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HomeMy WebLinkAboutBLD2005-00497 •UILDING PERMIT APPLICAN B RDOe 00497 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00497 Received Date: 7/28/2005 SITE ADDRESS: 203 MACHIAS LOOP RD PORT LUDLOW, 98365 OWNER: PETER STURZU PHONE: 360-379-0109 MITZI J STURZU JTWROS 460 PINECREST DR PORT TOWNSEND WA 983682509 PORT LUDLOW NO. 1 SUBDIVISION: Block: Lot: 3 PARCEL NUMBER: 990400503 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION SECOND STORY ON EXISTING RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: VALUATION 40,000.00 ADD'L: 500 HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 3N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: PUBLIC BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 1 Total: 2 Total: 3 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $593.25 SLE 07/28/05 76408 APPROVED Plan Check $385.61 SLE 07/28/05 76408 State Building Code $4.50 SLE 07/28/05 76408 SEP 1 4 2005 Total: $983.36 effer on County Planning & uildi j 'epartment ,CJf 4/�'` gee_ c A :..... ._ . - To: Jefferson County Dept. Of Community Development. Site Address: 203 Machias Loop Rd 4eell �. 7) .. ?- Permit# BLDS-00497 Parcel: 990400503 f, `�-� Project Description: Second Story on existing residence. tB o <108 ffERco onof Attention Kathie Dear Kathie This letter is to inform you that we never began work on this project. The idea was abandoned soon after we applied for the permit and after we got some cost estimates. Since there is nothing to inspect, per our phone conversation on Friday Feb.1, please initiate the paper work to cancel this permit. Thank you very much for your advice as to how to proceed with the paperwork . Peter& Mitzi Sturzu Q/ • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00497 Received Date 07/28/2005 SITE ADDRESS: 203 MACHIAS LOOP RD Issue Date 09/14/2005 PORT LUDLOW, 98365 APPLICANT: PETER STURZU PHONE: 360-379-0109 MITZI J STURZU JTWROS 460 PINECREST DR PORT TOWNSEND WA 983682509 SUBDIVISION: PORT LUDLOW NO. 1 Block: Lot: 3 PARCEL NUMBER: 990400503 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: PROJECT DESCRIPTION: SECOND STORY ON EXISTING RESIDENCE CALL IN FOR THE REQU RED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: A) A UFFER: N/A Footing: l}J( /D/5//S" Foundation: NSA 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: 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 V„�oN co JEFFER•COUNTY • 1I ,"U w �.' j r DEPARTMENT OF COMMUNITY DEVELOPMENT I-) 1621 Sheridan Street• Port Townsend•Washington 98368 360/379-4450• 360/379-4451 Fax �,45 0 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessary): NI EAXJ � °0JD stoex ON V/KlS11 )6-12E54 IF-MCE. Tax Parcel L' Property �c Number: I q© �{Do Sa3 Size: ��r (acres/square feet) Site Address and/or Directions to Property: 2.03 'M{K-ek-I 45 I.-COP -0 AD t Part L o lot-°vJ 1 b 3lo b Property Owner(s)of Record: P Q I. 11r7-1 &cu R-7-1) Telephone: L3(00 379- 0109 Fax: email: Mailing Address: 4160 Pirtc(lZ, l. D 6 ?i' 'CoWt4s(ztAD Applicant/Agent(if different from owner): J• N1 Alli- Pic-kg-4 - Pr2C(4-tiEC-f Telephone: LZcta) 5-t2-g€DS Fax: L7-o0 7SO- 85lo9 email: Seabo[ck 2) /v15i\ .Lcii•r\ Mailing Address: (SO 10 Ka 4r DieL- 2..4.,k9 . Gt-t ge.OD t4e (S. . U)k c �i t c What kind of Permit?(Check each box that applies) yl,Building U Variance(Minor,Major or Reasonable Economic Use) U Demolition Permit Conditional Use[C(a),C(d),or CI** lai.Single Family- Pr''DI".%014 - Discretionary"D"or Unnamed Use Classification • Garage Attached/Detached- - --- Ul . Special Use(Essential Public Facilities)** U Manufactured Home .-• U\Boundary Line Adjustment U Modular U:Short Plat" U Commercial* IJ pinding Site Plan" U Change of Use ` U ong Plat" CI Address i Road Approach'''IL 2 �S , 0 fanned Rural Residential Development(PRRD)/Amendments•- U Propane UFlat Vacation/Alteration" U Allowed"Yes"Use Consistency Analysis IJ Shoreline Master Program Exemption/Pennit Revisions" U Stormwater Management U Shoreline Management Substantial Development" U Site Plan Approval Advance Determination(SPAAD)• U Shoreline Management Variance U Temporary Use U Comprehensive Plan/UDC/Land Use District Map Amendment U Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment U Forest Practices Act/Release of Six-Year Moratorium May require a Pie-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 `A I hereby designate J I"II(I nt- �E-ot(ZL_ 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: 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 adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: (::\Documents and Settings\mochil\Desktop\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 project. Signature: Date: I' - - GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: . _ ( ) JU! ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS L__-___ _ NUMBER: NUMBER ARCHITECT/ENGINEER: ) "n kcit as.k21...- Ait,Ctk' I j ri' Cr I PHONE (6:6 � `, FAX:( y,.) ") j0''Q ;(01 MAILING ADDRESS: tS(i 10 VC);iFaA2.- Z.)ktD , i..{ tt56 ,. 15. EMAIL ,( 4,i Lt 2.0 tv i\ .(L Al Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 1 New k(, Wood Existing: 2- JKSewer Addition U Steel Proposed: 1 Bank I Community System I Alteration/Remodel U Concrete Total: `) Height: I l Individual System 1 Repair U Masonry SEP Permit# Demolition U Other. Bedrooms: Water Supply: Existing: 2 Setback: Li Private well i I 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: i Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove I Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove 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: C) 2Nu Floor O ,DO 1 Base fee: 913-25 3f6 Floor Additional Section: '" Mezzanine: Plan Check fee: ✓¢r- /` I Heated Basement State Surcharge fee: Unheated Basement Pot Water Review fee: _ Other Unheated 911/Rd Approach fee: ,/' Garage/Carport .3-17- Li TOTAL: $ q$3.3L _ Decks 764og Receipt Number: Other Cash/Check Number: 51°2. ESTIMATED COST(REQUIRED) Date: 12-005 •Fair market value of all labor and materials foundation to finish l+f ti91.rCrut' IT-1 Initials: C:\Documents and Settings\moehil\Desktop\Master Permit Application 7-II-04.doc 203 MACHIAS LOOP RD BLD05 497_ STURZU Approvals Req'd Prior to Final Inspection SEP RAP Z.O N SIPZ DPW ) •