r 1..... •F ra k ra£"'A iC d' r s wr',,k fi t.ts, r 4 R S iI f' :, b ;s k r .. ,X'2 r a a - '.�+c.r s; {`", k �e•s i_ k , • .S:•oars Foot2•e Cart ent 5 !t • . � . . F .1 <,1 1 �.�.K'I./d� P t, . r,t+t' 15,r k�,I'\a t ,s �><,,I ., F g �,-i � ,, , :•• • � , a Y vd ;.,,.[ ? d ,,A'Mal�Ptah e te� u .t r $V r dA(p e t � _:f f t RS �` {?S ''. ' ' t 1 ° 3 ' v t{2 =loor. Heated ' ������ Consattency few 10 * � fY a.he H o t1 y k E 4.pA.4\ . ; 7'- Base et 4 i ,, e• Nteetllne w �4 �i ' f tea §� a., dditli Bat ....: r, s .q k : 3i�fi r� { tom.,. m ^�,� MI Heat io m aset'ent ;�4t, Plan heck e • llnheafed B set eni i .£k .+t 5 g t r O T�u �ta� KGI Y V � t + ,/��"i'Xaw4 .i 4si SN t 5 ; °�,4�� ;- {1.1 i a F 4 r�YF y.,yi(1 i� 5 0th r, heateii;i }: a r5 , x:„Zi Pofilater ;MAIL:`f �"tu ask, " Garage/Carport!, y" ,* f3; - `# f ,.q.0 ®TEL . r� k K }� x FF f �� k 4.: ar9rftd'Apra . ..;'I F t.. {ri ' '' ,'. '1r c "6 tfi' Y Other•y. r • etr # .•ro, rw1+ aX0,4,4 , t ° 0 ✓ 'e � t ' y c 11.} 1.1 A V"':fc C 440 • f'iigF� � 1 `' ; r •• :i,: v: .x k z z gx441. rr ax t a y s 1 r EST•+ �y 4,0,*1 EQ U E®� u � . t< ..# - [: `� 1Yste f 6 x t Withrwa•kef il!a eillaborand erlal g atlori i "1 s :- rp , : . . 3 5 „• ,.. . r x • ;. G:\PerrnieCentar\###FORMatt##\DIM FORMS\Conant bRD Eo faiAifaater Petttnir::iE'nni,, ,;.,•s.. •',i,;,:. .;,` Contractors or Tradespeople Printer Friendly Page Page 1 of 1 S • Electrical Contractor A business licensed by L&1 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*984B3 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 • • I .: itliriiiwes Date /Z1 time received I/ °C am pm o ues. Wed: Thur. - Fri. BLD: 13 5'1 Date: "‘. /Z OWNER: Contact Name: ADDRESS: 3 7 2. iY►t_-CNdC!c.�; Contact Number 360 s- - • Notes: l.n.1 206 4 .x r • Foundation Plumbing - Framing Propane Tank • Mechanical Setbacks , Under-ground Framing Under ground Furnace _ Footing Rough in Air seal Above ground _ Gas _ Stemwall _ Hydronic Exterior shear Exterior lines • Oil _ Straps Interior shear Interior lines Ducts �F'_ . Post Hole ^ Ventilation . Appliance _ Underfloor _ stove Man-Homes _-. Setbacks • Insulation. Final Inspection Foundation_ ? s3 Biock&Tie — floor _wall ceiling. . Address Posted • 0 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#: BLD13-00059 Received Date 2/20/2013 SITE ADDRESS: 372 MEADOW RD Issue Date 2/20/2013 PORT TOWNSEND, 98368 APPLICANT: STEPHEN P NORDINE TRSTEE PHONE: 360-385-3220 SUSAN D REID TRSTEE 372 MEADOW RD PORT TOWNSEND WA 98368-9426 + SUBDIVISION: Block: Lot: PARCEL NUMBER: 002121022 Section: 12 Township: 30N Range: 02W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3.6_01385-5875 Contractor's License SUNSHP*077QP Expires 1'f/ /2013 OWNER, STEPHEN P NORDINE TRSTEE PHONE: 360-385-3220 if different: SUSAN D REID TRSTEE 372 MEADOW RD PORT TOWNSEND WA 98368-9426 PROJECT DESCRIPTION: WATER HEATER 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 2/20/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: q//J, 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