HomeMy WebLinkAboutBLD2005-00573 UILDING PERMIT APPLICAIN MPLAOW00pe536
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
ERMIT #: BLD05-00573 Received Date: 9/2/2005
ITE ADDRESS: 5282 CAPE GEORGE RD
PORT TOWNSEND, 98368
)WNER: JEREMIAH GORSLINE PHONE: 360-385-6132
ELIZABETH MACBARRON
5282 CAPE GEORGE RD
PORT TOWNSEND WA 983689035 OCEAN GROVE ESTATES
SUBDIVISION: Block: 2 Lot: 7&8
PARCEL NUMBER: 977100206 Section: 24 Township: 30 N Range: 02 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP DETACHED GARAGE
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 12,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 432
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 0 Prop: 0
Total: Total:
Routing Date: ci I (i/ 06)2o.
Type Amount Paid By: Date: Receipt: Approved/Date
State Building Code $4.50 SLE 09/02/05 76612 APPROVED
Plan Check $136.01 SLE 09/02/05 76612
Permit $209.25 SLE 09/02/05 76612 OCT - 3 2005
Total: $349.76 Jefferson County Planning
& B din partment
.4bt,_
RV- i4
• S
Jeffeo County parBUILDtmeG PERMIT
621rs n Sheridan De Street, Port Townsend IWA 9836$e n t
PERMIT#: (360)379-4450 FAX (360)379-4451
SITE ADDRESS: BLD05-00573
5282 CAPE GEORGE RD Received Date 09/2/2005
PORT TOWNSEND, 98368 Issue Date
APPLICANT: 10/3/2005
JEREMIAH GORSLINE
ELIZABETH MACBARRON PHONE:
5282 CAPE GEORGE RD 360-385-6132
PORT TOWNSEND WA 983689035
SUBDIVISION: OCEAN GROVE ESTATES
PARCEL NUMBER: 977100206
Section: 24 Block: 2 Lot: 7&8
CONTRACTOR: Township: 30 N Range: 02 W
PROJECT DESCRIPTION: DETACHED GARAGE (18' by 24')
CALL IN FOR THE REQUIRED PROJECT.
INSPECTIONS THAT APPLY TO YOUR
SETBACKS: ECT.
UFFER:
Footing: 0�D -oS
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground nsulation:
Shear Wall : , .ps
Sheathing: t t-av il
Framing: 'Z
Plumbing:
Propane Tank/Lines:
Insulation:
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval. r ' ()
HEALTH DEPARTMENT D PUBLIC WORKS APPROVAL REQUIRED PR
IOR TO FINAL
THIS PERMIT S VALID FOR ONE YEAR OR IT MUST BE PROPERLY E Y RENEWED
SPECTION
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE
TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -
p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY -SEE REVERSE
•
SPECIAL CONDITIONS FOR CASE A BLD05-00573
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 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.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
4.) The building height is not to exceed 35 feet.
5.) The front setback is 20 feet from the edge of the right-of-way from Cape George Road (a
minor collector), which is located to the north. The side and rear setbacks are 5 feet.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
��� o1V c , J
JEFFERSON NTY - T T--
L.ti `ice DEPARTMENT OF COMMUNITY DEVELOPMENT i
11 v ` '� 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax i I
a
;
S, NG�O www.co.jefferson.wa.us/commdevelopment I i I �'
Master Permit Application MLAnrr Ir, ,, ;
.0 r, rr�
Project Description (include separate sheets as necessary):
Tax Parcel Property
Number: Size:
(acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record: Tecr-( c�b(G L /�t7 g. I F., -�-s l..1 _. `-)/J
Telephone: R is O) =i r'P ( � .- Fax: /
Mailing Address: 1�-y'/1 f j4-r:5 ij email: •
Applicant/Agent(if different from owner):
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each box that applies)
wilding ❑Variance(Minor, Major or Reasonable Economic Use)
Cl Demolition Permit ❑ Conditional Use[C(a), C(d), or C]**
❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification
'Garage Attached etached ❑ Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
❑Address C; 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 aitorney'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 properly shall be requested and shall occur only during regular business
hours.
Signature: 4.L 2 �•
. y._�
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: ' J-
•
Date: ;r, r L'
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 project.
Signature: `j'4 il^�.~"' Date: 1/14 0 ra
GENERAL CONTRACTOR OR MANUFACTUR MT M tNS PHONE: FAX:
MAILING ADDRESS: .• ! EMAIL:
'I . SEF ' ,, RAINS
CONTRACTORS LICENSE '. L � ��' 1'� i,'
NUMBER: NUMBER
ARCHITECT/ENGINEER: L_ _ R HONE ( ) FAX: ( )
MAILING ADDRESS: pi l'T. OF COMMUNITY DI ELOPMFisT EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
A/New X Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System_
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well [1 Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
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:
Li Underground Tank ❑ Above ground Tank Size of Propane Tank:
LI Heat Stove [II Cook Stove Li Woodstove ❑ Fireplace Insert 0 Hot Water Tank ❑ Pellet Stove i l 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: q q ,0
2ND Floor Base fee: 7--en ,2S-
3r°Floor _ Additional Section: ✓e
Mezzanine: Plan Check fee: ( i�p 2/' ,
Heated Basement State Surcharge fee: 5b
Unheated Basement Pot Water Review fee: ,--
Other Unheated 911/Rd Approach fee: ../...---
Garage/Carport TOTAL: $ 313A,
Decks ' Receipt Number: •1(i/Ql
Other Cash/Check Number: ' —.2
ESTIMATED COST(REQUIRED) Date: et rZ d—
•Fair market value . • - - - rats foundation to finish l
Initials:
G:\PermitCenter\F•'7T DRD FORMS\Master Permit Application 7-8-04.doc
Lc' 869 -6L (09 ) 99c86 VM 'ON3SNMOI h Od
8986 VM 'ON3SNMO1 1NOd OV08 308030 3dVO Z8Z5 w o
C 'ad ,1d3A00SI0 'S g Z _ ��d US NOeleIVBOVW/3NI1S100 2
°° SVWOHI 3SS3r :JAB I. 1 `kIa NO3 30deid0
��,�� d A
fc.::.
1 At>"'
E ,
'; 70ry�.y' ::,:,0.-: 1 ':.: LLJ
J
Y""'°'1 F-'.. Y.G+is ►--1 Cn L;]
/ O, / ' w 4 ' 0 i- I«t'q ! I I
O. I I
U
,SZ� CD C� cvn
/_ a
C4�� / i441
O ".•a
aC„,,*k re Ll---,oe I>. ii,____p___________.__,, /
1 ‘N ct SA, , Mt
----‘*'--------'N'r.
�'
.... Ca 1) $ '(2 ,r •Pis
.,:„ e,1 .N 4 44 t., .... ,,, NfireS4 0 .__.---V mo....,„,,..„
IJ � k 0 9�
U L
' N -� \ y _ ...
Q�
C
N
X
U
N
/ \
Ce I
y /
Cr./
/
c
I
/ • U .
U
/ /
f
i/I / /
//
/ ' 2 '
/ /
'z
O '
/
Q
/
m
U
Q
S ,SZ!
I---
W
m
VIII
U )
CD
CD a'
�a
rY
o
W Z
Q.
CD
O 6� 0 y
O f "' o
c >-^ CN 6 E
W L
W a o, o
/
CD zo � - cii vi +'
CD
IO J o W O a ON O O a O
o d , sCN
C/) o z ran a� CO ¢ L3 00 `� o a� ^I I
N . cD U -J
aMo n 3o aa) a' _ 3 N o __ -6 u o� U CLI
W Q Q o U o �' Er)
CY.) > �' 0 cci) o vi �' (Y
Cr) N O Cr) O 0 U 'C .- a7-0 OO_ CD (n
Ci) Q
O U I— �O ,n al o n o r� Cl_ if'
N I— w co CD ' N Moo Cr) 0 Cr) o 0 o 0_ 5
a) ,Y
n 00 O t c¢.) v =' a � •n 0 0 0 n
W cu x x 'x 0 " 0 0 E
f l ) IZ a_ cn o _ - o c) c> Cl) -i-, Cl_ Cl_ a -•--,