HomeMy WebLinkAboutBLD2004-00689 • •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD04-00689 Received Date 11/2/2004
SITE ADDRESS: 41 SPARROW LN Issue Date 11/29/2004
PORT LUDLOW, 98365
APPLICANT: DALE K FLODIN PHONE: (260) 930-6527
PO BOX 11293
BAINBRIDGE ISLAND WA 98110-5293
SUBDIVISION: BRIDGEHAVEN DIV 8 Block: Lot: 5
PARCEL NUMBER: 935900005 Section: 9 Township: 27 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NEW DETACHED GAR
CALL IN FOR THE REQUIRED INSPECTIO THAT APPLY TO YOUR PROJECT.
SETBACKS: CZ /a
UFFER:
Footing: GXG /96-9/o1f,
Foundation: i p/3//fy ile-e4d
Stormwater FINAL Approval:
Underground Plumbing: j\ /
Underground Insulation:
Shear Wall :
Framing: i' I/IOS �J+F
Plumbing: N/A < l/
Propane Tank/ Lines: Ni (,4
Insulation:
Sheetrock: ,4-
Septic Sytem Final Approval (If not on sewer): N/A-
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: OK 411- 4 i bud /12./os
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT 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
SPECIAL CONDITIONS APPLY - SEE REVERSE
OUILDING PERMIT APPLICA tN MRLA04 00623 eview Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD04-00689 Received Date: 11/2/2004
SITE ADDRESS: 41 SPARROW LN
PORT LUDLOW, 98365
OWNER: DALE K FLODIN PHONE: (260) 930-6527
PO BOX 11293
BAINBRIDGE ISLAND WA 98110-5293
SUBDIVISION: BRIDGEHAVEN DIV 8 Block: Lot: 5
PARCEL NUMBER: 935900005 Section: 9 Township: 27 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW DETACHED GAR
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 7,700.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
CONST TYPE: GARAGE: 308 SETBACK:
DECK: 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: (...210y. F&W Landslide
0 - ez,
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $153.25 BAC 11/02/04 68572 APPROVED
Plan Check $99.61 BAC 11/02/04 68572
State Building Code $4.50 BAC 11/02/04 68572 NOV 2 9 2004
Total: $257.36
Jefferson County Plai;ning
& Building Department
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SITE PLAN ,: _G -E
; )4335CPLEDIC 1"rill/2":31.."'23:
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JEFFERSON COUNTY s �. °F 3J
DEPT.T. R UNITY DF, pM i
SIGNATURE: �m ,ater BMP
Required
SPECIAL CONDITIONS FOR CA BLD04-00689
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 sertback from Sparrow Ln right-of-way is 20 ft. Minimum side and rear setbacks
are 5 ft.
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.
I:\F_BLD_Permit_Buildng.rpt 1 0/29/1 999
4�.g,Soiv oo� JEFFERSON •UNTY .
'l' J '� DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368 i NOV - 2 2004
360/379-4450 • 360/379-4451 Fax
�q O� www.co.jefferson.wa.us/commdevelopment �..
Master Permit Application , MLA: WA-p� �- 3
Project Description(include separate sheets as necessary):
:, &zVr.,
Tax Parcel (� Property
Number: L 35 Rob 00 Size: / -Y3 O(D (acres/square feet)_
Site Address and/or Directions to Property: /y / s AA R. to OW ;: /A/ ,3,e.i D;,c/ /f L'_A/
Property Owner(s)of Record: 1)A 1 t F/ '>- , /1/
Telephone:?C K. 73 0 6 5.1 7 Fax: email:
Mailing Address: PO Actx' //-2 `7 3 3,i /iY ,. /-
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
MBuilding ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a),C(d),or C]**
❑Single Family ❑ Discretionary"D"or Unnamed Use Classification
fedarage Attached/Detached 0 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 ❑ Planned Rural Residential Development(PRRDyAmendments**
❑ Propane ❑ Plat Vacation/Alteration**
❑Mowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment
0 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 or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate /C /,e f IS C)' /- e
to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE jl�«/��'�,�LG>/G - Date: / / " Z `O 9
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. 04'c' X' -Signature: Date: / / ._''- — CI
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-trap ble respons bility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:\Ife ���c 7 c./t�= Date: / I 2 - C5 9
G:\PemitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
OWNER BUILDER STATEMENT
The signer of this statement does hereby certify tha ey are the Owners of the parcel referenced herein,tha they are not licensed contractors and that
they will be asgIImirg the responsibilityre of the General Contractor for the proposed project.
Signature: f�ij���L / c Date: / / . 2 — c ...7 _
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE:; FAX:
216 _ ; i
MAILING ADDRESS: EMAIL: I j_ L,� � � 1 r^,
CONTRACTOR'S LICENSE WAINS "' JL •'
NUMBER: NUMBERpr 'i Of t _ . - .. .. I:i I
ARCHITECT/ENGINEER: PHONE ( ` )- ----_, FAX ( !�' `;',[i;1
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
V New [YSVood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
O Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
O Repair 0 Masonry SEP Permit#
0 Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
If this is a Commercial Protect 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 ❑ Above ground Tank Size of Propane Tank:
O Heat Stove 0 Cook Stove ❑ Woodstove 0 Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove 0 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 For Office'Use'Only �l'e" a¢aa :`' iw��40 0
Current Proposed r nera -
Main Floor Consistency Review. i x ' ` -` 4{`� z' .
2" Floor Base fee: .- P fi : d 'tr "'
; ro4
3f 3 Floor Additional Section „,i ` Ei, :1 4` 3- �;,,'
- ; k� "t•:. r - tom. Z ">,
Mezzanine: Plan Check fee s 4� 1 . ,;� `;
Heated Basement State Surcharge fee $4 ' '
t
Unheated Basement Pot Water s�{ � 4 ' ' ' .r a;
sgo
Other Unheated 911/Rd Approach fee: �) x ': „" , .�
Garage/Carport C TO ..� , Ai' ;-' '
Decks Recei t Number. ` ,, rx
1, ,wSze a
Other Cash/Check Number. r;1-... .,:... erigG.::. ,,,,,,,7s "" iz
,-
ESTIMATED COST(REQUIRED) Date: - .-0
_ 't ' -,, ,
*Fair market value of all labor a • founds ion to finishit T :.
E' Initials: :- .. f; ''
G:\PermitCenter\FORMS\DRD aster Permit Application 7-8-04.doc