HomeMy WebLinkAboutBLD2005-00219 BUILDIN •G •PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00219 Received Date 04/11/2005
SITE ADDRESS: 690 RHODODENDRON LN Issue Date 04/22/2005
BRINNON, 98320
APPLICANT: MIKE RASTELLI PHONE: 206-244-7783
JODEE L RASTELLI
15640 18TH AVE SW
BURIEN WA 98166-2702
SUBDIVISION: PLEASANT TIDES Block: Lot: 28
PARCEL NUMBER: 988500028 Section: 14 Township: 25 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: EXISTING DECK REPAIR
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
UFFER:
Footing:
Foundation:
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:
OPP cupancy Approval: t`l(e(24,‘
EALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FIN
AL 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
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SPECIAL CONDITIONS FOR C SEA BLD05-00219
1.) 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.
2.) A Stormwater Plan has been submitted and approved by the Department of Community
Development. Once the subject permit has been issued the applicant shall fully
implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site•until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
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I:\F_B LD_Pe rm it_B u ild ng.rpt
10/29/1999
IIIPUILDING PERMIT APPLICA MLA05-00215
N Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00219 Received Date: 4/11/2005
SITE ADDRESS: 690 RHODODENDRON LN
BRINNON, 98320
OWNER: MIKE RASTELLI PHONE: 206-244-7783
JODEE L RASTELLI
15640 18TH AVE SW
BURIEN WA 98166-2702
SUBDIVISION: PLEASANT TIDES Block: Lot: 28
PARCEL NUMBER: 988500028 Section: 14 Township: 25 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP EXISTING DECK REPAIR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEK
VALUATION 1,500.00 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: 223
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date: ij I 5 / c irp
Type Amount Paid By: Date: Receipt:
eErPermit $54.00 BAC 04/11/05 72903 A� V .
Plan Check $35.10 BAC 04/11/05 72903
State Building Code $4.50 BAC 04/11/05 72903 APR 2 2 2005
Total: $93.60 Jefferson County Planning
CeBuilding Department
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• •OWNER BUILDER STATEMENT
The signer of this statement does h eby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assu th, espo ibili of a General Contractor for the proposed project. _
Signature: % �� . .
�43-' Date: `��/GS ,.` ' 0,-:, c;
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: i t
( ) '1 1 i APR ri: ,�..'_•
MAILING ADDRESS:
EMAIL: s
CONTRACTOR'S LICENSE WAINS ,�.;F c (pi'�'T`t
NUMBER: k r,q��t l y , .._�
NUMBER op pi.Ci CC ,.
ARCHITECT/ENGINEER: — PHONE ( FAX:( )
MAILING ADDRESS: EMAIL
—
Project Type: F me Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New !&Wood Existing: 0 Sewer
❑ Addition 0 Steel Proposed: Bank ❑ Community System
0 Alteration/Remodel 0 Concrete Total: - Height: ❑ Individual System
X Repair 0 Masonry SEP Permit# oz,—l3'7
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: _ Setback: ❑ Private well 0 Two Party
Type of Heat: Proposed: 0 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 0 Woodstove ❑ 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.
-
t ?Tt.,_ , , £1 •ma
'' a
' 'Square Footage .a � 1' ' ; +# sy��y r K r Current Proposed M1 ra i 144i-, 14 tr ' ♦��i , 6.r ,3.In. r a f -:aaMain Floor t` ;lA ci . ' b , v. ..wsn.i r o ' k► L * ', .I >, :1 s'a s.rSy-:. w4NI� Sr 04 ` y' :11 w v �t m : . rN R t ri s: a 4k2" Floor , tt a•
3f°Floor a s tj,_ YE.J 'D-ye k e . 1�f; y s 'i x,
Mezzanine: r rx.v,,ai # a"' a> �,�� r �' r
.., i *._ „9 `jAit ?t,r �4 Ski 4-itiEt ti
Heated Basement 6~r �� " _:° L r " r b �i>i�`
��` e $ S is'` .�iw r•�5 �� ti V.'�'`�r° �.' ` :4�'R`',x- Fa`k ��,r�
Unheated Basement°., ` .' ? pv . mot, �� k1 A
Other Unheated ''�'r.e` r i F L1 4 y�y, P a i a i y
kt i n t, ' L., o a "'d 1iS * m �' y s� ic'�y f
t r of f-t,., •'�'' ;+ , Sr1 a�, �+
r� YS 1 .P, rr k'- +1i� .F, S,i' 4.t + Ai'r "5.L 'zid 1
Garage/Carport .i'- 1 h.6 r, ;' ,c a .ri
r r rr ,, a ,, ! .G't .sz S`'y4 3 �` '� •c 43 e' •- 7'"n'', f$",t.- '��t`
Decks047
..*� ,�' �i ��.�,,�.;yy ,,�`'�� '�4.T4.3).,' � ,Orr ,;�� ��,���'� +
t- +. 4. '4' k 4 rfif '}V` t .y A 1, Kd(P{ `rtr.
Other .. -i t f -Gt� v;y. .41><r U § .'c, . 711 �1
fit"
ESTIMATED COST(REQUIRED) S - _ to yg.>
rt _,1 tt , 4 li+ 'IAl .kl ... ' ' 'p)11t-3:,..t . it §,
•Fair market value of all and matena s on to finish r`'F ', i .4`-n �� �� "� n ��", k i A ,Z ;*03,0
`'
'1"514Ullig".r..`?A.:11.,:i,r,;,::,, ,,,q4, , sol.tv ...,....,,•e:, 1.-:VA4.716,VV$4441t07-„1
err .t ar � a
G:\PemutCentcr\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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' $414.
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� JEFFERSOF cNT�' it,-;:°l,t 1 ti, 1
`� DEPARTMENT OF COMMUNITY DEVELOPMENT ..' - .
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax ig , I U
- 0 www.co.jefferson.wa.us/commdevelopment
`YS�1N�`S'
MLA: f'J -2�S
Master Permitgppricat,�c � L
Project Description(include separate sheets as necessary):
De-C.V..- RE*144 tZ 5eP/r 70- c- ct)f-e f
Tax Parcel �JG r— Property / i
Number: / D S5 600 2.6 Size: &0 X /co (acres/square feet)
Site Address and/or Directions to Property: ( 90 -o Po I e In 7 red'\ Lynn n e_ 6 r/n no:)
Property Owner(s)of Record: 2. D U 4- _
Telephone: 2(aG Lit4-t-72 Es Fax: email:
Mailing Address: /S E `/U /el) 5tti 5e 0 Tr/e Lt.A cg./ gib
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
gBuilding ❑Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or Cj**
❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification
❑Garage Attached/Detached ❑ Special Use(Essential Public Facilities)**
❑Manufactured Home ❑ Boundary Line Adjustment
❑Modular ❑ Short Plat**
El Commercial* ❑ Binding Site Plan**
❑Change of Use ❑ Long Plat**
El Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
0 Propane ❑ Plat Vacation/Alteration**
0 Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stomiwater Management ❑ Shoreline Management Substantial Development**
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 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 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 req re la spections.Access and right of entry to this property shall be requested and shall occur only during regular business
hours. -� �/
Signature: ^� Date: /A---kS'
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: Date:
G:\PertnitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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