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HomeMy WebLinkAboutBLD2004-00683 0 • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD04-00683 Received Date 10/28/2004 SITE ADDRESS: 1812 LINDSAY HILL RD Issue Date 04/13/2005 QUILCENE, 98376 APPLICANT: BRAD BURLINGAME PHONE: (360) 271-0296 KAY BURLINGAME 8760 ST HWY 303 E#5 BREMERTON WA 98311-9265 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 701292005 Section: 29 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NEW SFR W/ DECK CALL IN FOR THE EQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: ,��'' obr Foundation: G ovD ;lid-�' Stormwater FINAL Ap royal: Underground Plumbing:0$. to- rf-D5- r& Underground Insulation: Shear Wall : ©/� 1/��� eivk Sheathing: Framing: eK LJ ee . 1 i S � �/d� Plumbing: Of< ji QPropane Tank/ Lines: A/ , T K .--23 CX- Insulation: Aik ;S4-.0t, f( 4 2� DL � 6-1 P6 Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: i Final/Occupancy Approval �.6 n ti,IC - c„ d, rS I C,�,;-, ;,_3 ( G 1^ HEALTH DEPARTMENT AND PUBLIC `WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION /-/S . THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED /770 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 /� l6 SPECIAL CONDITIONS APPLY - SEE REVERSE (� • CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 Al Scalf, Building Official PERMIT #: BLD04-00683 SITE ADDRESS: 1812 LINDSAY HILL RD Issue Date: 04/13/2005 QUILCENE, 98376 Final Date: 6/16/2011 APPLICANT: BRAD BURLINGAME PHONE: (360) 271-0296 KAY BURLINGAME 1812 LINDSAY HILL RD QUILCENE WA 98376-9521 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 701292005 Section: 29 Township: 27 N Range: 01 W PROJECT DESCRIPTION: NEW SFR W/ DECK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/16/2011 I:\F_BLD_Occupancy.rpt 10/29/19 •UILDING PERMIT APPLICAO)N MLA04 00619 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00683 Received Date: 10/28/2004 SITE ADDRESS: 1812 LINDSAY HILL RD QUILCENE, 98376 OWNER: BRAD BURLINGAME PHONE: (360) 271-0296 KAY BURLINGAME 8760 ST HWY 303 E#5 BREMERTON WA 98311-9265 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701292005 Section: 29 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW SFR,W/ DECK TYPE OF WORK RES , SQUARE FOOTAGE: TYPE OF IMP NEW - ' ` VALUATION 150,000.00 1'1 Me 1,000 ��` CODE EDITION: 2003 ADD'L: 320e HEAT TYPE: EEE OCCUPANCY: R-3 HE�ASF• HEAT TYPE: OCCUPANCY: U NHEA ED i map{i10 64r 4 OF STORIES: emiCONST TYPE: 5N OTHER: % SHORELINE: CONST TYPE: GARAGE:`AX1�a�dt.q �� SETBACK: DECK: 320 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 2 Prop: 2 Seismic Streams Total: 2 Total: 2 Flood Way Floodplain Routing Date: F&W Landslide 10121 061 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,279.35 BAC 10/28/04 68567 APPROVED ��®a , Plan Check $831.58 BAC 10/28/04 68567 /`"� v State Building Code $4.50 BAC 10/28/04 68567 APR 1 3 2005 Potable Water Application $52.00 BAC 10/28/04 68567 Total: $2,167.43 Jefferson County Planning Building Departme Ac <6.� �6zI riy, SPECIAL CONDITIONS FOR CIA BLD04-00683 I 1.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 2.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less than one-half acre unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Unified Development Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC, and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). 3.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 4.) The building height is not to exceed 35 feet. 5.) Minimum setbcak from Lindsay Hill Rd right-of-way is 20 ft. Minimum setback from Song Dog Hollow right-of-ways 20 ft. Minimum setback from the"Dahmer Easement"as indicated on the iste plan is 20 ft. Minimum setback from the northern parcel boundary (adjacent land designated Commercial Forest) is 100 feet as depicted on the site plan. Minimum setback from western parcel boundary (adjacent land designated Rural Forest) is 250 feet. Minimum setback from the southern parcel boundary is 5 feet. 6.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 7.) A minimum of two (2) on-site parking spaces are required for the single family residence. • • • I:\F_BLD_Perm it_B u i ld ng.rpt 10/29/19 ��.¢SON 0 06, JEFFERSON•UNTY _ ; O ' DEPARTMENT OF COMMUNITY DEVELOPMENT '� ,---~----� -�-- � kilo '1 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-445 Fax OCT Z 8 2004 q O www.co.jefferson.wa.us/commdevelopment . `S�7NG�S L. • Master Permit Application MLA: of l Project Description(include separate sheets as necessary): S, ,v' u tw A.0 ee Tax Parcel Property 44 Number: /012p► L 0 Size: ' +� Q (acres/square feet) Site Address and/or Directions to Property: 1$11". £ i i)()SAY H d C•t_ QQ Qt„i,- ic.,-•$.. 'Z$17 6 Property Owner(s)of Record: t 1 hr0 Telephone:( O Z'7 tt" ,C. Fax: email: Mailing Address: 6,0 c rA1s' M tVJq .30�j �,(()' A( .- �1 Applicant/Agent(if different from owner): 1 Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) ❑ Building ❑Variance(Minor,Major or Reasonable Economic Use) ID❑ molition Permit CI Conditional Use[C(a), C(d),or C]** ngle Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home 0 Boundary Line Adjustment ❑ Modular ❑ Short Plat-* ❑Commercial* ❑ Binding Site Plan-- ❑Change of Use ❑ Long Plat** • • ❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference• **Requires a Pre-Application Conference Please identify any other local, state orfederal 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 it's 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 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.Access and right of entry to this property shall be requested and shall occur only during regular business hours. t� Signature: Date: /O O /i 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"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 and non-transferable res sibility or dhering and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: f2,�/ J 0 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc OWNER BUILDER STATEMENT0 The signer of this statement does hereby certify that 1110 are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibili of the G eraln Contractor for the proposed project.ct. Signature: 52-- .� �r--'' Date: I v I /6' GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) OCT 24? 2064 MAILING ADDRESS: EMAIL: '_ � 11 CONTRACTOR'S LICENSE 'SWAINS ' '`' 4 �'?' j4. r NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:.(- 't"yr r11 ,I MAILING ADDRESS: EMAIL Pry ject Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: pr New , .Y , . 1k Wood Existing: _„__V. o Sewer , a,❑ Additiog- * 0 Steel Proposed: . 2. f• Bank , ❑ mugity System o Alteration/Remodel '0 Concrete Total: a Height: &individual System 0 Repair 0 Masonry SEP Permit# 00-a K ❑ Demolition 0 Other: Bedrooms: Water Supply. Existing: Setback: ovate well ❑ Two Party Type of Heat: Proposed: �� ❑ Public PLC. Total: 2- 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: 0 Underground Tank 0 Above ground Tank Size of Propane Tank: ❑ Heat Stove 0 Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ Other 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,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Fol I.�:UseOnfy 5r ... Current Proposed .: . ' - a ' t� ' Main Floor Consistency Review a , `t r ,• 4 43.1.- ON:Parrip,4:,..,,-,..t,'' '1'"-i4;', t ‘0 2r u Floor Q �J �j Base fee: '", . * r w l t (,�u^(,)o 3 Floor =Additional Section: ff . 'S \n 1 CO Mezzanine: -Plan Check fee: ' 4 ' '� , :�I' F' Heated Basement State Surcharge fee: 8, SO4",�` r � z" � ;t kOD Unheated Basement Pot Water Review fee: f r �" •' 3 32c L153( w 'i. Y u r4 I:4Z; 091 Other Unheated 911/Rd Approach fee: 1: 't w 1 Garage/Carport—`` 1.0 x r' ' 4'�' il\AV. TOTAL. $ ' t , ,a ,, Decks t7 �'[V � x 32 1 'Receipt Nu. • ., a Other a� i a posh/Check Number ,;" wA ""ba, ESTIMATED COST(REQU - -:- Date: to(� ( "- �i ��t1 .Fair market value of al r nd materials foundation-Z.-Nish � "0 I� -,. 4'45 y r�$r'; •• : Initials: eV 42-, ;,•}'t,i4"' , ,','S,-41,g •i c g'�1 G:\PermitCenter\FORMS\0' D • ` '�+1 ••lication 7-8-04.doc -,....-- ..1 , . i 1..41011 03 03 0 z w z .ig -_-_-_. .,..t. 1 .., . ,.4 I C7, -1.01.10KIMMIPOW•11••••••00•10•01491.1.3101 %.••••••01, % --•••• - • a CNI 7 i 4 •$ r" i cl) , A .?. 'Fi, $,- i ! 1 : . 8 ci) ., III, ) ,• -k, , 0 d. . t.v. ,". rvizrw, 2b-ti,vt,..1.T.vci •E .. 5 eft Tx S isZtv'v ' )3 t1-157 a "Zrda-71y . C)I-7- Q7 z-x /.. w . , , 8 0 7 ‘ , _II -2,-j 0- I-- 4 7' 1 7 . i ., ' 0 ., .___. r. ,L, , ,, ',',. .: . .,, . \ i — ,,',:.- ' , ,- '' \ / 1 ; ,J4,13/^1 SiV CI A1.111111AINIOD .if-L'LlIN'i IS- 0 i 1' AINI103 NOS2113.33fd° Ici'd( 5L :S003 C' I IldY 'i ' A ,/ <-) / , . \1 / • i . ,.., 0 . NVId UITS 1 . . 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