HomeMy WebLinkAboutBLD2005-00790 BLD05-00790
allUILDING PERMIT APPLICA IJN Review T
ype:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD05-00790 Received Date: 12/29/2005
SITE ADDRESS: 181 SADDLE DR
PORT TOWNSEND, 98368
OWNER: JOHN E SAILER PHONE: 360-379-9010
KATHLEEN M SAILER
228 COMMERCIAL ST#290
NEVADA CITY CA 95959 CAPE GEORGE VILLAGE DIV 5
SUBDIVISION: Block: Lot: 18
PARCEL NUMBER: 941100018 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION C -NO MLA REQ - NO CHANGE IN FOOTPRINT
vil-D EXIST GAR TO HTD ART STUDIO 0.j.-50 ?G q nti, `D v i 1,140
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP ALTMAIN:
VALUATION 25,578.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 392 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: CAPE GEO
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
la \ c)lO5
Type Amount Paid By: Date: Receipt: /4 v /Da e/E r
Permit $401.35 LYK 12/29/05 78788 N
Plan Check $260.88 LYK 12/29/05 78788 FEB 8
State Building Code $4.50 LYK 12/29/05 78788 2006
Total: $666.73 Jefferson County PlanninL,
& Building Deparrment
Ce kilin'15'"r•°to 4s
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00790 Received Date 12/29/2005
SITE ADDRESS: 181 SADDLE DR Issue Date 02/8/2006
PORT TOWNSEND, 98368
APPLICANT: JOHN E SAILER PHONE: 360-379-9010
KATHLEEN M SAILER
1240 W SIMS WAY#38
PORT TOWNSEND WA 98368
SUBDIVISION: CAPE GEORGE VILLAGE DIV 5 Block: Lot: 18
PARCEL NUMBER: 941100018 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: UNHTD GAR TO HTD ART STUDIO -NO MLA REQ - NO CHANGE IN
FOOTPRINT
ALSO PROPANE STOVE AND LINES
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: '1/4i
UFFER: N/A
Footing: N/A
Foundation: N r�
Stormwater FINAL Approval:
Underground Plumbing: kVA-
_-U FZE-'C(2, I N
-ShearAh la/A L.L I N\I S,
ATTIL. l IVS
Plumbing: NI
Propane Tank/ Lines: € T4 A UAr I,JA)I1 O)9c0r/j04:. reg TV Pu►l ic,f,4.0(.( Z,Ioo
Insulation: -ca._
Sheetrock:
Septic Sytem Final Approval (If not on sewer):
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval:,, 6v06 I
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YE, `' IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455. CALL 2.4 17L ' IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.r i. 1:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
I:\F_BLD_Perm it_B u i ld ng.rpt 10/29/1999
al,
c0�, JEFF ON COUNTY •
' DEPARENT OF COMMUNITY DEVELOPMENT
ti � I-4 I^
621 Sheridan Street• Port Townsend •Washington 98368 n 0 C l►o nOl I
360/379-4450 • 360/379-4451 Fax
O� www.co.jefferson.wa.us/commdevelopment ��0.�yr 1 .`-
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Master Permit Application MLA: NO 1-1 Z 4
Project Description(include separate sheets as necessary): Cxi'¢1V/550--- OF t'S i Aer Sruoio
_ ' 1 eci577iv(I 6.4l e2 -
Tax Parcel 9w —/co -ail Property
Number: �,�/
Size: (acr quare feet)
Site Address and/or Directions to Property: O / ,. 2pzir
Property Owner(s)of Record: /Js.) ( 7ka„ J JAI am j
Telephone:,3&)-3 -90/t] Fax: _ email:..c?!/er e Oyt/•
cosi
Mailing Address: /ZVQ j,✓, Sfvt.tS A.IW 1436 j% ,Eex.) g 368
Applicant/Agent(if different from owner): (t. �l40thJS p A.) 7Cw
Telephone: 385-2J '1 ' Fax:
email:
Mailing Address: ///0 &i t-c-o r.J ie je - /3,c,,/A, A, 9e‘g
What kind of Permit?(Check each, t[�, O M It;,
Building r-, 'tom h, l5 Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit Conditional Use[C(a),C(d),or C]**
❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification
❑ Garage Attached/Detached DEC 2 9 2005 0 Special Use(Essential Public Facilities)**
❑Manufactured Home ❑ Boundary Line Adjustment
❑Modular ❑ Short Plat**
❑Commercial* ❑ Binding Site Plan**
hange of Use ❑ Long Plat**
❑Address ❑ Road Approach [I Planned Rural Residential Development(PRRDYAmendments**
❑ 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 C/y/ , to act as my agent in matters relating to this applicltion for permit(s).
-
OWNER SIGNATUR = - __ Date: Z(i / ,EC_ GS
By signing this application form /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 lattomey'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 perm'
I further agree to provide arrs,ss and right of entry to Jefferson County and its employees,representatives or agents for the sot- purpose of application
review and any .Access right entry to this property shall be requested and shall occur only du ng regular business
hours. /
Signature* Date: Z 6 9g OS--
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or mor: threatened or
endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal la known as the
"Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be unde -ken 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 .pecies regarding your
action(s)even if ire in pliance with the Jeff my development code.The Applicant acknowledges that he,she ► it holds individual
and non enable 15erin lying with the ESA. The Applicant has read this disdai and sig sad dates it below.
Signature: _
r �-.. Date:
G:\PermitCenter\FO S\DRD FORMS\Master Permit Application 7-8-04.doc
illOWNER BUILDER STATEMENT a
The signer of this stat hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they wif be a ng the res sibtiity of the ctor for the proposed project.
Signatur Date: 26 17-c_- 0 ----
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTORS LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: pun Shoreline: Type of Sewage Disposal:
❑ New n-Wood Existing: ❑ Sewer
❑ Addition 0 Steel Proposed: Bank ❑ Community System
$ Alteration/Remodel ❑ Concrete Total: Height: ,tt Individual Syysstem
❑ Repair ❑ Masonry SEP Permit#ePOZ-0O0,51?
❑ Demolition ❑ Other: Bedrooms: h p 0,e___ Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
T of Heat: Proposed: ❑ Public
fef Li i Total: Name of System:
ahoe-fizzaar cocaAIY
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: 7.50 Q I sP.)ci
Heat Stove 0 Cook Stove ❑ Woodstove ❑ Fireplace Insert o Hot Water Tank ❑ Pellet Stove ❑ 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 OfficeUso Only
Current Proposed ;. , .• �1( ti`
Main Floor C ity" 'tevfe0 1,iT. ,
2 Floor Etail i>ii in -- 771
31°Floor kko, IL,tf, .4v t 7
Mezzanine: Plan Check feel 5 .`w
DEC 29 200 (0A
Heated Basement , State Surcharge fee, 0
sr
Unheated Basement ',POW" ' w i `r;, =,..;;.-
Other Unheated ., , o teliu
' i t f
Garage/Carport cowv�YZ� ? �n r ';
Decks • '''. j 4. ';r
., eipt
Ctocck. umber _ '.
Other It/�:116C,1C`I�Ip1'IIhN'r , e ikt'-):•., T.,
ESTIMATED COST(REQUIRED) Dates ("
•Fair market value of all labor and materials foundation to finish
/YI Q Q Initials:
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COUNTY COPY
JEFFERSON COUNTY DCD
BUILDING PLAN REVIEW
APPROVED AS SUBMITTED
O APPROVED AS NOTED
0 REJECTED
Date _()LDLI Reviewer
NOTICE: Plans are approved excepting
any errors or omissions. All work must
pass inspection in conformance with
ell applicable codes and regulations.
Contact the Building Department
at 379- 4450 prior to making changes
or revisions to the approved plans
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DATE:
DEC 2 9 2005 I
APPROVED By:
DRAWN By
REVISED
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