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Home My WebLink AboutBLD2006-00001 • BUILDING PERMIT ~ ` Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00001 Received Date 01/3/2006 SITE ADDRESS: 56 LEIGHBROOK LN Issue Date 02/24/2006 PORT LUDLOW, 98365 APPLICANT: MARY 0 SMITH PHONE: 360-437-0291 56 LEIGHBROOK LN PORT LUDLOW WA 983658745 SUBDIVISION: TIMBERTON VILLAGE PHASE I Block: ? Lot: 21 PARCEL NUMBER: 998500021 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE PROJECT DESCRIPTION: UNHTD BASEMENT TO HTD LIVING SPACE-NO CHG IN FOOTPRINT CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 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 Final Approval: Final/Occupancy Approval: Q,1‹ -Cot- 444.1 64/a4 Q, 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 I:\F_BLD_Permit_Buildng.rpt 10/29/1999 • BLD06-00001 OUILDING PERMIT APPLICATN Review Ty pe: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00001 Received Date: 1/3/2006 SITE ADDRESS: 56 LEIGHBROOK LN PORT LUDLOW, 98365 OWNER: MARY 0 SMITH PHONE: 360-437-0291 56 LEIGHBROOK LN PORT LUDLOW WA 983658745 TIMBERTON VILLAGE PHASE I SUBDIVISION: Block: ? Lot: 21 PARCEL NUMBER: 998500021 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION UNHTD BASEMENT TO HTD LIVING SPACE-NO CHG IN FOOTPRINT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 0 VALUATION 77,082.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: 860 HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CMY WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: 2 Exist: 3 Prop: 1 Prop: 2 Total: 3 Total: 5 Routing Date: SSE t/y/vc Type Amount Paid By: Date: Receipt: pproved/Date P Permit $839.75 LYK 01/03/06 78852 <1 h _ ' J ' Plan Check $545.84 LYK 01/03/06 78852 State Building Code $4.50 LYK 01/03/06 78852 FEB 2006 Total: $1,390.09 Mignon Comay fr'Gariaiilvt • POSTMOA-af:6. I 233116 4,4,6 1V Cps n. JEFFERSON COUNTY / DEPARTMENT OF COMMUNITY DEVELOPMENT ' 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment �3'IN Master Permit Application MLA: Project Description(include separate sheets as necessary): Tax Parcel r rr 2 1 ,T'MM k Xroperty M _ /_ Number: t' �'u�� Size: rf6'� �Ioo (acres/square feet) Site Address and/or Directions to Property: gb t•�l c flue I par l.'W/ (IA Property Ownpr(s)of Record: hK • SM ) - - 4 Fax: email: Telephone: � �j' Z�I Mailing Address: Let, R � 1 e}4T !+u�-dol/ Applicant/Agent(if different from owner): LI 5711 14'C4 Telephone: 3V)•-is,1• Ivi j w Fax:,•• .o• .- d , • email: c -1T c1 Mailing Address: �1GI S AP.;*i T T —fte i tt-, 1'1Ni9Ati-c> t C oM What kind of Permit?(Check each box that applies) Building ❑ 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 ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat*" ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑ Address i Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** I Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** Stormwater Management ❑ Shoreline Management Substantial Development** I I Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance 1 Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment 1 Wireless Telecommunication* ❑ Jefferson County Shoreline Master Program Amendment 1 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: tya,.,./� -J✓ DESIGNATION OF AGENT I hereby designate ViI1'L1k 1-1 rit " to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date:ad-4 . 17� 2 5 By signing this application form,the own r/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 say-,''demnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which I'!, -n way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree t. , • •- :• ess and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any i : in pections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. ''f •05' Signature: i i I Date: N VV "V - The action or actions Applicant w I undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species :,r• could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangere• •. - .t"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has b- :: wl not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)ev- \� 1 •mpliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trap :• 4 ility for adhering to and complying with the ESA. The Applicant has read this isc aimer and sins and dates it below. Signature: ` `* �� Date: • ) 'Q S C:\Documents and Settings\mochil\ esktop\Master Permit Application 7-8-04.doc S S 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 theresponsibility ofof ie Gener I Contractor for the proposed pro•ets.ct. Signature: % /G Cll Date: �J / I /� --' GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: 11•,49600 I l�, oiV lit awl, PHONE (�60)4),//�''0�y/�PAX::((l,l I.,A)i1�� ,'7 bat- MAILING ADDRESS: )14 S+,p.�.tl n N` , , u A � 712$,,u 2. EMAIL /'�1Ai t''} 1,`(: I I`s/A1'�9T71NG/0rni`,i V Project Type: Frame Type: / Bathrooms: ll Shoreline:e Type of Sewage Disposal: ❑ New X Wood Existing: 1 I Sewer ❑ Addition ❑ Steel Proposed: 2 Bank `!`Community System `d Alteration/Remodel ❑ Concrete Total: r Height: 1 1 Individual System s Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: 1 Private well 1 Two Party Type of Heat: Proposed: • 1tC Public et-t rrt t�, Total: T 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 Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove i Woodstove i Fireplace Insert I Hot Water Tank i Pellet Stove i 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: 15 zu 2Nu Floor Base fee: ` 3fd Floor dditional Section: Mezzanine: / V Ian Check fee: J i-t ‘ ' gil Heated Basement :t::::::e: Unheated Basements(076 Other Unheated �, 911/Rd Approach fee: Garage/Carport TOTAL: $ 2 g/�}. cy Decks 3 ,J<v Receipt Number: 1885�� Other Cash/Check Number: I arn ESTIMATED COST(REQUIRED) Date: �1 .Fair market value of all labor and materials foundation to finish I 310 2CIr7 Initials: C:ADocuments and Settings\mochil\Desktop\Master Permit Application 7-8-04.doc I. A - 11 -I I