HomeMy WebLinkAboutBLD2005-00442 BUDING PERMIT APPLICATION MRLA05 0eview 0pe415
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00442 Received Date: 7/1/2005
SITE ADDRESS: BARQUE LN
PORT LUDLOW, 98365
OWNER: SCOTT HOULSLEY PHONE: 206-786-5714
P.O. BOX 1801
EUGENE OR 97440
PORT LUDLOW NO. 3
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 990700035 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: WEST SOUND DEV OF BAIN. ISLAND PHONE: (206) 786-5714
321 HIGHSCHOOL RD NE#265
BIANBRIDGE ISLAND WA 98110
Contractor's License WESTSSD966R2 Expires 12/22/2006
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION SFR W/ ATTACHED GARAGE 120 GALLON A/G PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,654
VALUATION 200,000.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: PRO
OCCUPANCY: R-3
OCCUPANCY: UNHEATED: #OF STORIES: 1
THER: 352
CONST TYPE: 5N OARAGE: 484 SHORELINE:
CONST TYPE: DECK: 172 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: CITY
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: Total:
Routing Date: 776,7, cio56)6
Type Amount Paid Bv: Date: Receipt: p AfU P R O rid ste _
Potable Water Application $53.00 SLE 07/01/05 73427 VED
State Building Code $4.50 SLE 07/01/05 73427
Plan Check $1,009.94 SLE 07/01/05 73427 AUG 3 fl 2005
Permit $1,553.75 SLE 07/01/05 73427 Jefferson County Planning
Total: $2,621.19 & Building Department
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BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00442 Received Date 07/1/2005
SITE ADDRESS: 22 BARQUE LN Issue Date 08/29/2005
PORT LUDLOW, 98365
APPLICANT: SCOTT HOULSLEY PHONE: 206-786-5714
P.O. BOX 1801
EUGENE OR 97440
SUBDIVISION: PORT LUDLOW NO. 3 Block: Lot: 35
PARCEL NUMBER: 990700035 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: WEST SOUND DEV OF BAIN. ISLAND PHONE: (206) 786-5714
321 HIGHSCHOOL RD NE#265
BIANBRIDGE ISLAND WA 98110
Contractor's License: WESTSSD966R2 Expires: 12/22/2006
PROJECT DESCRIPTION: SFR W/ATTACHED GARAGE 120 GALLON A/G PROPANE TANK
CALL IN FOR THE REQUIRE DNSPE;,TIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: 0K 4 7///OSe�4//
UFFER: /Vo
Footing: bK 9/7/05 f/
Foundation: OK&/GG4 /7/6,2562u3TAtia_ {1at.Doomnas Pea. PLAm)
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : OK ///17 45,
Sheathing: a< ////2/
Framing: GXC iz//Zq oS
Plumbing: d/< Gtiii a/arl (',j 1 AlGair Rtisayai�P £O knt i u 5/A1K /1bAL
Propane Tank/ Lines: �iu`'f PRDPp,u� 6i ti/4.5 y
Insulation: ex / 29 OS 1. DK///__ 05
Sheetrock: seN //Q 0`,Septic Sytem Fina A pro I (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: o .-('er C// 7[r
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVALREQUIRED 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 CAM BLD05-00442 •
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 Site 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.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less
than one-half acre unless totally screened from view of neighboring dwellings and
rights-of-way. Such screening shall meet all applicable performance and development
standards specific to the district in which the storage is kept, and shall be in keeping with
the character of the area. Screening shall meet the requirements of Unified Development
Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable
vehicles is prohibited except in those districts where specified as an automobile wrecking
yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC,
and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any
such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area
(ESA).
5.) Maximum lot coverage is not to exceed 45%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
6.) The building height is not to exceed 35 feet.
7.) Exterior lighting for residential uses shall not exceed twenty feet (20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
8.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
9.) Minimum setback from Barque Lane right-of-way shall be 20 feet. Minimum side and rear
yard setbacks shall be 5 feet.
10.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
11.) Per MPR Code Section 3.107, Accessory Dwelling Units (ADU's) shall not be allowed
within the MPR-SF zone.
I:\F_BLD_Perm it_B uildng.rpt 10/29/19
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Nk� ' \� � j DEPARTMENT OF COMMUNITY DEVELOPMENT t }
'� 621 Sheridan Street• Port Townsend -Washington 98368 ' .1 1�
360/379-4450. 360/379-4451 Fax I
�q�, p� www.cojefferson.wa.us/commdevelopment t!i k, JUL — 1 2005 '
Master Permit Application MLA: ,. .{
Project Description(include separate sheets as necessary):
Tax Parcel Property
Number: clew -7 0 0 0 2 b— Size:
_ (acres/square feet)
Site Address and/or Directions to Property: 3 S 64., L,,,,-e__ P 4- CJIQ r,J. /A ' 8 36 S-
Property Owner(s)of Record: Sco"("}" Hoc.)S ley I
Telephone: 20 fo-7 2c C, - S--wy Fax: k-"C.- 8 SS---lam/.? email:
Mailing Address: �o /•(e...i,.. Cross 2.2./ <654s<4oe/ 12,,-P Aft? d 2L S- 1. ,,.,.6,-,;D5,t is/J h/.-, `'( g//a
Applicant/Agent(if different from owner): 1-Ce,i.. Cry sS
Telephone: S c,,,►,e. Fax: S .-•-r email:
Mailing Address: S .--.t_
What kind of Permit?(Check each box that applies)
X Building ❑Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit 0 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 [I Boundary Line Adjustment
0 Modular 0 Short Plat**
❑Commercial* 0 Binding Site Plan**
❑ Change of Use ❑ Long Plat**
(Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments*"
(Propane 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions*"
❑Stormwater Management 0 Shoreline Management Substantial Development**
0 Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
0 Wireless Telecommunication* El 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 -'- S a4-J 04....depr _..}/K,et,�,,to act as my agent in matters relating to this application for permit(s).
r C t-aSJ
OWNER SIGNATURE Date: 6-30 -OS
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 ampss 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 right of entry to this property shall be requested and shall occur only during regular business
hours. '��/� �/� /�In
Signature: Jam //! ,01 Date: -36-)-CJ
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 adher,i99 to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: J Gv.
Date: to '-7U—Cl S--
G:\PexmitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.cloc
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: `;;I Date:
:'.�,iti1 i jilt,
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GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: 8S/U 3
(A)cS t— S0��� »,..t Imo, rnA.�,T Lc.C_ �-7 (2o`) 7Q2�C�—S 7i`f (ZaG)Yler
MAILING ADDRESS: 3;-( H5 Li Sc,,.. / �� NG i 2 C� /s c1 w ;r: L 2 sI--d) Z✓�1 175//0
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: 14.k,t.K ID v,l„-e PHONE (' / )7'g�' qO FAx ( )
MAILING ADDRESS: 773G d ul yc-y S . 4.- ,per r4_ Tiwn W _, ci c;76.
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New Wood Existing: S.Sewer
0 Addition 0 Steel Proposed: z- Bank 0 Community System
❑ Alteration/Remodel ❑ Concrete Total: . a Height: 0 Individual System
❑ Repair 0 Masonry SEP Permit#
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well ❑ Two Party
Type of Heat: Proposed: 3 N"Public
l-lvc.�r,c l .,ri f.....p Total: 3 Name of System:
e
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 X Above ground Tank Size of Propane Tank: /ZC)
❑ Heat Stove ❑ Cook Stove ❑ Woodstove `4_/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 F D� a�''t', .,:',4 ' i ... `7.4 v` � °
! ° Ste, c �` S zs
Current Proposed ,. "�s r ,- �� q, , `'.'w.. a ,,�.�t'0.i : =- �a '
Main Floor l _._,.... 'i ,r r+r z r -. -taw.' tr Ste, a wrTasx�T. A
It`0� - 'v aiF ' '+.Y` ^aa a,. v a •w,° p, t`-
2NU Floor y ' v � � 4v. .. s y ,,. . :. 4,4 ili;
3'"Floor 0,7 `.3 F�3•!t n ii `-: r°� a,�m F5 � px:111.5,,"S' " , bsr i ^L'a. �'.� ' , d
t -•t` a ,.. i a war' ti,at v �. " ,! V"`
Mezzanine: ` g , ,�s �f,. � r " r , x
1 a {''' r=r• �t ti i ,r 'Zeili..UX er. try•°mot'. 3;.- fi #
Heated Basement `� V;� '`�� r , ., , '
C��y.s !„ rJ _ i..s3 +. a�•Ss fir: ^� &� ,+ti'�"a}n � w :s .-.,k y fie 4.
,43S to )Sb I A.,p ;'S, �4'i�«` i` "* -5. _i .,A'a 44 .'� ` f: .' .c7;"
Unheated Basement — {}{}� }� � �� r �- �� �i 3�ti
,v4 �.']; n Sys 4: .r to a„1- ?w • �.
Other Unheated r,.1 -, ff -W c`� b 1, { ,� .- 0 -V t''
t� ty ' ylS � .s ,rye .li '`,�.,:.'� } �, 4'� �42's.,,w�?`?�P a;:�a�a84y&��c
Garage/Carport i `�y , x fi" ' �' rF x
Decks r x :i.e.,.,,,,..,,,.,e .us�tiik,,- - u '.i. a. a` `r 'E ' k .4 ,t 14if-
17Z t•it 4 r$ r�'r : r k`v, r L ', ty 1,"fi' a.5 t:
Other 1e A koµ2 s ,t,, t 3i'4 ,f.i,t t.1',, , 4 `" {i,4 ' ��'":""5"�.a r �`'r�a'�s'a tr. r .,Y
QO n(/S o ,,v• $c,t'.s,� J S L `3 .y.'J ° .,-� r 4 a i., `r y,,u f ,�''- a -,p..i i, . .`�' ,-.-- y., , ° J
ESTIMATED COST(i3EQUli2EQL o �� r ? ,, ; ` ri,:`,S i .•� ° ,fmtl`` _,,, ,-
lr �`"►�S� t ri r �'�a,�^ f f,r x'' -r,` .f�'���t x �' �I,y SS�s,,�t,
•Fair marketva ue of all labor and mate a s foundation to finish a{ i `�, ; .,�1 ,a i f x `fir Ir g I
2\.UU, 0UU '�Y/�? .,a < ,, �r.i - � .. ,isg , ,..44, ,-*-.ham. $ IPA.*Y
..a."h.' .a1:.5,sxwz.r'-1- eM;Y : ;ti g as ,..
G:\PemutCen -FORMS\DRD FORMS\Master Pemrit Application 7-8-04.doc