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Home My WebLink AboutBLD2004-00814 • ! BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD04-00814 Received Date 12/23/2004 SITE ADDRESS: 39 MC DONALD COVE RD Issue Date 03/14/2005 BRINNON, 98320 APPLICANT: BILL & PATTY BENSON PHONE: (206)546-2540 240 N 171ST SHORELINE WA 98133 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502282009 Section: 28 Township: 25 N Range: 02 W CONTRACTOR: KENNEDY CONSTRUCTION PHONE: (360)796-3036 PO BOX 203 BRINNON WA 98320 Contractor's License: KENNEC*033KB Expires: 4/28/2005 PROJECT DESCRIPTION: EXISITING CABIN FOUNDATION REPLACEMENT- NO MLA REQ'D CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: 5(1 S 7 Foundation: 111 5 �, Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: Plumbing: Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 9f.." 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 • SPECIAL CONDITIONS FOR CASE # BLD04-00814 1.) Dbox and lines out are clogged w/roots. Need to be cleaned out prior to final of BLD permit. Provide written documentation to health dept. 2.) The project shall adhere to the Best Management Practices (BMPs) 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. 3.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 4.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 5.) The identified Fish and Wildlife Habitat Area shall maintain a vegetative buffer setback of 30-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to any future development. 6.) If development is proposed to be located within 200 feet of the Ordinary High Water Mark (OHWM), it is subject to the provisions of the Jefferson County Shoreline Management Master Program. 7.) The proposal was reviewed for consistency with the Shoreline Management Master Program Section 3.402.5 and found to be consistent. The proposal is (1)a single family residence, (2) does not exceed 35 feet in height, (3) does not involve over-water construction and is located landward of the OHWM, (4) and meets all required setbacks as set forth in said SMMP. 8.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. 9.) Stormwater from impervious surfaces such as decks, driveways, and rooftops shall be dispursed on site. Tightlines to the beach are not authorized unless a geotechnical report is submitted to the Department of Community Development and said report demonstrates that infiltration on site is not feasible. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 1 IIPUILDING PERMIT APPLICA1N SEP03-00277 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD04-00814 Received Date: 12/23/2004 SITE ADDRESS: 39 MC DONALD COVE RD BRINNON, 98320 OWNER: BILL & PATTY BENSON PHONE: (206)546-2540 240 N 171 ST SHORELINE WA 98133 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502282009 Section: 28 Township: 25 N Range: 02 W CONTRACTOR: KENNEDY CONSTRUCTION PHONE: (360)796-3036 PO BOX 203 BRINNON WA 98320 Contractor's License KENNEC*033KB Expires 4/28/2002 REPRESENTATIVE: JIM KENNEDY PHONE: PROJECT DESCRIPTIOP EXISITING CABIN FOUNDATION REPLACEMENT- NO MLA REQ'D TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 7,500.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: 1,026 CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: 25 BANK HEIGHT: 35 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 /a3� Shoreline Q Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $153.25 BAC 12/23/04 68870 API- '` F"'' f"°' Plan Check $99.61 BAC 12/23/04 68870 a `�" °' State Building Code $4.50 BAC 12/23/04 68870 MAR I 4 2L3 Total: $257.36 Jefferson County Planning &Building Department rik6,` ONc JEFFERSOR�UNTY • ' DEPARTMENT OF COMMUNITY DEVELOPMENT R 621 Sheridan Street • Port Townsertd •i Vashington 98368 • 360/379-4450 • 360/379-4451 Fax &qS�NG O� www.co.jefferson.wa.us/commdevelopment ..-T-(2'Ct..) rS Master Permit Application MLA: JlJa (Y\LA Project Description(include separate sheets as necessary): A}6u) >=du vrJ•��-;off x;ST1/1)6-- e4B/AL.) ,(/6„v7 E,j Tax Parcel Property - Number: '0'L 2 <j Z C`i� Size: • .5 /4 C r`i2( (acres/square feet) Tn •, Site Address and/or Directions to Property: .3 �� i7C/J(X,,4ti) (!t,'c //� � Ci4_,, e/Ci' 7,S'3 Property Owner(s)of Record: // L c a P4 T? y E=N S nvt) Telephone: 2 C(. i`-/iv 2 S /f C` Fax: email: Mailing Address: 2 Y<' /&!. / 7%' ' 5"libize Live _WA- '7 S 1 3 3 Applicant/Agent(if different from owner): /<C 2'!L'EI)y t, 5T,e.41 C i i c'rt,/ Telephone: ' &C, 7C/(i• 3 c 3 G Fax: email: c,kei kr-0y 6 CJC..v R-'•C-t ("•.._ Mailing Address: /� /g 60B/2 i'iL'iU G rL1 CLJ/¢, 9 22.CI What kind of Permit?(Check each box that applies) ❑ Building ❑Variance(Minor, Major or Reasonable Economic Use) Cl Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** III Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment Modular ❑ Short Plat** ❑ Commercial* El Binding Site Plan** El Change of Use ❑ Long Plat** CI Address ❑ Road Approach ❑ 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 or federal permits required for this proposal, if known: • DESIGNATION OF AGENT I hereby designate 'G to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Brit Pjx:yt,.y,r-it., Date: I -_____LA �%t / 4 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. Signature: 9//1 vZ L�-f'-! C. 0 l Date: /L/'7 Li 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-tran able responsib'' for adhering to 9nd g6mplying with the ESA. The Applicant has read this disclaimer nd sig and dates it below. Signature: _ 11 L X d L/1'L.-eq[C Date: l 2 7 { G:\PermitCenter FORMS\DRD FORMS\Master Permit Application 7-8-04.doc • OWNER 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: /fie/L-,)&_k) Y e:. s-7,24c t-ir� (_ G•r) 77h 3r-3� ( ) A, MAILING ADDRESS: Fe) .tcc)c X C`- 3 2-I N tViet'U 1,C:44 EMAIL: `f S lC E ti y .c 1.y i�CY • c o'—\ CONTRACTOR'S LICENSE elite WAINS NUMBER: /K �A:it.., C C_!k G 7 K B 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 ❑ C9mmunity System ❑ Alteration/Remodel [Concrete Total: Heig,ht; / Vindividual System LI Repair ❑ Masonry ? SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: [1 Private well ❑ Two Party Type of Heat: Proposed: i LI Public Total: ti, > 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 LI Above ground Tank Size of Propane Tank: LI Heat Stove ❑ Cook Stove L1 Woodstove ❑ Fireplace Insert L1 Hot Water Tank ❑ Pellet Stove I 1 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 Current Proposed Amount Main Floor Consistency Review: u -P °' 2ND Floor Base fee: c ? 3n°Floor Additional Section: Mezzanine: Plan Check fee: Cr{ (41 c� • a•• Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: `],,� Other Unheated 911/Rd Approach fee: Garage/Carport r , TOTAL: $ 5l '3(o Decks r 'Receipt Number: �S(16 Other ' i Cash/Check Number: lJ �J ESTIM D COST(REQUIRED) Date: )111231 F1 •Fair arket va a of all,labor and materials f datio to finish V 7 ,'� ��' Initials: G:\PernitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc 01 ‘,--- .ci -K C), NiT) "0 <I\ O sc/ V\ n � n� N r N N —I 0 2 4 i g 1 l — __--- - i: ‘1\ K i ;A k „` i tl � Z • E c6— rTi G cZ "/ -z T Liis, -6,-__ PI �.. / I -;\, oL:\J) (1 , C=3 16IN qi $ (‘) -‘• III J Moll ro o O c � C- < 1 i ., a r