HomeMy WebLinkAboutBLD2005-00120 IIUILDING PERMIT APPLICA!ON :
Review Type.
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00120 Received Date: 3/1/2005
SITE ADDRESS: 2860 E MARROWSTONE RD
NORDLAND, 98358
OWNER: JOHN LYNES PHONE: 360-379-0994
LISA LYNES
905 WILSON ST
PORT TOWNSEND WA 98368-2926
SUBDIVISION: Block: Lot: T 25+
PARCEL NUMBER: 021332015 Section: 33 Township: 30 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI ADD WINDOWS TO EXISTING SFR - STAYING W/I FOOTPRINT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD
VALUATION 2,000.00 MAIN:
CODE EDITION: 2003 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER:
GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PWELL
PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 1 Exist: 1 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 1 Total: 1 Flood Way Floodplain
Routing Date: d F&W Landslide
ll� 5 Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $69.25 BAC 03/01/05 71494 APPROVED
Plan Check $45.01 BAC 03/01/05 71494 �19 r
State Building Code $4.50 BAC 03/01/05 71494 MAR - 9 2005
Total: $118.76
Jefferson County Planning
& Building Department
it -410-11 ob.
•
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
•
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00120 Received Date 03/1/2005
SITE ADDRESS: 2860 E MARROWSTONE RD Issue Date 03/9/2005
NORDLAND, 98358
APPLICANT: JOHN LYNES PHONE: 360-379-0994
LISA LYNES
905 WILSON ST
PORT TOWNSEND WA 98368-2926
SUBDIVISION: Block: Lot: T 25+
PARCEL NUMBER: 021332015 Section: 33 Township: 30 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: ADD WINDOWS TO EXISTING SFR-STAYING W/I FOOTPRINT
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
UFFER:
Footing:
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
�c Shear Wall : aje4/7/OW
Sheathing:
X Framing: QX 40./O5
Plumbing:
Propane Tank/ Lines
:
9. )( Insulation: 01( 4tf/7 DS
OX Sheetrock: QK �f�
Septic Sytem Final ppr val not on sewer):
Road Approach Final Approval: •
Zoning Final Approval:
ccpc Final/Occupancy Approval: 2,k ,,frcloiZ'K Por ch 4 ¢//fff DSi
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
s.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
• 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:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS 'JAR —
•
NUMBER: 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 ❑ Community System
pcAlteration/Remodel 0 Concrete Total: / Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: N 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:
❑ Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert I] 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 For Office Use Only
Current Proposed Amount
Main Floor Consistency Review:
2""Floor Base fee: Cog. (5
3`0 Floor Additional Section: �'!
,
Mezzanine: Plan Check fee:
Heated Basement State Surcharge fee:
Unheated Basement Pot Water Review fee:
Other Unheated 911/Rd Approach fee:
Garage/Carport y !e, '7
TOTAL: $ b
Decks Receipt Number: 7/41 G74
Other Cash/Check Number: 1
ESTIMATED COST(REQUIRED) Date: /�/�
•Fair market value of all labor and materials foundation to finish `
G,C: Initials:
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-f3-04.doc
ze¢,Soiv o„, JEFFERSON•UNTY S
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
k' Off' www.co.jefferson.wa.us/commdevelopment
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Master Permit Application MLA: No MLit-tcd,
om/
Project Description(include separate sheets as necessary): v/
b3 (.✓/N DO(A)5 X (S T/A-) )} €/u c
Tax Parcel _ Property nn
Number: Z / 3 3 (2....c1 S Size: , & /7' (acres/square feet)
Site Address and/or Directions to Property: .,253LvO L i L1 i i.kO w,S T o''J R.b A4)Kb 04 ti
Property Owner(s)of Record: ;)(-)f f N L.!.$/I L. YAJ C S
Telephone: '3 7 9- O?94' Fax: email: JLy • i\J ve-N i S`'LL</''�
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Mailing Address: 9c`5 C.ti1 i L_SC'N / c R-T- TcwNS/z/U t)
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
[1,Building ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
j Single Family 0 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**
0 Change of Use ❑ Long Plat*'
❑Address [I Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* U 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 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 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 anyrequired later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. / /
Signature: s..�.� /a Date: 1 /1 v
/
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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: � .- „ „ �'i,% Date: '///
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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FLOOR PLAN
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ANCHOR LOCATION
ALL GLASS AND GLAZING SHALL
co.VxPLY WITH CHAPTER 24j9
AS AMENDED BY3�
WASHINGTON STATE
BUILDING CODE COUNCIL
CONCRETE 5LAL
EX15TINt5 2xC'
5ILL PLATE
5lB'm x 10' THREADED
91- . HIGH5TREN
EPDXY, 5EE ANCHOR Lc
DETAIL TH15 5HEET IN5T
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EXI5TIN6 GRCUT F
PERMIT # BID
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JEFFERSON COUNTY BCD
FIL
JEFFERSON COUNTY DCD
BUILDING PLAN REVIEW
3- APPROVED AS SUBMITTED
❑ APPROVED AS NOTED
❑ REJECTED
Date-3- 0 Reviewer MA4_
a O errors Plans
or om ssiapproved
n& Alll work mug,
Pass Inspection all In conformance with
applicable codes and regulations.
MOO■■s�I
s
7
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Contact the Building Department
at 37.1-4450 Prior to making changes
Or revisions 10 the approved Plans
J�
10 p� 23347 Q 4�
EXPIRE:, JAN 15. 2007
1
MAR - 1 2005
L YNE5 RE5/0EN6E
5HEAR WALL DESIGN TO ACCOMMODATE NEW WINDOWS
2860 MARROW5 TONE ROAD
NOROLAND, WA
OIJAORA ENGINEERING SCALE: AS NOTED
JOB: 05-13 DRAWN BY.R5T
MARCH 2O05 5HEET l OF I