HomeMy WebLinkAboutBLD2005-00722 BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00722 Received Date 11/17/2005
SITE ADDRESS: 516 MCINNIS RD Issue Date 11/23/2005
QUILCENE, 98376
APPLICANT: JENNIFER S BRINK PHONE: 360-765-3070
516 MCINNES RD
QUILCENE WA 983768509
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 702134029 Section: 13 Township: 27 N Range: 02 W
CONTRACTOR: PRATT CONSTRUCTION COMPANY PHONE: (360)452-3360
112 J SHEA WAY
PORT ANGELES WA 98362
Contractor's License: PRATTCC210JL Expires: 3/25/2007
PROJECT DESCRIPTION: NSFR(REPLACING BURNED STRUCTURE)
CALL IN FOR THE REQUIRE IN PELT ONS THAT APPLY TO YOUR PROJECT.
SETBACKS: Ok ///z 45
U FFER: 0/4 /1,s..4/05
Footing: 1},e 01/041/
Foundation: OA /0/05,
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : EXT/h7eiGi - �//6"a2 ok As/a,
Sheathing:
Framing: 2tr"Gcoa - /1,-7-o- OK oJo4,
Plumbing: ., / -mac, -06
Propane ank/ Lines:
Insulation: ,�/� SE-A/ 1914. 02 of (9Z- i_/b- )
Sheetrock: /4-T 6NEXlR2 OO 3/i10�,
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: `2 & 'OGFE.
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 CIE A BLD05-00722
1.) 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).
2.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
3.) The building height is not to exceed 35 feet.
4.) McInnes Rd setback is 20 ft, rear setback is 5 ft, side setbacks should be no less than 5 ft.
5.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
6.) A minimum of two (2) on-site parking spaces is required for the single family residence.
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.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
U
.UILDING PERMIT APPLICA•ON MRLA05 00678 eview Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00722 Received Date: 11/17/2005
SITE ADDRESS: 516 MCINNIS RD
QUILCENE, 98376
OWNER: JENNIFER S BRINK PHONE: 360-765-3070
516 MCINNES RD
QUILCENE WA 983768509
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 702134029 Section: 13 Township: 27 N Range: 02 W
CONTRACTOR: PRATT CONSTRUCTION COMPANY PHONE: (360) 452-3360
112 J SHEA WAY
PORT ANGELES WA 98362
Contractor's License PRATTCC210JL Expires 3/25/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NSFR (REPLACING BURNED STRUCTURE)
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,134
VALUATION 164,346.00 ADD'L: 667 HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE: HTP
OCCUPANCY: R-3 UNHEATED: #OF STORIES: 2
OCCUPANCY:
CONST TYPE: 5N OTHER: SHORELINE:
GARA
CONST TYPE: DECKLE 124 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: 2WELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date: \.n.
I a nn
Type Amount Paid By: Date: Receipt: H w � • • e�p�te,
Permit $1,357.75 SLE 11/17/05 77425 U Vv/
Plan Check $882.54 SLE 11/17/05 77425 NOV4 2005
State Building Code $4.50 SLE 11/17/05 77425
Potable Water Application $53.00 SLE 11/17/05 77425 Jefferson County Planning
Total: $2,297.79 &13u ! l epartment
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. JEFFERSOSOUNTY �-- -----
w� •
' DEPARTMENT OFCOMMUNITY DEVELOPMENT`' 621 Sheridan Street • Port Townsend •Washington 98368 NOV � 7 2OO5
360/379-4450 • 360/379-4451 Fax
�� �p� www.co.jefferson.wa.us/commdevelopment
RING
Master Permit Application MLA: )5
Project Description(include separate sheets as necessary):
P P rY)
Tax Parcel 7 ! ;j L c; Property
Number: / cx /-J / Li 01, /ic/r.'/-
/ Size:
S e• (acr
es/square uare feet)
q
Site Address and/or Directions to Property: .: /r� "' f'✓/✓` 6,`)41; 67/a-<-(F.,:f' (7837 ,
Property Owner(s)of Record: v r I`/N/T /� Q.ty','
Telephone: 3(c 7(J ". o: Fax: email: -ifi/ 77 7 n:' ; ,,,
Mailing Address: 57 U, i l,,l1 - / , . , 9 >;
' Applicant/Agent(if different from owner): t,7 dr.'7,' '' 'ti �7 C0/14S P " .If', DA,I,it,,,}.t1
Telephone: ."> ' =1` .-- ,J Fax: 4:5 7 f' 7:,
3 t� email: f Pt ,.,
Mailing Address: //2 T j 1'p, o-1f%j , „/ • A_/..
What kind of Permit?(Check each box that applie
s)
)
❑ Building 0 Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit ❑ Conditional Use or C(d),,C a **
lai [ C]
Single Family ❑ Discretionary"D"or Unnamed Use Classification
O Garage Attached/Detached 11 Special Use(Essential Public Facilities)**
❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular ❑ Short Plat**
❑Commercial* 0 Binding Site Plan**
❑Change of Use ❑ Long Plat**
❑Address 0 Road Approach LI Planned Rural Residential Development(PRRD)/Amendments**
0 Propane ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management 0 Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 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 /I7 11.h,1.1 /%4 to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE ijYc% tte Date: /1) - 2 ."'Qe.
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 Ord 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: /!'L —YV-
7r—,. -.li.'�,V6 -L.-C L'. 1 ./_ Date: /0 - 1-C- o �—
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 adhe to and complyin9vith the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: �` �' � .�" � Z f L Date: 7(.) - L 4 "‘-')-
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: Da::e:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: (e/7 y 77-/6ac FAx:
7 j,ar f,r�r ,'` =%VI; ';/'./ - .4'/ (/ -1.:,;:. (34O ) y'S2- 3' �•,3 (3Ca ) V - yC
MAILING ADDRESS: r . 2 -r i•i',F,r' 'IF :,, ,. , • EMAIL: 1` /,ci"
i rr;
CONTRACTOR'S LICENSE WAINS
NUMBER: PR`J�7 J/ c CZ /0 J-_ NUMBER
ARCHITECT/ENGINEER: ='A:/T?'r i 7/'!`a',/ , T,:':t i'i PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
'( New 01, Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: - Bank ❑ Community System
0 Alteration/Remodel ❑ Concrete Total: <�; Height: $ Individual System
0 Repair ❑ Masonry SEP Permit# i(J —l0 f'
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well N Two
Type of Heat: Proposed: 3 Party
v CI 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:
❑ Underground Tank ❑ Above ground Tank Size of Propane Tank:
❑ Heat Stove 0 Cook Stove ❑ Woodstove 0 Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove 0 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 comport nts, c
1 including the reserve area. J+ . 1 c1(D ,(G_,)
Square Footage For Office Use Only t
Current Proposed
Amount
Main Floor Consistency Review; ; `'}
2Nu Floor 6 J CC��56��-t Base fee:
3f0 Floor 1 t53.o-I i .3s 7, . 9J
Additional Section: ,„—_______.--
Mezzanine:Mezzanine: Plan Check fee:
Heated Basement `,, ! ' Statue Surcharge fee: c
Unheated Basement �� _ -�..,I i tot Water Review fee:
Other Unheated :i NOV17 2005 t p1 t/Rd Approach fee:
c('X151 tnG
Garage/Carport f,
• t L t•Tti• TOTAL: $ I
Decks PY T r r"r l ilr t S n'
j-2 �{ Receipt Number: 7-11 t, ---
Other Cash/Check Number
ESTIMATED COST(REQUIRED) ( 4``
1(s LIG-,3 I Date --
.Fair market value of all labor and materials fou dation to Wish (L""!,I
(
c 0 .,_ E= --r',f - Initials: +
c4V2
G:\PemdtCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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