Loading...
HomeMy WebLinkAboutBLD2005-00060 • NO MLA RQRD BUILDING PERMIT APPLICATIRN Review T ype:. Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00060 Received Date: 1/31/2005 SITE ADDRESS: 464 BACHELOR RD SEQUIM, 98382 OWNER: GORDON L ANDERSON PHONE: 651-628-0597 DIANNE K ANDERSON 2445 ARONA ST ROSEVILLE MN 55113-3112 SUBDIVISION: WM H THOMAS SHORT PLAT Block: Lot: 2 PARCEL NUMBER: 002341012 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP BATHROOM FINISH - EXISTING PERMITTED SPACE, NOT GOING OUTSIDE FOOTPRINT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 864 VALUATION 4,000.00 ADD'L: 61 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: 2 Exist: 1 Wetland Erosion Prop: Prop: 1 Seismic Streams Total: 2 Total: 2 Flood Way Floodplain Routing Date: `-'C O2 O5 F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: A rp Permit $97.25 BAC 01/31/05 71319 012:51-ricykap Plan Check $63.21 BAC 01/31/05 71319 V ���!°0° State Building Code $4.50 BAC 01/31/05 71319 FEB = 0 Total: $164.96 Jefferson County Planning Building Depart,E ent 4-- tom► 6vreiv.,4)4 1'4 GS, I/2e 1057 Gig z3 vv, t- L' 6A-6.21. Rd ?� Gam ., , 'API- i l 3$z 7-A r /0azc.c P 0 0 el 3 $ /0 / 2.- '. -7. 2- I -r-e. ebk¢Jrv-vyvi h.d all Ii_ r 7 -t t- fi�:'�e G ov d P L(>� ( Lux .5� i) i in AID asp' I '' v, �k ♦� . � � � 1 zS � `/J� (yam P� t, ,,_ _,..., - ret•-t-P-K/fii)fIL vi..v.. y si dAt' 3 ' 2r;'}, . ... I y Zo,o 3 ,ure la# 144f4 1,,. . 1 It = / 0 0 ' '��,�,� r 6 O)' / 1 4iI/,tc ,4,\ _ g 9` / t4. , :/ G '/ 3x e c--lac. F .j 0111:1 .''. R 7!s,L)A.,", 1 LEA,h ()lilt. . , I . , . ... . .,.._. .i. , . , . ......... _ ....... 2LI' I'; . tiv ,,,, ,0•1,..., NH, pen 1 1 f i 1 I { i i 1 1 2- - -.\ , 1 1+ 0 00/ �36' ,/ . -. eirp.,,....„ _ , , ..............._____ rI E i 'M:. ,, /01X .2 i r 1 tr, I (✓»i,v,t ' ` j S4MfrS /` a .,..,,,. � , ,,_44., „ �` ,,,„\,,,, Tf_-) [ , ..„,._,, , , s' re \ ,I, , . ____... ,......, , : 4.,,,, , ,. , , ____ „......_..... ,.---;-1,,,,,. , �, dNILAr`dvrs i O i i 1 i ; 1 � s s. v SAS_ I 1 - V /'its,• ®o b / 0 4. ',., (3 A 4 114 In W ar it 1 ) . . 1\111 1/ h , / / , I...__..... _ ........— . . ._ , . CX-)S71"7041 Lert" F./0 0 If . ---- ---------------- . . . .04--ol----D1 . ,... ., .. ---1--- ! ' 1 7 ! 1 1 II 1 ; 7 ii / i • I / •,,,/ I 1 1 1 1 ..1 . I J . 1).> I , /—--------''-...i ! Cl Pse-f — _.... 6k1 r....--_. / /,--1.....t. a ,i •, S .,1 A ___ ii, 1.? .. .,1 I e- ......._ • ,7 ,..„.. ... ..._._ t,... . I 1 _ * i , r 1 [ 9 ..\ ) -1 4 '\.. I % &„ A , , .• ...› . .7\ N. i 6*4-A rooeh 02 ,4 ,, el 00 if- ,Th 1 ---N. i 1 4e0,44/, i opkielei , „ Thi.1 ti.f If 01)$4111h?4) 1 I 161.0 1 ;kl fi A I'V/44 i hi in )f 11.4 3 CI...ph+4•,,1 r low-0\ tottit-c) 45 ,<Pvi. 07 4 ko-c,,iiiii*".A; y-4-1,4 r-op.., 004- rio i 1:1;.01',rifee*;1. w•.'"' 4 e/oe t (01% r Si 04 ' ' - • • 4ordie) .fr. A Yt 144 4 r c� rvi 6 • ,, N cALA - 'let- Pro f 05 jA rya©14.\ t \Pi e- I1 t 06 ,ke (2 . c2,1- µLI SOWvI„ T g;.11— o(l!' I 3407e 4 2..” 3'b N ! i, + i ot 3 k ' -2/1- " boor 01 ��(N`�,� I i‘k i(V TI E:Plans area f' PProved excepting a Y etrors or omissions. All work must( I TPass inspection in conformance whh ail applicable codes and regulations. i i I . T I { 3' ,� ,r t-J rrr f 1�2s#� CD 1 7✓i !et f �} �1`— tir (-( H_ 6 V) (e;/)..5 /1FC%Sfi „it-- i ' i /fiL4 /s '� I , r I , I ^' �,, -t. Vr J r • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00060 Received Date 01/31/2005 SITE ADDRESS: 464 BACHELOR RD Issue Date 02/16/2005 SEQUIM, 98382 APPLICANT: GORDON L ANDERSON PHONE: 651-628-0597 DIANNE K ANDERSON 2445 ARONA ST ROSEVILLE MN 55113-3112 SUBDIVISION: WM H THOMAS SHORT PLP.T Block: Lot: 2 PARCEL NUMBER: 002341012 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: BATHROOM FINISH - EXISTING PERMITTED SPACE, NOT GOING OUTSIDE FOOTPRINT CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Framing: X Plumbing: 0K 3/z/06 Propane Tank/ Lines: Insulation: Sheetrock: _ Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: _ Zoning Final Approval: X Final/Occupancy Approval: 9., &-)I-06- 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 I:\F_BLD_Permit_Buildng.rpt 10/29/1999 • 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 respsnsibili f the General Contractor for the proposed project. Signature: 14"tkr• Date: '//4"/L7'S— i GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Ll New X1 Wood Existing: II ❑ Sewer ❑ Addition ❑ Steel Proposed: / Bank ❑ Community System 7, Alteration/Remodel ❑ Concrete Total: )-- Height: AIndividual System 1_1 Repair ID Masonry ii(4 Bedrooms: SEP Permit# '9�._L�080 Demolition ❑ Other: Water Supply: Existing: Z Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: D Public K/v.e h;c Total: 'L tV (4- 'Name of System: i' J) il 1 el .Tet`fe-csi„ C, If this is a CommerearProiect 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: Li Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot WWtgr 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 submka site plan showing all of the buildings,all property lines, nk 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 4 V l u Consistency Review: ci"') 2ND Floor ',4 Base fee: Q\ r 3`0 Floor • [� 'Additional Section: VW K,l • _0.1v' _ Mezzanine: Plan Check fee: (r)3 c3-1 Heated Basement State Surcharge fee: Unheated Basement 150 Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport -42 _& TOTAL: $ 11(041 9 j Decks -62 er Receipt Number: Other 761 Cash/Check Number: ` a ESTIMATE P COST(REQUIRED) Date: rt / t3 45 •Fair mark, value of all labor and materials .undation to finish ` ` // G'C`e' _ Initials: � G:\PermitC -r\FORMS\D' D 4 S\ .er Permit Application 7-8-04.doc .¢gON c, I zcv 6, JEFFERSON.UNTY eDEPARTMENT OF COMMUNITY DEVELOPMENT �' 4410vZ '4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 4,.. ° www.co.jefferson.wa.us/commdevelopment IiING Master Permit Application MLA: ND a LW?-121161 Project Description(include separate sheets as necessary): .4dr/ !a. S<CI..4 6AfATip+'^(7r'/cf, S)/tk,Shssce_) Tax Parcel d / `�/ L Property 7 .1 �c rc S Number: Size: (acres/square feet) Site Address and/or Directions to Property: # lv q i3ie h ki'r £ea.-mil , 664-41;,i , v 4 ' i 3 e Z...- Property Owner(s)of Record. 6 9 rely*. e.t v<di () /a_n n e. K .. 4 ride-4.Sn Telephone: 4-5/412 3 t-'S'/'1 G/2 1$1JJ5 71/ Fax: 4"S/ i 3/ I)7 7 email: dec ti cli L,'1ryt '! ,/,Zri'r Mailing Address: ). ii-41 /-4 roils- St 4Cse t. /le, m/t/ . -S-// 3 Applicant/Agent(if different from owner): /- - Telephone: /— Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) XBuilding - 1'c en i"de/- ILA; r d (,d'11 4 e-•n ❑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 ❑Garage Attached/Detached ❑ Special Use(Essential Public Facilities)*" ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑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: / .,:vi DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: �/ J 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 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.Access d right of entry to this property shall be requested and shall occur only during regular business hours. /C S_ Signature: �-t i '� ilicnl V�- Date: ///J�/ 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, a Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer responsibility for adt /inJg t�,a'n-d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: '�"tLL'N, -`�/sv'--..- Date: ///l'/e. G:\PermitCente ORMS\DRD FORMS\Master Permit Application 7-8-04.doc