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HomeMy WebLinkAboutBLD2005-00657 • �UILDING PERMIT APPLICATIONRevviewiew Type:ML y e: I pe: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00657 Received Date: 10/13/2005 SITE ADDRESS: 1473 OLD GARDINER RD SEQUIM, 98382 OWNER: GEORGE C DE BRUYN PHONE: 360-797-7981 JENNIFER DEBRUYN 1473 OLD GARDINER RD SEQUIM WA 983828775 SUBDIVISION: Block: Lot: T 38 PARCEL NUMBER: 002342014 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: TOWN & COUNTRY POST & FRAME PHONE: 425-743-1555 16521 HWY 99 SUITE B LYNNWOOD WA 98037-3161 Contractor's License TOWNCPF099LT Expires 6/30/2007 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr POLE BUILDING GARAGE TYPE OF WORK GAR SQUARE FOOTAGE:: TYPE OF IMP NEW MAIN: VALUATION 26,796.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: 152 SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 Total: 2 Routing Date: lo c.,));) Nros- Type Amount Paid By: Date: Receipt: A PPROVE r Total: DECO 2005 Jefferson County Planning & Building Department CaQQuvc\ .e11- "K frr C�Q '5cet9_(:) • Jefferson CountyBUILDING PERMIT Department of Community Development 621 Sheridan PERMIT#: (360)379-44.50 FAX (360)379451WA 98368 SITE ADDRESS: BLD05-00657 1473 OLD GARDINER RD APPLICANT: SEQUIM, 98382 Received Date 10/11/2005 GEORGE BU Issue Date JENNIFER DEBRYN N 12/20/2005 1473 OLD GARDINER RD PHONE: 360-797-7981 SUBDIVISION: SEQUIM WA 983828775 PARCEL NUMBER: O02342014 CONTRACT Section: 34 Township: Block: OR: TOWN p: 30 N Lot: T 38 & COUNTRY POSTRange: 02 W 16521 HWY 99 & FRAME SUITE B PHONE: LYNNWOOD WA 98037 425-743-1555 Contractor's 3161 PROJECT DESCRIPTION: License: TOW � CALL IN FORT RIPTION: POLE BUILDING NC' F099LT Expires: HE REQUIRED INSPECTIONS HAR GARAGE SETBACKS: UFFER: UC>� APPLY TO YOUR PROJECT. Footing: Foundation: 6� G t Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: ` NA /� l2� Plumbing: m A Propane Tank/Lines: N A Insulation: N Sheetrock: Septic S �'� ytem Final Approval(If not on sewer: Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL R ALID FOR ONE YEAR Q IRED PRIOR TO FINAL INSPECTION THIS PERMIT IS V HOT-LINE 379.4q� OR IT MUST BE P CALL 24 HOURS IN ADVANCE ROTO SCH DU EVI BUILDING INSPECTION NS P Office Hours 9:00 a.m. -4:30 SCHEDUL HOT LINE AVAILABLE 24 p m E INSPECTIONS. SPECIAL CONDITIONS A DAY NDITIONS APPLY-SEE REVERSE • SPECIAL CONDITIONS FOR CASE # BLD05-006 57 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.) 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 such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). any 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 Old Gardiner Rd is 20 feet. Minimum side e and rear setbacks are 5 1:1F_BLD_Permit_Buildng.rpt 10/29/1999 �,gON C, w--i ° JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT �' ` `4 M 621 Sheridan Street • Port Townsend • Washington 98368 �, 360/379-4450 • 360/379-4451 Fax gG,S,... .6.....y www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: ©Q->_C;= Project Description (include separate sheets as necessary): Poc..E Bo u-0.16- Tax Parcel Number: 00 2 3 4-la O /c� Property Size: AC "C— (acres/square feet) Site Address and/or Directions to Property: /4/73 o/d Ci arc('- -. /?i. Property Owner(s)of Record: GjCor y.n j- `le.,,,,,F„ 0Q i3rvY 'o Telephone: 3-6�-3_'- _3 7 ` Jvoc• 36d- 797- "7 T Y/ email: Mailing Address: .5,..7e Applicant/Agent(if different from owner): ec.-ti j. .c,,.,7'i./ Telephone: 1-&coo -- &a c(_ qs$-a Fax: 4'. - - 7YA - 4/372r email: Mailing Address: /6 5 2/ 114)'/ y'c) / • c',-fc 8 .454'ry w„o// Wf 7 k o 37 What kind of Permit?(Check each box that applies) ❑Building ❑ Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a),C(d),or Cj** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification !'G`arage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular 0 Short Plat** 0 Commercial ❑ Change of Use 0 Binding Site Plan"* 0 Long Plat** .72 Address I Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** C Propane 0 Plat Vacation/Alteration**0 Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** Site Plan Approval Advance Determination(SPAAD)* C Temporary Use Shoreline Management Variance ❑ Wireless Telecommunication* Comprehensive Plan/UDC/Land Use District Map Amendment 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices ease 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 fe dJ- v-f f►% to act as my agent in matters relating to this application for permit(s). / OWNER SIGNATURE C'• /©/� _j Date: By signing this appl cation 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,inde.inify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may'- any •ay accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to . ovide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any r:quir-, later inspections.Access and right of entry to this property shall be requested and shall occur onl during regular business hours. Signature: / C / �� Date: m/s:-Os_ 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 ould lead to a potential"take'of an endangered species as those terms are defined in the federal law known as the "Endangered Specie ct"or"ESA.'Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been i ued ill 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 ou re in c mpliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer a responsk ility for a ng to and complying with the ESA. The Applicant has read this disclai rer rid signs and dates it below. C Signature: 1����l� RD J 0 Date: C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc • • TI.1..!, .IL ... ,, .., : , r i F. 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: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: J PHONE: -7 O t../7 a" fr. '/ FAX: MAILING ADDRESS: /ts 5-2 /�(r/� ( moo) �a`{ - �,s5 Z (1/?5—) 7c/'L_ G/39 CONTRACTOR'S LICENSE Ly/n-,ov0oc �9 S� tieEMAIL: �rh7i >`S r NUMBER: /OLv G �a3� WAINS -'' h,'/�• CI, ARCHITECT/ENGINEER: NUMBER MAILING ADDRESS: PHONE EMAIL Project Type: Frame Type:ype: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ Addition 0 Steel Proposed: p Sewer❑ 0 Alteration/Remodel Concrete Bank 0 Community System ❑ Repair Total: z- Height: 0 Masonry Individual System ❑ Demolition C Other. Bedrooms: SEP Permit# 9 1 Existing: Z Water Supply: Type of Heat: Proposed: o Setback: ❑ Private well : Two Party ths fr` Total: � R.Public — Name of System: �P '-C. Co U� j Number of ParkiIf this is a Commercial Projectyou must answer the followin : ng Spaces: Current: Number of occupants(includes owners,tenants,employees, etc) CurrentNumber of ADA Parking Spaces: IBC Occupancy: IBC Type of construction: Proposed If this is a Pro ane Tank and/or A liance Installation ermit mark all item Willbelow that apply Service? Yes / No i Underground Tank i Above ground Tank i Heat Stove i Cook Stove I Size of Propane Tank: Woodstove i Fireplace Insert i Hot Water Tank I Pellet Stove i Is this a liance bein installed in a Manufactured/Mobile Home? Yes / No Other 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, includin. the reserve area. S.uare Foota.a For Office Use Only Current Pro.osed Main Floor Amount MN Consistency Review: / 2'' Floor •00 Base fee: 3' Floor 4 . rD� MI Additional Section: Plan Check fee: Heated Basement 27# .0 I State Surcharge fee: //�� Unheated Basement —i•SO Pot Water Review fee: Other Unheated ,..-.. MEM 911/Rd Approaph fee: Garage/Carport L o54 •' ...-----• ISIN .ter .Taw a TOTAL: �/ DecksIIIIII $ (�� •L///�� b Receipt Number: I ,f �» Other �D'j Mill Cash/Check Number: ESTIMATED COST(REQ- a...., 5 (ZS Fair market value of- ..or and maten. . foundation to finish Date: I D 2 6 7 q 6 Initials: 1� �� C:\Documents and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc yy suile C•16521 Hphway99•Lynnwootl,WA 98037 3161 Please Check After DoingSite Plan: ❑Septic and draintield ❑Lot size Draw-Norm Arrow in Circle -- /r{{ !.,,o T COu ILDING - Ade ine ow 258 4171 Puyallup:(743)B10 9552 P _- -7 PST RAM B AEminetrelive HeeCquanere:(125)743-1555 ❑Property dimensions ❑Sewer lines Ll Elevation of property r- FAX (425)742-4378 Toll Free:1-900.824-9552 ❑Existing buildings ❑Setbacks of proposed&existing buildings ❑Bodies of water , .e.PERMABILT — Contracto.LK.«:TOWNCPFo99LT O ry a F ty I ❑Proposed building ❑Main road with name ❑Floorplan Quali3 x f .�.�1 ❑Easements C17 ru r Access to proposed building ❑Slopes&Contours(5'increments) 3 2 y Job Name: 4,� Job Site Address: Legal Description: Tax Account#: t7 , 2 3 y2 o / DIRECTION f N 2> x 6- %--wii.. cocv 3X� �. /8 / ' " purr.tee4,- ovcc l7r")C --.._I L� f�r -t 2 Lc i i 1-?P -RGI t I Ci d o > i -t-_i 1* o I ` l i a I ~' 1 /p x I � c I `tc;v CDI_. ��I I - M 4, —`+-- N , 1 c I I I I 6 //— j__ I /z ► i /2x mil,rira i : I '—_ I_. - I... I ' L ill C Iti ,Z ( 8 a z /2_ _ I _...._...,_.,_4..._.,.w.,� —ti I �:- -- ,,. -"" I I .r i /Ey 1 13 Y ".... ..-.� .. i.... :. I I I —I ,—-------I 1 - } I I_. I I I : 4. 1 �.� , ro_z _ . 2 .�. ----j I. I—i I ; ! . _„,_4, �' Cc/ice Pfe ._ t i e4.• 'ar71'y / 2 r / /Slf',.p S ..`:417> 1 t A7t3 d) I • I I — 2 44 4 / R PD( 1/-7 lc//r,•fij 1 I 1 _ _ f r J f"Y / 1 -_ Co/0k RVO ( 7F.lci ,.ic. ,v l /. (re(.1J> DO NOT SIGN INCOMPLETE SITE PLAN! Customer has verified and approved the location of the building,orientation of the b d' g to the No ,and verifies that_aM'"--- White-Customer Copy Canary-Office Copy Pink-Accounting Goldenrod-Production utilities are shown on this drawingin the correct location. ..---- Customer �C, �}Signature r Lead# e/ / 9 q 01995 Perma-Bill Industries FR-34 06/04 V c 1 /700 s . ot S` II i Ir N 1.11 .7 l --I -- —. — --i--1----.i.. --,._ i._—.1__�___.. _... 4 .. . . . 471 • ", -- - I 1 � I /l 1 �.— — - -._ ..•� _ 00 ' I 1 i I I I ' 1 I • "1t .� I /2 1 I ,tR'aQ I 1 1 f . ;a I I v ( I , ti 1 1 I . , W t I I 3 .- W p 1 G • 1 n .k I I I A , , O --7C,,i) 7 ,_.. - T,. -Ni j 1 ,, 1 I I I 1 I 1 ' : ' : ! ' '', • ' -^ W,,,,„I,. ; 1 /' f ' i 1 x i . 1 • � I -A . — L.. - I �, ; i W N N Yo�,� ,S i 1 0 ....___,______t_____i____+___,.---1----Li-- r,-- f"� f i itv, . . i , • . . 4 • 71 . i I I I• Z F •4, a , I iI L , i 1 — 1.� _ �n , • . - fi • •'h: -- � r ; I is !1....:._+__L____,..... I yre _ I x' 0 .. . 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