HomeMy WebLinkAboutBLD2015-00183 - MECHANICAL 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 #: BLD15-00183 Received Date 6/3/2015
SITE ADDRESS: 223 AERIE LN Issue Date 6/3/2015
PORT TOWNSEND, 98368
APPLICANT: EUGENE W GARDNER PHONE: 360-531-0072
LYLE E GARDNER
223 AERIE LN
PORT TOWNSEND WA 98368-8713 1
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901085001 Section: 8 Township: 29N Range: 1W
CONTRACTOR: AMERIGAS PROPANE L P PHONE: 425-219-9972
2831 74TH DR NE
MARYSVILLE WA 98270
Contractor's License AMERIPL055LL Expires 8/2/2015
OWNER, EUGENE W GARDNER PHONE: 360-531-0072
if different: LYLE E GARDNER
223 AERIE LN
PORT TOWNSEND WA 98368-8713
PROJECT DESCRIPTION: REPLACE EXISTING PROPANE TANK AND INCREASE SIZE TO 500
Directions GALLON
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 6/3/2016.
REQUIRED INSPECTIONS:
Installation per Manufacturer Specifications/CO2:
Tank/Line/Appliance:
Final Approval: 'TI8/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
11tidemark\data\forms\F_BLD_Perm it_P ropane.rpt 6/3/2015
IPUILDING PERMIT APPLICAT fts1 BLD15-00183
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD15-00183 Received Date: 6/3/2015
SITE ADDRESS: 223 AERIE LN
PORT TOWNSEND, 98368
OWNER: EUGENE W GARDNER PHONE: 360-531-0072
LYLE E GARDNER
223 AERIE LN
PORT TOWNSEND WA 98368-8713
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 901085001 Section: 8 Township: 29 N Range: 11/I
CONTRACTOR: AMERIGAS PROPANE L P PHONE: 425-219-9972
2831 74TH DR NE
MARYSVILLE WA 98270
Contractor's License AMERIPL055LL Expires 8/2/2015
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI REPLACE EXISTING PROPANE TANK AND INCREASE SIZE TO 500
GALLON
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION
CODE EDITION: 2012 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: 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 $156.00 JLA 06/03/15 156162 APPROVED
Total: $156.00
JUN - 32015
Jefferson County DCD
11{irlcmerrlrla/nlfnrn,e\G QI fl Ann Mel rn• g/1r,n1F
Parcel Print Page 1 of I
• •
Parcel Number: 901085001 c5/12/2015
Owner Mailing Address:
EUGENE W GARDNER
LYLE E GARDNER
223 AERIE LN
PORT TOWNSEND WA 98368-8713
Site Address:
223 AERIE LN
PORT TOWNSEND 98368-8713
Section: 8 School District: Port Townsend(50)
Qtr Section: NE1/4 Fire Dist: Chimacum(1)
Township: 29N Tax Status: Taxable
Range: 1W Tax Code: 0111
Planning area: 98368-8713
Sewer: Drainage:
Bank: View 1:
View 2: Zoning 1: RR-5 -Rural Residential
Zoning 2: Zoning 3:
Sub Division:
Land Use Code: 1100
98368-8713
Property Description:
CLOUGH LARGE LOT SUBDIVISION LOT 1 SUBJ/OPEN SPACE EASEMENT
http://www.co.jefferson.wa.us/assessors/parcel/parcelprint.asp?value=901085001 6/3/2015
AMERIGAS PROPANE INC Page 1 of 2
411 4111
Home [nick)en Espanol Contact Search L&I ECU
A-Z Index Help My Secure L&I
Safety Claims&Insurance Workplace Rights Trades&Licensing•
GWashington State Department of
Labor & Industries
AMERIGAS PROPANE INC
Owner or tradesperson JEAN S KONOWALCZYK,SR COUNSEL PO
BRENDAN BOUVAIRD BOX 965
VALLEY FORGE,PA 19482
Doing business as
AMERICAS PROPANE INC
WA UBI No. Governing persons
601 621 842 BRENDAN
P
BOUVAIRD
DON L OWENS;
ROBERT C MAUCH;
SAMUEL R MAURIELLO;
TIMOTHY R ZINK;
IWorkers' comp I
Do you know if the business has employees?If so.verify the business is up-to-date on workers'comp premiums.
L&I Account ID Account is current.
537,607-01
Doing business as
AMERIGAS PROPANE INC
Estimated workers reported
Quarter 1 of Year 2015"Greater than 100 Workers"
L&I account representative
T41 CARIE PICKETT(360)902-5592-Email:PICC235 @Ini.wa.gov
IWorkplace safety and health I
Check for any past safety and health violations found on jobsites this business was responsible for.
Citation issue date
02/07/2014 Violations
Inspection no.
316964493
Location
411 N Havana
Spokane,WA 99202
Citation issue date
08/16/2013 No violations
Inspection no.
316856335
Location
156 Myrtle Rd
Aberdeen,WA 98520
Citation issue date
03/16/2012 No violations
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601621842&SAW= 6/3/2015
• 6if31 / 5-4373
4,"SON `OO, JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
loctv. 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitvdevelooment
gsylNG Tel:360.379.44501 Fax:360.379.4451 I Email:dcd(aco.jefferson.wa.us
Building Permits&Inspections I Development Consistency Review I Long Range Planning Watershed Stewardship Resource Center
Master Permit Application MLA:
Project Description(include separate sheets as necessary):
/11.60AV c fn dl L., I.42__r & &L..n\ d� 13 -LCIO -c e, S /C�
Tax Parcel Number: 90 / Q 850 t� I Property Size: "7. 2 cre square feet)
Site Address and/or Directions to Property:
?,z3 mile,, 1.i&F), , �T 7-41 coop.s a
Property Owner(s)of Record:
Telephone:3 AO Sal I n O 7.7-- Fax: email: r r.C�O_P/1.2 A ?
Mailing Address: /
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation
❑Building ❑Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use)
❑Single Family ❑ Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification
❑ Commercial* ❑Special Use(Essential Public Facilities)**
❑ Change of Use ❑ Boundary Line Adjustment
❑ Address ❑ Road Approach ❑Short Plat**
❑ Home Business ❑Cottage Industry ❑ Binding Site Plan**
Propane ❑ Long Plat**
❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration**
El Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development**
El Temporary Use ❑Shoreline Management Variance
El Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑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 to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date:
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 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 ap tion that he orlshe wants r'or notice. �O • F✓ J
Signat • � Date:
The action or ions Applicant will underta as a result of the issuance of this permit may negatively 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
a non-tr enable r¢rSponsibility f adhering to and complyin with the ESA. The Applicant has read this disclaimer and signs and dates it below.
• C/ d Date: CO • 2' /-Of'
- . may/- /51°I 'P 07/24/2073
1 to 3-• se- 57 3
/7 5 ro
• •
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:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New ❑ Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition L Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: r Public
Total: Name of System:
If this is a Commercial Project 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:
Underground Tank Aboveground tank Size of Propane Tank: 3 OO I ,
Heat Stove Cook Stove Woodstove Fireplace insert r/eh^t�O i evotS telleP"T knaT retaWtoH i
Is this appliance being installed in a Manufactured/Mobile Home? Yes / 'lam
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,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated EH Bld App Review:
2°Floor Heated Consistency Review
Other Heated Base fee:
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL
Decks 911/Rd Approach fee:
Other TOTAL: $
44 o"j). —.a."_1 A&e_, Receipt Number:
Cash/Check Number:
FAQ,) .-)
ESTIMATED COST(REQUIRED) Date:
•Fair market value of all labor and materials foundation to finish
d5 Z 1 !a O , 9' 1 Initials:
07/24/2013
1 __
l i...„.....
t .
Go. i-Cli'',)---41- 111FM t V5 P PANE
a @3
P.1.-\.'c v._4-,A 265 Chimacum Road Sequim,WA 98382
Po
/-1
Port Hadlock,WA 98339 (360)683-1881
'k ib,"rar$21111;0111.0 NEW WM W1111■11,./00.11m,wler,...-,/.411.411166....,.. . (360)385-6883 Fax:(360)385-6914
,,,,,,r,,,,,,,,,, 4.- ,,,...„,.._„air „„,„,,.......„,_ 77:70:4XIMW.O■ ww.v.mountainpropane.com
1 # :j
lir f 1.)t C.k...,11 ' , - (, . DIRECTIONS
2)\— C.)0-1
INSTRUCTIO NS
-,,
**Estimate does NOT include electrical,water lines, ditches or permits, unless specified.**
DESCRIPTION PRICE OR AMOUNT
RATE
. . .
• ,
i
, .
. ...,
, .
•
..i,,
. . ■
LABOR
This estimate is for completing the job as described above. It is based on our evaluation and does not include material SUB TOTAL
.,_ ...,„
price increases or additional labor and materials which may be required should unforseen problems or conditions arise
after work has started. TAX .
X // TOTAL AMT. ,/ \
OF ESTIMATE .7■ ' U --
CUSTOMER'S SIGNATURE DATE
_ _
,
\
-3„..., l.P\ , ,,
r c 1 \
-es 4.1- ..... ,,,\I
\
Q-7 \
4=D '., ' Z 1
1(' col ..,
: :1_,
„
(s) 1 0 ,
\
•1
.,
r\ : s;,,i. . ! ‘.\\\
\\''
Q . •■■•••
I ..4`1 \ (5
• . %
\
..T.t \ %Tr,
Ca
..,
\ >"
0 r-0,4
,
A .
• \'"'t.:
,..,
e.A\ cil s- ....___,
`..,
CI \
C:1 r' N•
2)
1 1 ■
\--4. .
l' '',,, 'S.,
111,
'.`..
r4 i
.•/1,-4-‘•:4,
/
N.'7.1‘)
/1 =17.."":.,:iji
V:' .!-.1 __ . E7-.:---A) ' I
70 fq
/ c'•
irll
i
1,2
) ..,..., :4
471") (t u
1
..... _
VN i .,., 1.•-•—;'''l I: fir
.. /
c•- 00, , . , ; !,..!3
1 D I ...' / ....
^ Q
ii
1 . ,
\r,
.. 7 V:f3; ,crr,‘ (7.2—
i •"•••:- ..., -...ir
... .._,—.
R.)
I :-)
0 .4-
0
'...1) 'st,
i 0 z., .■ •- NI 0
co, '57: :
, /
crs 1 .. -- ! ° V7 '4 z,c 6 0 '
' ,.. 2, ,
t
'---""
i...
I \ .4., Z-- 4
to r-- 11-u ' -•3 'PC "-3,S7 '' hoo'
1 rvN ,,,, f c Tic%:,-f- '
IN
4, , re co v
.2>c, 1--cly, - 11 CUse. '..1 '.. 1.
->s''.1.,
! !VI)
, "u\ Yc.„.., 4'1'
t\
i --.7
I> ‘,1 . % / eic •
i
1
t,,, I , k 1 L 6 ,—_,e_ ....._......„0.0 -.... i
--).--- ! -a- ...›■ 4- ,...._ 5 '1 <a/Q...7 --‘
77 - rc
41-
,' 0
-44•44:4.‹.. 1
‘
c• i nk".."4..\...k il \7,7.
.q) ;.,,.,'.
;77.• 0‘ --
)\ • -c..) ; , N. • -,3' _---: ' i.t1i' ‘•
'"•-t ......., --}-) :
k,
.1 1
0
CA,.....i........tC 0
I.. 1.
,,.. ..,.. c--..
,...-, .,-..
cq k/..^r°o - ...L. it.
......., f::: 4 )••• • I 40 .
I ■ wat trj ?, o•-•'' in Tin -i) t, (7.:1•44s C7) \ 1
\,.• V'• ■— '.'5K .0"'-‘ 1 - 4
1 ;
11Ct 3 : I I
C.....‘)...
''----1 4. :•,a1--- 0 I ...e". It —
IA I tti
0.•
---4 " {...* ••••., CI,
1
•••,..A
"Z..... ea.
7----
•^N 1,.i— 5
...: Q‘) ..5.•-_____r•
1
.'"---••••-- . , OPrr-1:4.•N .4..... tZ
--Z) ......„. . . ._ - —___. CZ•tVw ..C...)% h , --,,
G --f---,
.y., . ---....,
( - -
•
Jefferson County DCD Building Division
Correction Notice
PERMIT NUMBER c<S
OWNER �c4."( 1 or4--¢--
JOB LOCATION 223 Pt2-6e i4i
Inspection of this structure has found the following violations:
�rQ t _ tits
COr
`X' S A-e-c--4-1 c.� ( 2 Q2ir e c- s
.'or) Pe St ■/`elo% 'c''4—
tUl
Y..I✓
•
};)tAre : PO) Pv n,.: us fit- r v►t-e-
2 s .
eke...5re_ c«
pro o-t- sU p5;-
You are hereby notified that no more work shall be done upon these premises until
the above violations are corrected, unless noted otherwise. When corrections have
been made, call for inspection.
•
Date '41---N 1 S Inspector IA ��i 111
BUILDING DIVISION(360)379-4450 INSPECTION HOTLINE(360)379-4455
THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE 1