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HomeMy WebLinkAboutBLD2005-00318 • • BUILDING PERMIT APPLICATION MRLA05 0eview 0pe304 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00318 Received Date: 5/13/2005 SITE ADDRESS: 902 WOODLAND DR PORT TOWNSEND, 98368 OWNER: MICHAEL J MC ARDLE PHONE: 602-576-2215 KATHLEN J MC ARDLE 18611 N 22ND ST. # 58 PHOENIX AZ 85024 WALTHEW'S ACRE TRACTS SUBDIVISION: Block: Lot: 11 PARCEL NUMBER: 930400019 Section: 27 Township: 30 • N Range: 01 W CONTRACTOR: SUNRISE CUSTOM CABINETS PHONE: 360-427-2448 CHUCK RUTHERFORD 70 E HEATHERWOOD CT SHELTON WA 98584 Contractor's License SUNRICCO61J5 Expires 4/21/2007 REPRESENTATIVE: CHUCK RUTHERFORD PHONE: 360-427-2448 70 E HEATHERWOOD CT • SHELTON WA 98584 • PROJECT DESCRIPTIOr NEW DETACHED GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 10,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: GARAGE: 720 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: WITO QCZ4) 44.7()/ — P Type Amount Paid By: Date: Receipt: Approved/Date Permit • $279.25 BAC 05/13/05 73128/73127 Plan Check $0.00 BAC 05/17/05 State Building Code $4.50 BAC 05/13/05 73128/73127 Plan Check $181.52 BAC 05/13/05 73128/73127 Total: $465.27 It 9 ° ' r4 :,1 I�AY 2 0 2005 .) t, , a\_.______ ; .��;"1,C .v May 20. 2004 Mr. Peter Bunyon Department of Community Development 621 Sheridan Street Port'Townsend, WA. 98368 RE: Permit#B1_,D05-317 Tax Parcel #93-0400019 Property: 902 Woodland Drive, fort Townsend, WA. 98368 Dear Mr. Bunyon: Per our telephone conversation we wish to cancel the above-referenced permit due to the fact that a sudden family emergency has arisen that requires our immediate attention here in Arizona. It is necessary for us to cancel all plans for this project at this time. Since it is our understanding that our contractor. Chuck Rutherford, has not yet submitted the`'Storm Water Management" information required to start any work on this permit we would greatly appreciate it i f you could refund our permit application fee at your earliest possible convenience. (Our check#482 in the amount of$3,539.06 just cleared our Bank of America account yesterday.) Thank you so much for your prompt phone call; please call one of us back as soon as you talk to your supervisor with regard to the amount of this refund. Very truly yours, It I�,"c 2• ��� f �L , f Kathleen J. McArdle,owner of record X' • / • /0-•It 7(:- . ' Michael J. McArdle,owner of record a 'd 17BIOILG209 atp-le ow taeyotw d92 : I0 SO 02 ReW _902 WOODLAND DR BLD05-317 =3 d Q MC ARDLE -E.E. MASzc1. vcu o P. 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: --- ----- - ( 0 ( ) MAILING ADDRESS: EMAIL:, CONTRACTOR'S }�AY LICENSE III 1 3 2005 WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL — Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: l 0 Sewer ❑ Addition ❑ Steel Proposed: / Bank IICommunity System ❑ Alteration/Remodel ❑ Concrete Total: / Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: / Setback: [] Private well I I Two Party Type of Heat: Proposed: I I Public Total: Name of System: If this is a Commercial Project 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: I i Underground Tank ❑ Above ground Tank Size of Propane Tank: I I Heat Stove CI Cook Stove I I Woodstove I I Fireplace Insert I I Hot Water Tank [I Pellet Stove CI 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: 219 •z 3`d Floor Additional Section: _1 Mezzanine: Plan Check fee: ( Il . S2. Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: f,� - n Other Unheated 911/Rd Approach fee: .�� GO". L� Garage/Carport 120 l0 7O• TOTAL: $ 4105 .2"j Dot-z�.ecEr� Decks Receipt Number: 131 2 $ ' 13121• Other Cash/Check Number: (d-t12-54 c z. ESTIMATED COST(REQUIRED) Date: �3 ID •Fair market value of all labor and materials foundation to finish Or Initials: fik5 G: PermitCenter FORMS DRD F\ \ \ FORMS Permit Application 7-8-04.doc L SON C • • ,tw o\ JEFFERSON COUNTY W f \� DEPARTMENT OF COMMUNITY DEVELOPMENT '.' `i ` �' 621 Sheridan Street • Port Townsend •Washington 98368 /� 360/379-4450 • 360/379-4451 Fax v �' p� www.co.jefferson.wa.us/commdevelopment ' INC Master Permi ' pplication MLA: 05 —2 �1 0 ` -- Project Description(in de separate sheets as necessary): ©� Tax Parcel Property Number: Size: (acres/square feet) Site Address and/or Directions t, Property: Property Owner(s)of Record: Telephone: Fax: email: Mailing Address: Applicant/Agent(if different from own.r): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that ap. 'es) • Building El Variance i inor,Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditi. al Use[C(a),C(d),or C]** ❑ Single Family 0 Discr; lonary"D"or Unnamed Use Classification 0 Garage Attached/Detached ❑ Sp: ial Use(Essential Public Facilities)** ❑ Manufactured Home ❑ :.undary Line Adjustment ❑ Modular ■ hort Plat** El Commercial* ■ Binding Site Plan*" ❑ Change of Use ❑ Long Plat** ❑Address l 1 Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** • Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis m Shoreline Master Program Exemption/Permit Revisions** ❑ Stomiwater Management horeline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD) ❑ 'oreline Management Variance ❑Temporary Use El Co q prehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jeffe •on County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Mor. .rium *May require a Pre-Application Confere e **R••uires a Pre-Application Conference Please identify any other local, state .r federal permits required for is proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in ma'ers relating to this application for permit(s). OWNER SIGNATURE late: By signing this application form, e owner/agent attests that the information provided herein,and in any - tachments,is true and correct to the best of his,her or it's knowledge. Any aterial falsehood or any omission of a material fact made by the owner/ag: t with respect to this application packet may result in this permit bein,, null and void. I further agree to save,in. mnify and hold harmless Jefferson County against all liabilities,judgments,court co ,reasonable attorney's fees and expenses which may in y way accrue against Jefferson County as a result of or in consequence of the granting if this permit. I further agree to prove access and right of entry to Jefferson County and its employees,representatives or agen or the sole purpose of application review and any req red later inspections.Access and right of entry to this property shall be requested and shall occu •nly during regular business hours. Signature: Date: The actio or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endang: ed species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Enda'•ered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this per 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 ac••n(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:\PcrmitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc