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Home My WebLink AboutBLD2005-00566 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00566 Received Date 08/31/2005 SITE ADDRESS: 284 FOXFIELD DR Issue Date 09/13/2005 PORT TOWNSEND, 98368 APPLICANT: ROBERT S ROBERTS PHONE: PATRICIA A B ROBERTS 284 FOXFIELD DR PORT TOWNSEND WA 983689549 SUBDIVISION: KALA POINT#4 Block: Lot: 99 PARCEL NUMBER: 965000093 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: PROJECT DESCRIPTION: EXTING DECK REVISION TO RAILING LATTICE DELETED NO MLA CALL IN FOR THE REQUIRED INSPECTIONS THAT A P Y TO YOUR PROJECT. SETBACKS: H 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 FinaLAD_proval: Final/Occupancy Approval: /0—I Q-DS-- T AN 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 t�UILDING PERMIT APPLICA1 N BRD05 00566 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: SITE ADDRESS: BLD05-00566 284 FOXFIELD DR Received Date: 8/31/2005 PORT TOWNSEND, 98368 OWNER: ROBERT S ROBERTS PHONE: —57q--`3 -Cl PATRICIA A B ROBERTS ( (, 284 FOXFIELD DR PORT TOWNSEND WA 983689549 KALA POINT#4 SUBDIVISION: Block: Lot: 99 PARCEL NUMBER: 965000093 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION EXTING DECK REVISION TO RAILING LATTICE DELETED NO MLA TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 1,000.00 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: WATER SYSTEM: BEDROOMS: BATHROOMS: A " H O V E L..Jp Exist: Exist: Prop: Prop: SEP 1 4 2005 Total: Total: Routing Date: ,. Jefferson County Planning 8/31/0 & Building Department t Type Amount Paid By: Date: Receipt: . q1CVEU Plan Check $0.00 SLE 08/31/05 Permit $0.00 SLE 08/31/05 State Building Code $0.00 SLE 08/31/05 5EP 1 4 2005 Total: $0.00 Jefferson County Planning Oil & B ' ' g Department iFe,2 S A1/4 1v c06. JEFFERSON�JUNTY • ---_. \ w ti,v- t 'ice 13 NT DEPARTMENT OF COMMUNITY DEVELOPME (t i 1' `, .. 1-4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 4.qs Goo$ www.co.jefferson.wa.us/commdevelopmentAU�i 3 0 UO HIN Master Permit Application MT m Project Description(include separate sheets as necessary): /1 aV .- er ca..") f�fre '-e c ii4v...��. deck. •1r.,u►�._ DD d ra c I 4 'o-u-....i sevq o eie-e-k ,S4:v.1 v- A-e�.TL..f t Cmn .I+ue-f u' 4 S C .✓1 S e- trr/vo de c k, rest Qf ec�, jai-Ktn f et.fe,Ic re rivii vii Ave slAvA e- . D t-al r a,+.n et•('t l , c•c4. Tax Parcel _ Cof I/ Property / Number: ` �S act e7 93 / /L i a,lot 4- Size: /0 Ci Je f e / (acres/square feet) Site Address and/or Directions to Property: 2k 'F i o c'4(I )Drives / Port' I awHse�cl,, /AJit l 36£f Property Owner(s)of Record: a I - S I . r�4 -i-t , A4 f!'c c t 4 A.B /ep Gk,.-.ir Telephone: e c - i 7 y-3/o 9 Fax: sc..,..,1 email: Mailing Address: Lam'+ .xr-r.-(d L.✓}'d� I nr'1- To wr,_„..,ct, we) g2.36g Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) X Building ❑Variance(Minor, Major or Reasonable Economic Use) 0 Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family 0 Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** 0 Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑Commercial* Cl Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address l l Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments" 0 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 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 required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. // o Signature: 4L , .:SeG Date: &/Z`l/pl I i l he 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-transfe �a res ib'•'/ for dhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: fl�cti� ,�" Date: s/Lr'/rls 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 assu g the responsibiliXy of the General Contractor for the proposed project. Signature: . f ,C�—fly- Date: ‘'/'fw(— GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) 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: ❑ New R Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System X Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: I 1 Private well I i Two Party Type of Heat: Proposed: L 1 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 i Underground Tank I i Above ground Tank Size of Propane Tank: I 1 Heat Stove I I Cook Stove I I Woodstove i I Fireplace Insert ❑ Hot Water Tank I Pellet Stove t1 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: ` 3`d Floor Additional Section: ,----" Mezzanine: Plan Check fee: Heated Basement State Surcharge fee: SC Unheated Basement Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport TOTAL: $ 6;?_ 4 C./ Decks Receipt Number: 7( 3(0 5 Other Cash/Check Number: a ESTIMAT OST(REQUIRED) Date: / 0/0� •Fair ma t value of all labor and materials foundatr to finish _ t 1( 0C)"`-- Initials: !!! G:\Pemv ter RM 0 aster Permit Application 7-8-04.doc