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HomeMy WebLinkAboutBLD2014-00296 - MECHANICAL •LDING PERMIT APPLICATIM BLD14-00296 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00296 Received Date: 8/18/2014 SITE ADDRESS: 1650 KALA POINT DR PORT TOWNSEND, 98368 OWNER: BRUCE KNOTT PHONE: 360-344-2076 STEPHEN E OXBOROUGH 1650 KALA POINT DR PORT TOWNSEND WA 98368-9532 9650 SUBDIVISION: Block: Lot: PARCEL NUMBER: 965000288 Section: 27 Township: 30 N Range: 1V1 CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 Contractor's License SUNSHP*077QP Expires 11/17/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOt Install 120 Gallon Tank , New Gas Piping & Gas Inserts TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: 1 OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: pouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $228.00 SRE 08/18/14 151417 ��� Total: $228.00 AUG 9 b 2"1A Je fersori _,v \\tidemark\data\forms\F_BLD_App_Bld.rpt 8/18/2014 • g4-261 1� ON co - JEFFERSON COUNTY "-Z _ DEPARTMENT OF COMMUNITY DEVELOPMENT �' 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 9 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessary): "�aAK- S.5-I Gas R \c) ) lr‘se- Tax Parcel Number: Q b 5OO('Z ? ac Property Size: •q c, r s/square feet) , Site Address and/or Directions to Property: l /� p V iko� \La\0. 2c Of 1U2` I�0 rk��OUal15 Lt rC{ Property Owner(s)of Record: rtst e 14.11-01.1- ape./ . 1-e--1)hGn O X he rt alb Telephone: NA '3 d-+- 'ZO 1(o Fax: email: hrkhp+'+btQ c1.o 1.Loll," Mailing Address: 1 loS d .{lit L AG i rrt DeArc. / }�T-.T'O ti)t44�nl V W A 4;18. -.8 • Applicant/Agent(if different from owner): .e Telephone: Fax: — email: --- Mailing Address: -- What kind of Permit?(Check each box that applies 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),ur 12 Ctl ❑ Manufactured Home Modular ❑Discretionary"D"or Unnam I s ❑ Commercial* ❑Special Use(Essential Pu}Ii c ' ❑ Change of Use ❑Boundary Line Adjustmen, '�JJ j ❑ Address ❑ Road Approach ❑Short Plat** ❑ Home Business ❑ Cottage Industry ❑Binding Site Plan** i AUG 2014I s Propane ❑Long Plat** I ❑Sign ❑ Planned Rural Residential v 9pment(PRRD)/Amendmen ❑Allowed"Yes" Use Consistency Analysis ❑ Rat Vacation/Alteration** lEFFERSO'N CUNT/ t* ❑Stormwater Management ❑Shoreline Master Prograr j Exerh3RklQyt{P1 ) yr nrmEm- ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management S bstantldl eve upmt,r O Temporary Use ❑Shoreline Management Variance ■ O 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 ,ct :s my agent-in matters relating to this application for permit(s). OWNER SIGNATURE ("6-a--- A ,13e.4..4... r Date: pl ry By signing this application form,the owner/agent attests that the information provi ed 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. ,off access and r'e t of entry wL be assumed unless the applicant informs the County in writing at the time of the a••lication ts.-at h/l,�Apr she ware, r�io�. oti•;. Signature: i_,...,,,,, $'t4 a.42;. I :4t t, Date: The action or actions Applicant will undertake as a result of the Issu.,/ce 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 d.velopment ale.The Applicant acknowledges that he,she or it holds individual and non-trans ble rasp. sibif for -• •-Ing '. an. •.m• - g . ith the ES•/ he Applicant has read this ' clai r and'sig s end dates it below. Signature: le '1 e /.,.,,�!, .L LL 4 Date OO1� 0G , G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 529-08.doc 4I�1 \ �. JEFFERSON COUNTY Mor BUILDER STATEMENT o I 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: h GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: iE ■kn 5W-■nc `Pro p ctn (31d 385-5-.7q-7 ( ) MAILING ADDRESS: I d..5 31 Y2._\-\..e, CONTRACTOR'S LICENSE �1 EMAIL: I NUMBER: WAINS ,sof\ARCHITECT/ENGINEER: 5),...„ p NUMBER MAILING ADDRESS: PHONE ( ) FAX:( ) t Project Type: EMAIL P New Frame Type: Bathrooms: Shoreline: T ❑ Wood Existing: Se of Sewage Disposal: ❑ Sewer 0 Addition ❑ Steel Proposed: m ❑ Alteration/Remodel ❑ Concrete Total: Bank 0 Community stemmF 0 Repair Height: ❑ Individual System ❑ Masonry SEP Permit# !' ❑ Demolition 0 Other: Bedrooms: , Type — of Heat: Proposed: ❑ Private well ❑ Two Party — Total: ❑ Public Name of System: if this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: l Proposed: Number of ADA Parking Spaces: I Number of occupants(includes owners,tenants,employees,etc) Current IBC Occupancy: IBC Type of construction: Proposed Will you have Food Service? Yes / No If this is a P no Tan . •d/or A..liance Installation .ermit mark all items below the a• •I ; I Underground Tank I l•• - •round Tank i Heat Stove 1 Siz12-0 e of Propane Tank: ( p (� Cook Stove I Woodstove I(Firepiace In i Hot Water Tank I Pellet Stove I Other 5 t t Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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, tanklocation and size,distances from the propane tank to all property lines, buildings and septic system components, includln• the reserve area. S•uareFoote•e Current Pro.osed q H`ii rkR t`d, I uC wp ` A4Ve r'1 i f t Fr 4 Main Floor Heated ^ G B App . b S nw"� Oki:�; #} Y'� ,r+ EH Bld App Review. ,� 2�'Floor Heated " t V Iv Consistency Review: yJ @t� F f , � 7 (J (�� Other Heated , 'a j Base fee: Mezzanine _!.rtr$P . Alt4d g. 1, Additional Section: Heated Basement rr e, f Plan Check fee: Unheated Basement rlg°�£ iag, t r State Surcharge fee: Other Unheated 1' - ,i,",.,".„,; .. ,.a Pot Water Review fee: Garage/C Ill. 1 �� r � , 0 1 r 1 SUBTOTAL Decks � j�)°� S e-. 0 " / � 1� 'Nl? 911/Rd Approach fee: Other I I i f,'I r, 1 r I l Ii i t TOTAL: /�I �a r ,' 4 1 .t � Receipt Number. "' n' CC�^MflNITY it v L0_rMFRT t eT „9 Cash/Check Number: ESTIMATED COST(REQUIRED) ' '' Date: *Fair market value of all labor and materials foundation to finish f Initials: ' G:\PernutCenter\###FORMS###\DRD FORMS\Master Peanit Application 5-29-08.doc � w JEFFERSON COUNTY K w,so DEPARTMEI�OF COMMUNITY DEVELOPSNT yi NG Date: Time Received: I(9�3 arrj/pm Mon. Tu Wed. Thur. Fri. Date: BLD: I L-�G{Lj Contact Name: Owner: Contact Number: 360 9 f: .D*2 Address: t p Kl k- 7 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor -�-� Foundation Wall Address Posted Block&Tile Ceiling JEFFERS COUNTY OC.0 NO. 15/1417 DATE �Ii / o14. RECEIVED FROM �YNn i V lX ' 19YOfTX/YL- DESCRIPTION BARDS A, , ,, AMOUNT CURRENCY e Id P'111 p Il , COIN 5lll...11l AAA\\AA�1� HH'KC�� I q (HE 1I9 C i 17-�irc . '-41-c'()J � r k a , froplo +04,k- 8 RECEIVED BY _ J A . >yA �i TOTAL r1� 471° • 0 SITE VISIT REPORT (PLOT PLAN) Kilo-`1' et S, aX6o Quota I Al �.1, � � DATE: � \R AN ADDRESS 1 450 il-A\a �-- PHONE #: 3�oD r3 4 . 2074, po C_TIION$ 5 2 1c\ ?d i(Z L &c-7D i(../4\A , FAX #: K '4k I L6D DIA K\t Email ft 8Ki a7TS ,4t C..Car'1 PLANNER: ,two,. L, . Include all street names adjacent to property,property lines,tank, appliance&piping locations,distances of tank to property lines and buildin•s se.tic wells wetland areas distance to water bodies. i • 1 a f lIY.\Y`5 R06M Roark Ef__ 1i11 I 12 rsOZt & i Si 7 <- I S - y essr I 1y 0 4 e j C G IE IN[ -�l D : , AUG 1Q 2014 � � 31 .l JEFFERSON COUNTY '�'y DEPT OF COMMUNITY DEVELOPMENT 11_4, 0A�� \-. 1 I 4. IzoV POI\ Jl aisl bCri I CS.T i LA r• W .•a ' GRAWL.ActocSiwsfp-e,MERGIa.Se7' -Fe„... „r , 'rvi2F USE', AS I n •,r-rI Q -Li rreay. -eve-rkvv) , C 4t5-e- e_At • \\Sunshine 11ETBUSINESS\FORMS\PROJECT PLANNING\SITE VISIT REPORT-PLOT PLAN.doc Parcel Details Page 1 of 2 • • tot , r- Jefferson Count i ..,,,rr''*, Home County Info Departments Search Parcel Number: 965000288 SEARCH Parcel Number: 965000288 Printer Friendly Owner Mailing Address: BRUCE KNOTT STEPHEN E OXBOROUGH 1650 KALA POINT DR PORT TOWNSEND WA98368-9532 Site Address: 1650 KALA POINT DR PORT TOWNSEND 98368 Section: 27 School District: Port Townsend (50) Qtr Section: NW1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 1W Tax Code: 0111 Planning area:Tn-Area (4) Sub Division: 9650 - KALA POINT 3-8 Assessor's Land Use Code: 1100 - Residential - Single Unit Property Description: KALA POINT #8 LOT 329 Tax, AIV, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats &Surveys Septic Monitoring Info '2 ';- Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later , Windows - Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel NO=965000288 8/18/2014 SUNSHINE PROPANE Page 1 of 2 • • 0 Washington State Department of Labor & industries SUNSHINE PROPANE Owner or tradesperson 10853 RHODY DRIVE PETERSEN, JAMES F PORT HADLOCK, WA 98339 360-385-5797 Principals JEFFERSON County PETERSEN, JAMES F, PRESIDENT BISHOP, RON M, VICE PRESIDENT EWING, MICHAEL H, SECRETARY YOURISH, ROBERT, TREASURER ROSS, LEVI K, AGENT Doing business as SUNSHINE PROPANE WA UBI No. Business type 600 342 368 Corporation License Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Electrical Contractor Active. Meets current requirements. License specialties HVAC/RFRG License no. SUNSHP*984B3 Effective—expiration 01/23/2002—01/23/2016 Designated administrator CHAWES, RICHARD Active. Meets current requirements. License type License no. Master Electrician CHAWER*954JE Bond RELIANCE SURETY CO $4,000.00 Bond account no. 6086432 Received by L&I Effective date 01/23/2002 03/20/2000 Expiration date Until Canceled https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*984B3&SAW= 8/18/2014 SUNSHINE PROPANE Page 2 of 2 Savings • No savings accounts during the previous 6 year period. License Violations No license violations during the previous 6 year period. Workers' comp 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. 422,171-00 Doing business as SUNSHINE PROPANE Estimated workers reported Quarter 2 of Year 2014"11 to 20 Workers" L&i account representative T1 !JAN BENTLEY (360)902-4652 -Email: STRO235@Ini.wa.gov Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept of Labor& Industries. Use of this site is subject to the laws of the state of Washington. tictcS5 ,Washington* —<01 Mai<t oNo>qok%4F fr https://secure.lni.wa.gov/verify/Detail.aspx?UBI=600342368&LIC=SUNSHP*984B3&SAW= 8/18/2014 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 #: BLD14-00296 Received Date 8/18/2014 SITE ADDRESS: 1650 KALA POINT DR Issue Date 8/18/2014 PORT TOWNSEND, 98368 APPLICANT: BRUCE KNOTT PHONE: 360-344-2076 STEPHEN E OXBOROUGH 1650 KALA POINT DR PORT TOWNSEND WA 98368-9532 SUBDIVISION: 9650 Block: Lot: PARCEL NUMBER: 965000288 Section: 27 Township: 30N Range: 1W CONTRACTOR: SUNSHINE PROPANE PHONE: 385-5797 10853 RHODY DR PORT HADLOCK WA 98339 (3.60i3$5-5875 Contractor's License SUNSHP*077QP Expires 1'1/17/2014 OWNER, BRUCE KNOTT PHONE: 360-344-2076 if different: STEPHEN E OXBOROUGH 1650 KALA POINT DR PORT TOWNSEND WA 98368-9532 PROJECT DESCRIPTION: Install 120 Gallon Tank , New Gas Piping &Gas Inserts 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 8/18/2015. REQUIRED INSPECTIONS: Installation per Manufacturer Specificatioyrs/CO2: 1/71 /S ✓✓7 Tank/Line/Appliance: LA-t1-l } Final Approval: -7/ZS , I,g: l 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 HOURSADAY 1ltidemark\data1form s1F_BLD_Perm it_Propan e.rpt 8/18/2014