HomeMy WebLinkAboutBLD2005-00483 Ilk
UILDING PERMIT APPLICAtN MLLA05 00447
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00483 Received Date: 7/22/2005
SITE ADDRESS: 503 JOLIE WAY
PORT TOWNSEND, 98368
OWNER: ANTHONY 0 FRANCIS PHONE:
KRISTIN M AXTMAN
503 JOLIE WAY
PORT TOWNSEND WA 983689073 II
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 001071019 Section: 7 Township: 30 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI NSFR WITH A/G 90 GALLON PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW 3
VALUATION 133,100.00 MAIN: -719-S3
CODE EDITION: 2003 ADD'L: 618 HEAT TYPE: RAD
OCCUPANCY: R-3 HEAT BASE: HEAT TYPE: PRO
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: 5N OTHER: 68 SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 1
Total: 2 Total: 1
Routing Date:
7(2. /05--- egg
Type Amount Paid By: Date: Receipt: AP IVy(v5QatEE
Permit $1,184.15 SLE 07/22/05 76192
Plan Check $769.70 SLE 07/22/05 76192 AUG 2'2 2005
State Building Code $4.50 SLE 07/22/05 76192
Potable Water Application $53.00 SLE 07/22/05 76192 rson County Planning
Total: $2,011.35 Buildin Department
0 BUIL 0 DING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00483 Received Date 07/22/2005
SITE ADDRESS: 503 JOLIE WAY
PORT TOWNSEND, 98368 Issue Date 08/22/2005
APPLICANT: ANTHONY 0 FRANCIS
KRISTIN M AXTMAN PHONE:
503 JOLIE WAY
PORT TOWNSEND WA 983689073
SUBDIVISION:
PARCEL NUMBER: 001071019 Block: Lot: +
Section: 7 Township: 30 N Range: 01 W
CONTRACTOR:
PROJECT DESCRIPTION: NSFR WITH A/G 90 GALLON PROPANE TANK
CALL IN FOR THE EQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: �- ts-.4
U F F E R. . IS--d.j
Footing: 9--/5'cwe
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : i Alai W,'SL O r14 ell it /&-0& �-'
Sheathing: (
Framing: . pc, [!-1(10,U< OPlj
Plumbing: 24.4;A f R(,-u W )"
Propane Tank/Lines: (46. q i -c..l,)E,�t 1-VD _ob
Insulation: .4 c.f1 �
Sheetrock: 1
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: -6.-- c,o,rrr ^Q1
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 A BLD05-00483 •
Alt
1.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
2.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
3.) 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).
4.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
5.) The building height is not to exceed 35 feet.
6.) Minimum setback from Jolie Way right-of-way is 20 ft. Minimum side and rear setbacks
are 5 ft.
7.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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.
8.) A minimum of two (2) on-site parking spaces are required for the single family residence.
I:\F_BLD_Permit_Buildng.rpt
10/29/19
��i;?$°lv cO& JEFFERSO•OUNTY •
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port T n -vvg- 1Cr,
360/379-4450 • 360/379-44 F i ;( L. [' '4' "'
4q p� www.co.jefferson.wa.us/commd e oTp'men�
S NG" '
is
Master Permit Application ;_ JUL 2 2 2005 M' - -/
Project Description(include separate sheets as necessary): r---
NY //^ _�,� �______�
Vd .StiltJ 41C, 4 f ppCX rr M Fra-nr cs l,. I
Tax Parcel Property-- -V
Number: b 0 1 - D 7 I -Q I -- Size: � acit-Q� (acres/square feet)
Site Address and/or Directions to Property: 50; 1p lip vJtLi.
Property Owner(s)of Record: kri-/i .y �r�,;s 4-g fjrr
� fi 4t he ftnah
Telephone: 37Q- 2(069 J Fax: 3 7! —2WI email: ka,th (00 J( pe.i .kiwi
Mailing Address: 503 0o l;c a ) pr
Applicant/Agent(if different from owner): fl(i
Telephone: Fax: _ email:
Mailing Address:
What kind of Permit?(Check each box that applies)
7 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* E Binding Site Plan**
❑ Change of Use D Long Plat**
D Address ❑ Road Approach I Planned Rural Residential Development(PRRD)Amendments**
y'Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis O 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: i q
DESIGNATION OF AGENT I
I hereby designate tt\/ri 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 right of entry to this property shall be requested and shall occur only during regular business
hours. /'
Signature: ------ - _ Date: 0S
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-tran f-rab e responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: , .4 a L i^ Date: �,�,...t.()c
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 responsibility of the General Contractor for the proposed projeect.
Signature:��(�� _�- Date: 2(. i(.)411- OS
C
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
A.# ( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ,
X New Wood Existing: q ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank Rh'
' ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: I Height: 0 Individual System
❑ Repair ❑ Masonry SEP Permit#Selo 11 'b 1*f
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 0 Setback: X Private well ❑ Two Party
Type of Heat: Proposed: a2 ❑ Public
t�al r I- ,o--viti Total: Name of System:
1 er,ems.
If this is a Commercial Project you must answer the following: IV 1
Number of Parking Spaces: Current Proposed: l( 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:
[1 Underground Tank • Above ground Tank Size of Propane Tank: G()gild•
❑ Heat Stove A Cook Stove ❑ Woodstove Li Fireplace Insert sy4 Hot Water Tank ❑ Pellet Sfdve U 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. r r
Square Footage For Office'Use Only yy i _ , Lc; '•
Current Proposed E lmoun
Main Floor l ncy Review: k L C
N� 31 ` 1 \`� r_$t JUL 2 2 2005 f . CSC;
2 Floor /_ g [ t 0 'Base lee:
31°Floor r Additional Section;- , An',rlt 14;C:
kiq
Mezzanine: Plan Check fee:�`' •. x-7 ; c
11�t 1 fG 1 .
Heated Basement State Surcharge fee: t (- 1
Unheated Basement Pot Water Review fee:
nIA h C,(_,
Other Unheated 911/Rd Approach fee:
Garage/Carport N l TOTAL $ `'I (I a
Decks n I Receipt Number: t [ ;
Other Cash/Check Number: i,1414, -
ESTIMATED COST(REQUIRED) 1 Date: ' ' x^
•Fair market value of all labor and materials.foundation to finish
Initials: 1 -
I
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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— SITE PLAN 3130 HOWARD STREET i �I.
503 JOLIE WAY PCRT TOWNSEND,WA 98368 8PORT TOWNSEND, WA 98368 E (360)
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