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HomeMy WebLinkAboutBLD2003-00651 0 0 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD03-00651 Received Date 10/16/2003 SITE ADDRESS: 294772 HWY 101 Issue Date 10/23/2003 QUILCENE, 98376 APPLICANT: MARION K LAKENES PHONE: (360) 765-3288 LINDA A LAKENES PO BOX 445 QUILCENE WA 98376-0445 SUBDIVISION: CAMPBELL'S H.W. ADDITION Block: Lot: PARCEL NUMBER: 937201052 Section: 24 Township: 27 N Range: 02 W CONTRACTOR: APEX CONSTRUCTION PHONE: (360)765-4374 PO BOX 807 PORT HADLOCK WA 98339 Contractor's License: APEXC**000CZ Expires: 12/21/2003 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: 8' CHAIN LINK FENCE 1' BARBED WIRE - NO MLA REQ REQUIRED INSPECTIONS: / ir [ ] SETBACKS+ hplt__ %► 4 . .1eJh OK liet>sciit /MIS /6/560133 fly y;,0 " " UFFER: �� Footing: / Foundation: 9 ii /1/ Underground Plumbing: Underground Insulation: 74 Shear Wall : �f Framing: N - Plumbing: Propane Tank/Lines: /�- Insulation: r/�" Sheetrock: V ' — Septic Sytem Final Approval: Zoning Final Approval: [� Final/Occupancy Approval: r✓ /2.-I$"'03 4""' HEALT EPARTMENT APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PE MIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY PERMIT # Bin 0 3 - 0 6 5 1 JEFFERSON COUNTY DO • BUILDING PERMIT APPLI 'ION BLD03-00651Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00651 Received Date: 10/16/2003 SITE ADDRESS: 294772 HWY 101 QUILCENE, 98376 OWNER: MARION K LAKENES PHONE: (360) 765-3288 LINDA A LAKENES PO BOX 445 QUILCENE WA 98376-0445 SUBDIVISION: CAMPBELL'S H.W. ADDITION Block: Lot: PARCEL NUMBER: 937201052 Section: 24 Township: 27 N Range: 02 W CONTRACTOR: APEX CONSTRUCTION PHONE: (360)765-4374 PO BOX 807 PORT HADLOCK WA 98339 Contractor's License APEXC**000CZ Expires 12/21/2003 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP 8' CHAIN LINK FENCE 1" BARBED WIRE - NO MLA REQ TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 2,200.00 ADD'L: HEAT TYPE: CODE EDITION: 1997 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Floodplain Routing Date: ( F&W Landslide 1 �� (� 3 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $83.25 KAS 10/16/03 60183 APPROVED Plan Check $54.11 KAS 10/16/03 60183 State Building Code $4.50 KAS 10/16/03 60183 OCT 2 3 2003 Total: $141.86 Jefferson County Planning & Building Depar ent PERMIT # RID 14, 0 3 - 0 6 5 1 JEFFERSON COUNTY DCD Jefferson Ca Department of Community Development # ©N 06 621 Sheridan Street,Port Townsend WA 88368(360)378-4450 rk. 4� 0 0 0 AppI © © Project Description: Building Type: Project Type: Frame Type: ❑ Single Family 19 New ❑ _Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry , ❑ Multi-family/#of Units ❑ Demolition ❑ Other. f'' ❑ Industrial / ❑ Other: I'.v',UL ' ...t l/al, Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing. ❑ Sewer ❑ Community System ❑ Electricity ❑ Oil Proposed: Proposed: ❑ Individual System jVit ❑ Woodstove ❑ Propane Total: Total:. If not sewer,fill out the following: ❑ Heat Pump ❑ Conventional ❑ ternative ❑ Other Permit# SEP` Water Supply: ❑ Private well ❑ Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor Consistency Review 2ND Floor Base fee 83-.A-5 3rd Floor Plan Check fee—65/o .may• I/ Htd Basement State Surcharge fee 4-QSo / Unhtd Basement Subtotal /q . • E3"t4 Garage/Carport Pot Water Review fees Decks 911/Rd Approach fee —q?— Commercial TOTAL / I U ' ,- f1 p Industrial Receipt# o/' 05 Other Cash/Check# 8b0 Total Valuation: _ Initials • /� ! 1 Or Date /i ID 3 Estimated Co t: ' a,2O O,� l / If within 20f.the Sf eline, • .....=, Distance to Bank or Ordinary High Water Mark ft.Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure hall be requested and shall occur during regular business hours. Sigl at> :.. ... k - • Date: ti f- 'D -v 3 OVER -P- H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 JEFFERSON COUNTY kelk i�� ' ' ) ,,. _? DEPARTMENT OF COMMUNITY DEVELOPMENT OCT4. 1 6 �:�3 . ' 621 Sheridan Street• Port Townsend •Washington 98368 0 360/379-4450 • 360/379-4451 Fax http://www.cojefferson.wa.us/connmdevelopment/ Stormwater Calculation Sheet MLA# PROJECT/APPLICANT NAME: q„+.-li -4,. n This stormwater calculation sheet should accompany stand-alone stormwater management permit applications, building permit applications,and other land use approval applications that involve stormwater review. STORMWATER CALULATIONS-IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) H Rlaz sq/ft Structures(all roof area) sq/ft Driveway I irt, sq/ft Driveway QN sq/ft Sidewalks ��Ov J 1 L sq/ft Sidewalks .) sq/ft Iv Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft Other sq/ft Other ►\))h sq/ft Total New -stI L sq/ft Total Existing aC sq/ft TOTAL NEW+TOTAL EXISTING* " 0 sq/ft *This amount will be used to check total lot coverage Please also indicate the amount of land-disturbing activity, in addition to the creation of impervious surface, that will take place: LAND DISTURBING ACTIVITY Drainfield area cleared sq/ft Well,Structures, Utilities,etc. sq/ft Driveway sq/ft Other sq/ft Total Land Disturbance sq/ft STORMWATER MGMT PERMIT.DOC REV.12/23/2002 � A) © m.(•M9 (C (i( ON � i, JEFFE�ON COUNTY • 4 � 0, `► DEPARTMENT OF COMMUNITY DEVELOPMENT O �Re/� 4 ,� 621 Sheridan Street•Port Townsend•Washington 98368 ii rr } r J ;� i'~'''\l ISZt7N0` O 360/379-4450.800/831-2678.360/379-4451 Fax 11 ,) - — _._._ .�_._ 1 www.co.jefferson.wa.us/commdevelopment ( . j , Master Land Use Permit Application Form 1 OCT 1 6 2003 ,; j 1 PROPERTY/NFORMATION Tax Parcel Number. 0 0 0 1J 0 DI ' D�- 'a6 Subdivision Name: C V AnAildtat Lot Number. 1 131.1( re r Property Size: (acres/square feet) Existing Use of Property: L Site Address and/or Directions to Property: c .11 0t,: APPLICANT&OWNER IINFORMAT1ON Applicant(if applicable): A v,11 GG �,rr ...._ Telephone:166-0) Two 413 ' Address: VI() 1�D i� T t 01 City: `-I\)).1L cl, .� State: (L)i. Zip Code: 9�33Lx` Email Address Applicant's Signature: — Property Owner(s)of Record: �w.a y 'S .. Telephone: ()PO) 3 CS- •"3 a e Y Address: `` I e 1 (4- ..t1.)-,n,.e l City: _. ,_,.i,,.__,) State: Zip Code: q ' `}e' Email Address I acknowledge that the applicant above is applying for a building permit on my property. Owner's Signature: I hereby designate c,,`;TC„ Ct&, to act as my agent in matters relating to this application for permit(s). ()OP OWNER SIGNATURE) (DATE) DESCRIPTION OF PR*'•`,z' USE OR ACTIVITY(include separate sheets as necessary) "+ 'F ...Q 4 C_`Ow.c,. JU ... ' L. ► 11 1 C 13 r i.A .ter ., 6' O ' ' t &JAIL. C9. 11 * [THIS SECTION FOR OFFICE USE ONLY] Refer to the specific sections of the UDC referenced below for more information and further requirements.An asterisk(*)indicates that a supplemental application or questionnaire may be required. Type 1 Permits Refer to: ❑ Septic Permit/Evaluation of Existing System(EES) UDC Section 6.4.1 and Chapter 8.15 JCC ❑ Building/Demolition Permit UDC Section 3.2.1 and Table 3-1 ❑ Allowed"Yes"Use Consistency Analysis UDC Section 3.2.1 and Table 3-1 ❑ Home Business Table 3-1 and UDC Section 4.20 ❑ Stormwater Management* UDC Section 6.7 ❑ Road Access* UDC Section 6.8 ❑ Boundary Line Adjustment* UDC Section 7.2 ❑ Minor PRRD Amendments UDC Section 3.6.13.15 ❑ Sign Permit* UDC Section 6.15 ❑ Site Plan Approval Advance Determination(SPAAD) UDC Section 8.7 ❑ Shoreline Master Program Exemption/Permit Revisions UDC Section 5 ❑ Temporary Use(based on use may be Type II or Type III)* UDC Sections 4.38 and 4.39 (OVER) roe II Permits • Refer to: • Discretionary"D'or Unnamed Use Classification UDC Sections 3.2.1,3.2.2 and Table 3-1 Cottage Industry UDC Section 7.3 and Table 3-1 Short Plat,Preliminary and Final* UDC Section 7.3 Binding Site Plan* UDC Section 7.5 Conditional(Administrative)"C(a)"Use UDC Table 3-1 and Section 8.8 Conditional(Discretionary)"C(d)"Use UDC Table 3-1 and Section 8.8(Discretionary Permit Review Process Determined by Administrator) Variance,Minor* UDC Section 8.9 Wireless Telecommunication Ordinance 06-0712-99(UDC Appendix C) Shoreline Substantial Development(Primary Use) UDC Section 5 I Forest Practices Act/Release of Six-Year Moratorium for Single- UDC Section 4.16.5(c) Family Residence I Appeal UDC Section 8.4.2 SEPA 8.10.12(b) yoe Ill Permits I Conditional"C"Use UDC Section 8.8 I Long Plat,Preliminary* UDC Section 7.4 I Planned Rural Residential Development Preliminary Approval UDC Section 3.6.13(must be in conjunction with an (PRRD)and Major Amendments* underlying land division application) I Plat Vacation/Alteration UDC Section 7.1.3(d) I Variance,Major* UDC Section 8.9 Reasonable Economic Use Variance* UDC Section 3.6.4(h) Wireless Telecommunication Ordinance 06-0712-99 UDC Appendix C I Shoreline Management Substantial Development,Secondary Use* UDC Section 5 l Shoreline Management Conditional Use* UDC Section 5 3 Shoreline Management Variance* UDC Section 5 3 Appeal UDC Section 8.4.3 SEPA 8.10.12(c) 'voe IV Permits 7 Long Plat,Final UDC Section 7.4 3 PRRD,Final UDC Section 3.6.13 voe V Permits 3 Special Use(Essential Public Facilities) UDC Section 3.3.5 3 Jefferson County Comprehensive Plan/UDC/Land Use District Map UDC Section 9 Amendment* 3 Jefferson County Shoreline Master Program Amendment* UDC Section 5 3 Appeal of SEPA UDC Section 8.10.12(d) ather Local,State or Federal Permits 3 Please identify any other local,state or federal permits required for this proposal,if known: ICKNOWLEDGENIENTS [PLEASE NOTE THAT TWO SIGNATURES ARE REQUIRED] By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property.Any material falsehood or any omission of a material fact made by the applicant/owner 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 attomey'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. This right of entry shall expire when the County (through the Administrator or the Administrator's represe ',fives)condudes the application has complied with all applicable laws and regulations.Access and right of entry to the applicant's A hall be requested and shall occur only during regular business hours. fahi 1. /O-1 PROPERTY OWNER. (DATE) The action or actions Applicant will undertake 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 lake'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 and non-transferable responsibility for adhering to and complying with the ESA. M has this disclaimer and signs and dates it below. 2. Z�y /e/ji/V PROPERTY OWNER (DATE) I L___ Z ri P, O • f — - J ' Oul 1. rg ` 11 )j, j.-JF _-.___. --__ 0 -.8 E. C 1 µ — t 4 7,-1",) -'-4""" lt.."-" I ' 1 a 4 . .I4) :ct'11°- I c� 1 I Z v i �' e-- ca T �K - a coC4 ® 'a" t ' 3 € i JiI pC D aeAil is. a it. ram .. 'CD ° (1) IA Ram ti, Er) laid Oo a or 1 t6 4 i, 1.1_ c_., 0.-- tp Ai, ?e .q)--4:, , ,off , , , 1 •*\ \I lk- , es ,fic=2 4 ,0 ,_ .3 a a' . <` 4 t.,.. /.,.., 4 ,,..„ ,,,, ... . ® Yam , cii ',.a-, -... k0 ?2:pg 4.:- id),.., 0. ,,,,._, ,.jya, ._._ \... ...4,,, __ *fli . 11. 0, —,c, .. ,i-v/cf,%. z.,, . --,, 17 -,-.„. ...... 1 t 1 --, : N. 4 s "�il q --_-- - I