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Home My WebLink AboutBLD2013-00074 - MECHANICAL BLD13-0004 BUILDING PERMIT APPLIC.ION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 7' PERMIT#: BLD13-00074 Received Date: 3/4/2013 SITE ADDRESS: 1070 EGG & I RD CHIMACUM, 98325 OWNER: MARJORIE A BOYD PHONE: 360-732-0579 1070 EGG AND I RD CHIMACUM WA 98325-9722 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 801022003 Section: 2 Township: 28 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' 250 GALLON TANK SWAP OUT TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: 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 $76.00 JLA 03/04/13 140062 APPROVED PPRIj O,/,ED Total: $76.00 MAR 042013 Jefferson County DCD C.JcmorL\rInfn\fnrmc\C RI fl Ann Rlrl rn} '/A/')!11Z 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 #: BLD13-00074 SITE ADDRESS: 1070 EGG & I RD Issue Date: 03/4/2013 CHIMACUM, 98325 Final Date: 3/11/2013 APPLICANT: MARJORIE A BOYD PHONE: 360-732-0579 1070 EGG AND I RD CHIMACUM WA 98325-9722 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 801022003 Section: 2 Township: 28 N Range: 01 W PROJECT DESCRIPTION: 250 GALLON TANK SWAP OUT 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 3/11/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 3/20/2013 •ON-0• 0 �, JEFFERSON COUNTY I . • A.. .,.._...4,110.,.. . 'DEPARTMENT OF COMMUNITY DEVELOPMENT • `,. 621 Sh�eriidan Street•• Port TQwnsen.d'Washington 98368 . 360/379-4450 • 3601379-4451 Fax . e.°' www.co•Jefferson:wa..us/commdevelopment Master Permit Application MLA; •.• . Project Description(include separate sheets as necessary): 1 • a 1. 'i •. t# . t _.&_...! A • Tax.Parcel Number r i • •o Property:Size: (acres/square feet) Site Address•and/or Directions to Property: ; _ . _.`4 Property Owner s):of Record. -�--�—� t- ( �� • Telephone: ' .05---2 / Fax. . Fax: email: . •• Mailing Address: . ••App'ficant/Agent(if different from •owner) .«v_. .Al� __ nom.' . Telephone: 385'- 8. 7.,7 • , : Fax .-38 5--.5 S 75; . ' email: .�r S` `dti- �0 'C-- ., Mailing.Address: . /d 8:.53• k.Ile?.p y. •OP,::: PT._ t/R1-wc% r.;)A What,Kind of Permit?(Ctreck each-box that applies • ❑Lot or Road Segregation .•Gsuiiding ❑Critical ffAreas Stewardship Plan• O Demolition Permit ❑Variange(Minor,Major or Reasonable Economic Use) . 0 Single:Family Ca Garage..Attached./Detached, 0 Conditipnal Use 10(a),.C(d),or C]*" . O Manufactured Home , 0 Modular .- ❑Discretionary"D"or Unnamed Use Classification. •, O Commercial* . • 0 Speast Use(Essential Public Facilities)** • CI Change of Use -. : '0 Boundary t ine•Adjustmment O Address ..,.. . ..❑Road Approach, '.'II Short Plat"" D Home.Business ❑ Cottage industry t0 Bindin�Site Plan"" . ;Propane :0 Long;Fiat** . c Sign •-. . Li Planned Rural Residential:Development(PRfk.D)/Amendrrients." • O:Allowedf"Yes"Use.Consistency.•Analysis ❑Plat Vapation/Alteration"" . .o.Stormwater Management ' 0 Shoreline Master Program.Exemption/Permit Revisions*" ,O Site•Plan ApprQVal Advance•Peterrnination(S.PAAD)* 0 Shoreline Management Substantial Development** • ci Temporary Use: 'CI Shoreline IUlanagement Variance • 0,Wireiess'Telecbinmunicetlon". - ❑Comprehensive Plan/UDC/L.and Use DistnctMap-Amendment O Forest Practices Act/Release of Six-Year Moratorium . 0 Jefferson County.:Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree-Vegetatton'Request •. .. •• .. ** e4rifres,a.Pre-Applicatlpn•Conference•Please Identify arty other local;state.or�federal.perntits required;for bills.proposal,if known: DESIGNATION OF AG NT I;:ereby..designate ... .: •. to act as my agent in matters relating:to this application for permit(s):• ,c �('� �CNNER SIGNATURE / 1'� Date 2 -7.g-/ By signing this application form,•the owner/agent.attests.thatthe information provided herain,.and in any attachments,:is true and correct to the.best of . his her or.its knowledge Anymaterial�falsehood:or any omission of a rmatedaifactmade°bythe-owner/agent with respect.to"this applica'ttan'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 costa,reasonable attorney`s fees and expenses which:may in any accrue against Jefferson County as a result of orin 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,asstiMed unless the applicant informs:the County in writin9 at the . • 1 time of the application that he:or shg wants prior notice.- •nature � Pate. Z`. � �/J . tr• r . 7• • The.action•or actions Applicant.will undertake as'a result of the issuance of.this..permitimay negatiyely impact upon one.or more threatened or endangered species and could lead to apotential.-"take"of an endangered species.as those terms are defined.in the federal law known as the . "Endangered Species Act"or"BSA,"Jefferson.County makes no assurances to.the applicant that:the.actions that will'bg undartakea;becausethis. • permlthas been issued will not violate the S.A.E Any.lndividual,group or-agency can file a lawsuit:on behalf of an.endangered species regarding your actions)even if you are in compliance with the.,Jefferson County development code;The:Applicant acknowledges that he,-she or.ithokts individual • and non-transferableresponsibiii for adhering to and complying with.theESA. The Applicant has read•this disclaimer and-sign and dates it below: ' . ` Sign tune s . . -r. Date ...: .° Z'.7§�� • t • C:•\Pr.m+K- nrsr\tat*PnRM.C###\l7Ro PflRMS1r,,.Y..,ri-1RTl Fn..+,•\M.•..,P.....:r a.,.,1:.....;....n 141 no a..... • . . • SUILDER.STATEMENT • The signor 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..t�h/e responsibility oo�f��the General Contrac(or•for the proposed project: Signature: .. .Q _L�.r.{.P t. : . date:,;. ..4Z:7.2-17-1:3.; . GENERAL CONTRACTOR e- v- : , ,. ER: PHONE: FAx: . sue- +: Z*I e c 2.., P, - (;bd ) 3 Fs- -r 7 17 • (•MAILING ADDRESS:. 0 �.r I il t EMA(L: . . _ " 3 64 3 es s P 75 p .r CONTRACTOR'S LICENSE WAINS' • NUMBER: .. S i.l - �p47 7 Q 14 NUM�R• . ARCHITECT/ENGINEER: .. .. . , . PHONE .(:.. ) FAX:( MAILING ADDRESS.: EMAIL. Project Type: Frame Type: • Bathrooms: . • Shoreline: Type of Sewage Disposal: ❑ Wood Existing: . 0 Addition O Steel • • Proposed: ____._ . Bank Sewer 0 Alteration/Remodel • 0 Concrete Total: Height: . 0ommuniry Systefn • .0 Repair 0 Masonry Individual System 0 Demolition . Bedrooms: . . Water P 0 Other: . Existing: ° Setback: srmit.#' ' Type".oH eat: Proposed Private well 0 Tvio Party: a T•0411:.-. Rublic • .: Name of System:• •If this;is.a Commercial Project you must answer the followings Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: L . Number of occupants.(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: • . Will you have F:oodService7'Yes•/ No ' • *-If this is;a Propane Tan and/or Appliance Installation permit,mark all Items bete xtha apply: f Underground tank • I ove round T ' k y Size of Propane I. Heat Stove I Cook Stove i Woodstove I.Fireplace=lnsert I HotWater Tank 1:Pellet-Stove. I .Other is this-appliance being installed in a Manufactured/Mobile Home?. Yes /.No . When applying fora 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<froin the propane tank to all property buildings and septic system components,. including:the.reserve area. • •Y A ,c.' b .J t„ ? i Y 1 'S uare Foota e. Current Pre rased 0 , +f, s � �"' }s-•,sue ' 1. ,e:;: f ,,. , Main.Floor Heated' �� ... ��'�.�. X�sx� �..�•, � ' , � ��,�t�.�� .�� °)� � '�'��. ' ,f, ,144-;j , EH Bid App Review: 2' Floor Heated. . O. ,,* •5 ` Consistency Review: • Other Heated Base.fee • .Mezzanine `<x +e.,y, �,,,,f "..;., Additio_ nal Seotien. . Heate n Basement n's 4 P .. �� G,,�.r ,� Plan:Check fee: Unheated:Basement r-,,.'' v , rf••`State.Surcharge:fee: . Other•, nheatei9 tr 'Pot Water Review fee: •'Garage/Carport. ,,,?0:2:r w I i • SUBTOTAL 4 s i1t Docks {F x '' 1 Ir 911/Rd,Approach fee: rc sixi1 . Other , {, Wti o- ttr TOTAL: Receipt Number a T:f fig.e. Cash/Check Number: ESTIMATED:COST-(REQUIRED) ••Date. .• '•Fair market•value of all leborand m aterials foundation to finish Initials. G:\PerrnitCenter\###FORMS###\DRD FORMS\Current DIM Fo ie(Matter PtnwrAnnl mtinn 5-20.AR:A,;, , .. . . - . . . . . -241e1Vitt, :::WettiWt •- . ._,S.P..,:-,..4.?4,,:';'- A. i5.WP"Sr-'1717,5A7C • . . . - •kt •. . ' . . ry VI_i time received am / pm _. . _ Mon. TueS. Wed h Thur. -Fri. Data5--- ...... Aor BLD: k IIIIL Date: 1(47 . . • - f . . . - ' 4 Contact Name: OWNER: . _ . 4 14ce• „ . . • ADDRESS: Contact Number.360 ''' '.5.---c79 7 . . Notes: 206 • ' . .;.: .... . • • . . . ' . . • . Foundation ri Plu__ 23.n . - Framing . /4 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 S _ - Post Hole ___ • Ventilation . . Appliance - Underfloor Gas/wood stove ManHones . . Setbacks _____ • • Insulation. • Final Inspection ;.b. . Foundation. .. * . Block&Tie ______ floor wall ceiling. . Address PoSfed • • i Contractors or Tradespeople renter Friendly Page • Page 1 of 1 Electrical Contractor A business licensed by L8I 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 Had lock 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 Specialty Effective Expiration Status License Name Type Specialty 1 2 Date Date ENVIRH1004D9 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 I https://fortress.wa.gov/lni/bbip/Print.aspx 3/4/2013 • • 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 #: BLD13-00074 Received Date 3/4/2013 SITE ADDRESS: 1070 EGG & I RD Issue Date 3/4/2013 CHIMACUM, 98325 APPLICANT: MARJORIE A BOYD PHONE: 360-732-0579 1070 EGG AND I RD CHIMACUM WA 98325-9722 4 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801022003 Section: 2 Township: 28N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11 601 013 5875 OWNER, MARJORIE A BOYD PHONE: 360-732-0579 if different: 1070 EGG AND I RD CHIMACUM WA 98325-9722 PROJECT DESCRIPTION: 250 GALLON TANK SWAP OUT 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 3/4/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApprovah: ,-'-- � �3i1 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 3/4/2013