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HomeMy WebLinkAboutBLD2005-00403 #1ILDING PERMIT APPLICATIJ MLA05-00375 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00403 Received Date: 6/15/2005 SITE ADDRESS: 20 TALA SHORE DR PORT LUDLOW, 98365 OWNER: THANH NGUYEN PHONE: 206 313-5631 265 243RD AVE SE SAMAMISH WA 98074 TALA SHORES #1. SUBDIVISION: Block: Lot: 20 PARCEL NUMBER: 998200118 Section: 22 Township: 28 N Range: 01 E CONTRACTOR: BROCKMAN BUILDERS PHONE: (360)638-1125 33145 EGLON RD NE KINGSTON WA 98346 Contractor's License BROCKB*051 B6 Expires 4/15/2001 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO1` REPAIR OF EXISTING ACCESS STAIRS TO BEACH - NOT OUTSIDE OF EXISTING FOOTPRINT TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP DEK MAIN: VALUATION 8,500.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: `4 /L / of Type Amount Paid By: Date: Receipt: Approved/Date State Building Code $4.50 RAC 06/15/05 73381 APPROVED Plan Check $108.71 RAC 06/15/05 73381 Permit . $167.25 RAC 06/15/05 73381 JUL 2 5 2005 Total: $280.46 eff County Planning & u apartment I' • 0 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00403 Received Date 06/15/2005 SITE ADDRESS: 20 TALA SHORE DR Issue Date 07/25/2005 PORT LUDLOW, 98365 APPLICANT: THANH NGUYEN PHONE: 206 313-5631 265 243RD AVE SE SAMAMISH WA 98074 SUBDIVISION: TALA SHORES#1 Block: Lot: 20 PARCEL NUMBER: 998200118 Section: 22 Township: 28 N Range: 01 E CONTRACTOR: BROCKMAN BUILDERS PHONE: (360)638-1125 33145 HOFFMAN RD NE KINGSTON WA 98346 Contractor's License: BROCKB*051 B6 Expires: 9/15/2006 PROJECT DESCRIPTION: REPAIR OF EXISTING ACCESS STAIRS TO BEACH - NOT OUTSIDE OF EXISTING FOOTPRINT CALL IN FOR THE REQUIRED INSPECTJONSTHAT APPLY TO YOUR PROJECT. SETBACKS: x,j , 2//_3 ":5 UFFER: Footing: 61 .. ,7 41:,/'d" Foundation', e, 1�//,-/& Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: il Shear Wall : if Sheathing: "/.." Framing: 'k t_y/37�'L, Plumbing: /t;��J Propane Tank/�Lines:, t Insulation: / QS Sheetrock: l// Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: C�� - ���a1 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 SPECIAL CONDITIONS APPLY - SEE REVERSE SPECIAL CONDITIONS FOR CASE A BLD05-00403 1.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC) Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 2.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 3.) 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. 4.) A Small 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. 5.) Prior to commencing development activity, proponent is responsible for informing the Washington Department of Fish and Wildlife (WDFW) in order for WDFW to determine whether this action is subject to the Washington State Hydraulic Code (Chapter 220-10 WAC). Hydraulic Project Approval (HPA) is required for all hydraulic projects, which are defined as construction or performance of other work that will use, divert, obstruct, or change the natural flow or bed of any of the salt or fresh waters of the state. 6.) The building height is not to exceed 35 feet. 7.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 8.) The setback for the replacement stairs are the same as the layout of the existing stairs. I:\F_BLD_Permit_Buildng.rpt 10/29/19 1 • y,�� JUN 1 5 2005 N -}-' �{f".�(�j y ! , �� - I IV \ S.. ft\ 1 -' ` emu '-' W Z "' 1" `c' - - j w � � CD : I Li_ _ U ,� O . N o G. 1` `• �I CIS w°W. Q q 0 i CA 0a O 120! i ° 64 o oN z � --rn UmV �rhoH a___— A � F- . z D 11�: o o c �i 111':I O z },� =i�i i! w o % _ 1 I 3 _, �, s111 I I 1 a u ° �1 111IiIt a ! Al.et OG ^ o � III'.�. k-p cn (7: v) ki - iiiv6 , ...". __.1 0 0 /1 : I tiC1\ ii b r l . . \ (13 a.) _,_,. , , v. . , , / .,. .!,,,s„ J.,. . , 0 , .:. 1'' i / i '---- ,'., t •\l, Cn eV I 1 `O �_, \ \0jr - i/ •C Q I 1 leis "'`�-�� i © 3 - ( 3 ! 6 t aI 41 vl � l�l 6 a �� J rviiiii6._, , N SO JEFFERSON C TY 0 DEPARTMENT OF�MMUNITY DEVELOPMENT • 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �q O� www.co.jefferson.wa.us/commdevelopment '/U N 1 R 2005 SgING�S Master Permit Application MLA: 'a_ --(--375 Project Description(include separate sheets as necessary): P -A0-1 A C C'�-� -5 S 177-(f2,5 Tax Parcel Property Number: �/� � � - 1 f' �-C.9� /( Size: c g 3 (411 (acres/square feet) Site Address and/or Directions to Property: �f) TA I f27f� Rd). Property Owner(s)of Record: 7-AecJ 4-1' J •L4 y Telephone: (ZGO 3/ 3.-S6 3 Fax: email: eite r'0,zsat✓ {yr Mailing Address: ,, 23 /.�,/P 5E-- ,r.1tf.lt;�j<,MS'"� 'i 7s- Co,i4 ,t,st; :2t�7- I Applicant/Agent(if a5--fferent from owner): Telephone:01 �-)2 F=y— /( ) Fax: email: CCf[tr1% 'o eAl-Arw"e i Mailing Address: WFjat kind of Permit?(Check each box that applies) Building ❑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 [7 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: \ 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 required later inspections.Access and ri entry to this property shall be requested and shall occur only during regular business hours. ' Signature: Date: / _ i 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 wi Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfera resp for adhe to and complying with the ESA. The Applicant has read this disclai er and si ns and dates it below. / Signature: Date: 04 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc iOWNER BUILDER STATEMENT . The signer of this statement does hereby cerli ey are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming th1 respo i '' I Contractor for the proposed project. / / Signature: ;°a Date: 0 '/ G1 Ste_ 1 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Pam;— Bi' }C.kk mAnr _ ( , ) 2.7( - 9. 0r r 5 )2005 MAILING ADDRESS: t)ke0r�yV/ IZ:) EMAIL: CONTRACTOR'S LICENSE t (�f s - WAINS NUMBER: NUMBER - i 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: Height: ❑ Individu2' ❑ Repair ❑ Masonry SEP Permi_..`1 I.—�(-1 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: [I Private well ❑ Two Party Type of Heat: Proposed: ❑ 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: ❑ Underground Tank ❑ Above ground Tank Size of Propane Tank: ❑ Heat Stove Li Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ 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: 2NU Floor Base fee: kg rl 3fd Floor Additional Section: J Mezzanine: Plan Check fee: 6 08 8 / 1 1 Heated Basement State Surcharge fee: „ so L Unheated Basement Pot Water Review'fee: - Other Unheated 911/Rd Approach fee: Garage/Carport $ 3 a I..1t Decks Receipt,Number: ~f_ 30 I. Other _ Cash/Check Number: /k 1 3 I ESTIMATED COST(REQUIRED) Date: �`4 '' / "' air nlarket value of all labor and material oundation to finish l 7 � Xi g1L0 0. OY� Initials: 1 _ \PemritCenter\FORMS\DRD FO't,» Master Permit Application 7-8-04.doc S ____ JUN 1 5 2005 _i__, f'%)!(n ,...../..--,v_.-4,„, i -,-1‘.41------). \ g..'if w . - I L__ c r — ---- j L' t- - W N OA Q N FOa z; N O REVISED'3T ' dated ►1 r,ios, 44 F' = p. p.0 Has been APPROVED I t ii // -" ' �t — ..... a+ ~o by JEFFERSON COUNTY "tt DEPT.OF r t , D . - 1 wz SIGNATURE: / kieg..JVi _/_/ _ A to n - ., I P' N O � .gyp r• !i al 0 ... E� �S'yp[ % Q 0L^ R F� _ i . A a- Lc, z IiI JE f� 1 , r b y nr- D �/ Q N 1p i i W --t ui 5I 1I1 a , iIi ! i i a w� � �, ra u. =�l i I i APPROV [. i , i ' - 1r_-. 2 5.2€10: 1 , ter :� 2 ,.. ... .c Jefferson County Hann ail ; ,= '� &Building Gepartmert f j ` o ti�' �. 2 4 . ,_ ,.... I 1 ,\0_,, (, =, Nic, ---,_ � tea c, ,..) - , , ,,.. , , c 31 ` RECEIVED `—...._ 41 rs ki 1 a I �EffER�O C8II Y DCD E( �t�1T #>� Bl ` aILI i 1.11SYiii i/vv.■II i .:w'