The URL can be used to link to this page

Home My WebLink AboutBLD2013-00081 • BUILDING PERMIT APPLI ION BRLD1e 00081 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD13-00081 Received Date: 3/12/2013 SITE ADDRESS: 25 BLUFF LN PORT TOWNSEND, 98368 OWNER: JOHN C KULLER PHONE: ELIZABETH M KULLER 25 BLUFFS LN PORT TOWNSEND WA 983689572 THE BLUFFS BLDG 28 SUBDIVISION: Block: Lot: 3055 PARCEL NUMBER: 965300055 Section: 26 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 11/17/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr PROPANE TANK SWAP 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: SETBACK: DECK: 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 03/12/13 140089 APPROVED Total: $76.00 MAR 12 2013 Jefferson County DCD 1\4irloma rL\rJnM\fnrmc\F RI Il Ann RId rn+ 1/97/9!111 •-ttl; 1J 4 • y-uy ,m-Z�k • eft Date - time received 39 am Mon. es. `Wed, Thur. - Fri. BLD: I3 — g1 Date:__ l� i OWNER: Contact Name: ADDRESS: _ Contact t Number:360 S--2c'7 Notes: 206 r� Foundation Plumbing • Framtn - —� Pro ane Tan Mechanical ' • S • etbacks Under-ground Framing Footing Rough in Air seal Under ground Furnace Stemwail _ Hydronic 1 Above ground • Gas Straps Exterior shear Exterior lines _ Interior Oil _ Post Hole Interior lines Ducts Ventilation •Man-Homes Underfloor Appliance • Gas/wood stove_ Setbacks Insulation Foundation + on. Final Inspection Block&Tie floor wall ceiling . tY Address Posted • - i Contractors or Tradespeople1inter Friendly Page • Page 1 of 1 Electrical Contractor A business licensed by LW 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 Specialty Effective Expiration License Name Type Specialty 1 2 Date Date Status 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 $4,000.0001/23/2002 Assignment of Savings Information No records found for the previous 6 year period Insurance Information No records found for the previous 6 year period Summons/Complaint Information Summons and Complaints are not filed with the department for this contractor type Warrant Information Warrants are not filed with the department for this contractor type Infractions/Citations Information No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 3/12/2013 • +. ,oN o0 . JEFFERSON COUNTY ' DEPARTMENT OF COMMUNITY DEVELOPMENT `a 621 Sheridan Street • Port Townsend•Washington 9836$ 360/379-4450 • 360/379-4451 Fax • www.co.jefferson.wa..us/commdevelopment • Master Permit Application MLA: Project Description(include s arate sheets as necessary): Tax Pastel Number. .tpeb OO, F--5- Property Size: (acres/square feet) Site Address.and/or Directions to Property: Property.Owner(s.of Record. Tele.phone:� , --- )---D— Fax: -, email: Mailing Address: ` • Applicant/Agent(if different from owner): MIr/�,i-4,J® Telephone: 9U5 - 57,7 Fax: 38 5 5 875: er'nail: fr s` d a,-e Mailing Address: /d<1'53 kN O 6 .6P. ._P%;. t/1- L 0 c A What kind of Permit?(Check each-box that applies ❑Lot or Road Segre`ation °Building 0 Critical Areas Stewardship Plan 0 Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) 0 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** O Manufactured Home 0 Modular - 0 Discretionary"D"or Unnamed Use Classification 0 Commercial* 0 Special,Use(Essential Public Facilities)** 0 Change of Use 0 Boundary Line Adjustment a Address . .0 Road Approach 0 Short plat** 0 Home Business , Cottage Industry 0 Binding Site P an*4,' ;Propane 0 Long Plat** 0 Sign 0 Planned Rural Residential Development(PRRD)/Amendments** O Allowed"Yes"Use"Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management ❑Shoreline Master P ogram Exemption/Permit Revisions** 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Manage e.nt Substantial Development** 0 Temporary Use 0 Shoreline Ma age ant Varian.ce 0 Wireless Telecommunication* 0 Comprghensi e Pi 1'1/U00/Land Use District Map Amendment 0 Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson Cot 'ty Shoreline Master Program Amendment *May require a Pre-Application Conference 0 Tree Vegetation Request **Re•uire a Pre-A. licatipn Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT , I . i ereby designate to act as my agent in matters relating;to this a plieation for permits) 1'0 •WNER SIGNATURE Date: 31 it /3 By signing this appUcatOn form,the owner/agent attests that the information provided herein,z nd 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 o ner/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,judgmen s,court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence gf,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 re• '• ter inspections. Staff's access and right of entry will be assumed unless the applicant lnforrns:the County in writing at the r time of the appli,'tion r 1 .or.;.- wants prior notice. - •nature: Air- Date: 3 f i(j!3 The action or a r frApplicant will undertake as a result of the issuance of this:permit may negativ ly impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those teems a e defined in the federal law known as the "Endangered Species Act"or"ESA,"Jefferson County makes no assurances to the applicant t at th actions that will be undertakenbecause this permit has been issued will not violate the ESA. Any individual,group or agency can file a la -uit-o behalf of an endangered species regarding your action(s)even if you are in com•liance with the Jefferson County development code,TheAppl' =nt cknowledges that he she or it holds individual and non-transfer:' •iii , r adhering to and complying with the ESA. The Applicant has read this disclafm ran •signs and dates it below. Signature: - Date; : •3/// 4.3 1� iv (:.\Prm,;r(rnter\auttmams.e##\T1Rn Ron MS\(:m,.nr'nit T1 Rte..,,.\AX.,o•.rP....,:r a r. c�n n•. • • 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 assu ing the responsibility of the General Contractor for the proposed p eCt Signature. Date:. ; .1'.1- (" 1�" GENERAL CONTRACTOR e.' , • . ,- . .. = • - . ER: PHONE: FAX: Stcr., Sutra 9°(2--1.- PA- ( ) X 7 7 (30 3 es-S'P 75 MAILING ADDRESS: C7 5 t P. 61 ES4AIL: CONTRACTORS LICENSE WAINS NUMBER: 5 CA Vl S-( 02 7 Q e . (sIlytoa R ARCHITECT/ENGINEER: PRONE MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: ' � Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: I 1f 0 Sewer 0 Addition 0 Steel Proposed: l Bank ❑ Alteration/Remodel 0 Concrete Total: , Height: 0 Individu! ti Community System System . .. ystem 0 Repair 0 Masonry ' SEP Permit# ❑ Demolition 0 Other: . Bedrooms: I Water Supply: Existing: Setback: 1 ❑ Private well 0 Two Party Type of Heat: Proposed: 0 Public ' Total:. .. Name of System:.. 1 If this is a Commercial Project you must answer the following: Number of Parking,Spaces: Current: Proposed: Number of AbA Parking Spaces: Number of occupants(includes owners,tenants, employees,etc) Current p�oposed • IBC Occupancy: IBC Type of construction: 1 ill you have Food tervice? Yes / No Jf this is a Propane Tan]kan.d/or Appliance Installation permit,mark all items,below that apply: I Underground Tank bove ground Tan Size of Propane Tank: I Z . 1 Heat Stove 1 Cook Stove VV stove 1 Fireplace Insert I Hot Water Tank 1 Pellet Stove . 1 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / Flo 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, inciudin•the reserve area. S•uare Foota•e Current Pro•osed j j F ` ' r .P,, IJ �,' •` i t�17,d � "F f �.� Main Floor Heated �t� 7 ::EH Bid App R-view: "41,--1,1?.. aRA 1 0 2` Floor Heated u a`d,tt ik ` Consistency R=view Other Heated,\,i 4«t r 5,I.4 'Base`fee: Mezzanine b: ° h' 3;#� ,. Additional Section: 1'x * Heated Basement ,� �"'t " Plan Check fee:` Unheated Basement 4 r, �,�, "t.�s�r,k` State Surcharge fee: Z M Other nheated' , i ` ' a a Pot Water Review fee: �;,-,-,;',,, ,,,ii.f 2f , 1 Garage/Carport: '; SU TOTAL Decks �. ySq,�r, rr y,= 911/Rd Approa fee: Other � M 4 I,,;i` t.1-',..-4.,...4,,,,,. TOTAL $ f:, `, Receipt N. mba r r ',#r ''i �� Cash/Check Nitlnber. ESTIMATED COST(REQUIRED) bate. •Fair market value of all labor and materials foundation to finish initials: G:\PermitCenter\###FORMS###\Di2D FORMS\Current 13RD Fob\Master Pemvr Am,l,'aei;nr,5_/01114 a..,. • SITE VISIT REPORT • (PLOT PLAN) JOB t\N � t�lA Lizr DATE: 31 l l I CONTACT: . ADDRESS "ZS BLi. Fi S LANT. N 1 PHONE #: DJRFjCTIQNS T('o eC TD 4 ' L 4 f+,�Df I "ro FAX #: ,, �1 2� a;.1 1 Email PLANNER: b v- 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. 12.P —P, Pa, 3 d .5 1D3 C Jo I6 (A, "W 2442‘'WC,_. J 20 14. o ay. S e^l } M-AN e C1 2 F-eL • • • • • • \\Sunshine l\E\BUSINESS\FORMS\PROJECT PLANNING\SITE VISIT REPORT-PLOT PLAN.doc 0 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 #: BLD13-00081 Received Date 3/12/2013 SITE ADDRESS: 25 BLUFF LN Issue Date 3/12/2013 PORT TOWNSEND, 98368 APPLICANT: JOHN C KULLER PHONE: ELIZABETH M KULLER 25 BLUFFS LN PORT TOWNSEND WA 983689572 3055 SUBDIVISION: THE BLUFFS BLDG 28 Block: Lot: PARCEL NUMBER: 965300055 Section: 26 Township: 30N Range: 01W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/16/201 5 5875 OWNER, JOHN C KULLER PHONE: if different: ELIZABETH M KULLER 25 BLUFFS LN PORT TOWNSEND WA 983689572 PROJECT DESCRIPTION: PROPANE TANK SWAP 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 3/12/2014. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: 10-1-47 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 3/12/2013