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Home My WebLink AboutBLD2005-00357 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00357 Received Date 06/1/2005 SITE ADDRESS: 10402 RHODODENDRON DR Issue Date 06/10/2005 CHIMACUM, 98325 APPLICANT: EARL WOODLEY PHONE: 360-385-1585 CAROL FLETCHER 211 CHIMACUM PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: T71+ PARCEL NUMBER: 901101010 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: REPAIR STORAGE SHED - NO CHG IN FOOTPRINT, UNHTD, NO PLUMBING 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: Final/Occupancy Approval: ga-46 (_ql 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 10/29/19 ItUILDING PERMIT APPLICAIN BLD05-00357 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00357 Received Date: 6/1/2005 SITE ADDRESS: -, -. 1O42&RHODY DR CHIMACUM, 98325 OWNER: EARL WOODLEY PHONE: 360-385-1585 CAROL FLETCHER 211 CHIMACUM PORT HADLOCK WA 98339 SUBDIVISION: Block: Lot: T71+ PARCEL NUMBER: 901101010 Section: 10 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: Top 722 5TA74 'Lf o4/L- V 4 / 'o12tip. PROJECT DESCRIPTIOI REPAIR STORAGE SHED - NO CHG IN FOOTPRINT, UNHTD, NO PLUMBING TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: 440 VALUATION 600.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: u UNHEATED: # OF STORIES: CONST TYPE: .6--/V OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date:. 6 n1,6 t 4-Z Type • Amount Paid By: Date: Receipt: Approved/Date Permit $38.75 BAC 06/01/05 73305 APPROVED Plan Check $25.19 BAC 06/01/05 73305 State Building Code $4.50 BAC 06/01/05 73305 JUN 10 2005 Total: $68.44 efferson County Planning uil 9 epartment .c;,,��¢gorr c°rNkc. JEFFER. COUNTY , ' DEPARTMENT OF COMMUNITY DEVELbI3MENT `' ` ' 621 Sheridan Street • Port Townsend •riashin ton 98368 k i., . . 360/379-4450 • 360/379-4451 Fax gSNGp jaiwww.co.jefferson.wa.us/commdevelopment i I 2005 isL- ) Master Permit Application (__ MLA: NO Cr1a)'1( (- Project Description(include separate_sheets as necessary): ,. )Y\ ('. yyr\ r( Tax'Parcel �/) Property Number: ?di /v / 2)/zi., ize: , / acres/-quare feet) Site Address and/or Directions to Pwerty: �'Q��I -PLZ17'' / 441t, , Gc I4 9 / Property Owner(s)of Record: L ! ., :-.F Telephone: i i( g'�— its--_ S Fax: 360 - 7� �C7 S email: pG 'GGyp,(/:(ch Mailing Address: 2./ / (.ii ' V}) t4(' t n.i t( - 4 ,.._K ( k),, ?V5,ci Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) trj,Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family Me� ❑ Discretionary"D"or Unnamed Use Classification Qtbrege+ Attached o Detache 5 FLU( ❑ Special Use(Essential Public Facilities)** ti Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* CI Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address I i Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis [.1 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 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 any re aired later inspections Access and right of en to this property shall be requested and shall occur only during regular business hours. �� Signature: Date: �� 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)ev if you are in co liance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non- n ta�>ble gees o ' 'lityfio ad ring ��,aa�°mplying with the ESA. The Applicant has read this disclaimer an signs and dates it below. Signatur : 16—e ��'t� ✓t-'F-,.. Dater 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 responsibi• o the General� Contractor for the proposed project. Signature: G �%�� -tom — Date: —� U 5 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: MAILING ADDRESS: EMAIL>— CONTRACTOR'S LICENSE j "WAINS 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 ❑ Alteration/Remodel ❑ Concrete Total: ` Hei9ht: ❑ Individual System t 2(Repair ❑ Masonry SEP Permit# �' n Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well L i Two Party Type of Heat: Proposed: ❑ Public Total: Lt) r" j ,,�- ti �� Name of System: 1 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: ❑ Underground Tank i i Above ground Tank Size of Propane Tank: ❑ Heat Stove I I Cook Stove I I Woodstove I Fireplace Insert I 1 Hot Water Tank I I Pellet Stove I i 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"u Floor Base fee: c 3rd Floor k' ` Additional Section: Mezzanine: Plan Check fee: . . i 9 Heated Basement State Surcharge fee: c Unheated Basement 4174 Pot Water Review fee: Other Unheated 911/Rd Approach fee: k) ( A l 1')0t} (r\6 Garage/Carport 1 A. TOTAL: $ � 1`if 4 Decks j/.1 Receipt Number: Other N Cash/Check Number: I, G" ri ESTIMATED COST(REQUIRED) )� / Date: /U , , •Fair market value of all labor and materials foundation to finish (t 1 J I d i'i -, _. ,-fri ; Initials: (1 .:,____(__9-- ' ' IC-'7 G:\PermitCenter -\FORMS\D R13FC3RMS\Master Permit Application 7 8 04.doc t mo Ci) 3—(44 Oice ir ( 0 A C , --- z pcn 5 ge y /--------e/u c. cl 1 --. 1 › (- r ,------ - .--- 0 j \ \ ,-\ e•- `,7,- 2 0 / i ---- 1. . --- '2_ (--) g q• !, c .7 Fl c7.4:1 — 03 \ A r J 'NI Aj-----. • k ---Th ------. , (-(& T. c , c:\ CD .) 1,i 17 A , r\,. # • r411 . " 1 17 -n AI -o j- -, m ...... > - --)\------ P----- 0 r'n i i * , g ..... • 4r- Q a ci . I I. cL( r Uir rN, °^fir. iN'?':ti'Aa'!va pro 74 h~M4,=:;..,c.,+u*, ir:..' '} ""latt - 0429 ODY DR BLD05-357 — WOODLEY/FLETCHER Approvals Req'd Prior to Final Inspection SEP RAP ZON SIPZ DPW -t 51a lorj CanealibCC 42 du2k-0-5L- bte_ (//