HomeMy WebLinkAboutBLD2006-00061 BUILDING PERMIT APPLICAITN BL Revviewiew T Tyy061
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00061 Received Date: 2/13/2006
SITE ADDRESS: 152 SOARING EAGLE RD
PORT LUDLOW, 98365
OWNER: JAMES M BETTNER PHONE: 360-437-7704
MARY A BETTNER ,
152 SOARING EAGLE RD
PORT LUDLOW WA 983658231 CEDARHOLM VILLA
SUBDIVISION: Block: Lot: 34
PARCEL NUMBER: 942300023 Section: 19 Township: 27 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr REMODEL EXIST UNFINISHED BASEMENT TO HTD LIVING SPACE -
REMOVE 1 BDRM ON MAIN LEVEL FOR STAIRWELL NO MLA 9.'/ 1o1
REQ + 1WA) - ?apQ�c�t1o� X�st;itir� D Pc� itop t .11
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT VALUATION 'LzG,000.80. 134 MAIN:
�ADD'L: HEAT TYPE: PRO
CODE EDITION: 2003 HEAT BASE: 1,220 HEAT TYPE: RAD
OCCUPANCY: R-3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE:
DECK: 3a0 SETBACK:
BANK HEIGHT: 200
SEWAGE DISPOSAL: ALT
WATER SYSTEM: LUDLOW
BEDROOMS: BATHROOMS:
Exist: 2 Exist: 2
Prop: Prop: 2
Total: 2 Total: 4
Routing Date: a l/7/C/ �^
Type Amount Paid Bv: Date: Receipt: K A pORME
Permit $1,049.75 LYK 02/13/06 78992
Plan Check $682.34 LYK 02/13/06 78992
State Building Code $4.50 LYK 02/13/06 7E992 MAR 2t 2006
Potable Water Application $55.00 LYK 02/13/06 78992 Jefferson County Planning
Total: $1,791.59 &Building Department
C9-QPtti �-
•
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00061 Received Date 02/13/2006
SITE ADDRESS: 152 SOARING EAGLE RD Issue Date 03/24/2006
PORT LUDLOW, 98365
APPLICANT: JAMES M BETTNER PHONE: 360-437-7704
MARY A BETTNER
152 SOARING EAGLE RD
PORT LUDLOW WA 983658231
SUBDIVISION: CEDARHOLM VILLA Block: Lot: 34
PARCEL NUMBER: 942300023 Section: 19 Township: 27 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
•
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PROJECT DESCRIPTION: REMODEL EXIST UNFINISHED BASEMENT TO HTD LIVING SPACE
REMOVE 1 BDRM ON MAIN LEVEL FOR STAIRWELL NO MLA
REQ
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
UFFER:
Footing: PELL Focnw45 APPDAY LL 8/17fr?
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing: Laic c/J0)4- (-' t-Qi ?Eck Ft lot dk /OM
Plumbing:40'40)c l`1 ? O7
Propane Tan Lines:
Insulation: 4 LLs Dk Z. Z 7
Sheetrock:e:37‹ .1/i
Septic Sytem Final A proval MUST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: ✓ 7- 17-10
HEALTH DEPARTMENT D 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
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_�,cc�.¢goN cue,. JEFFEROCOUNTY _ « '
' DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368 F E B 1 3 2006
360/379-4450 • 360/379-4451 Fax
-- . .
gs No 9 www.co.jefferson.wa.us/commdevelopment J
Master Permit Application MLA: No I'Y1,L, 1ENf
Project Description (include separate sheets as necessary):
iVeiVOPEZ, 04/c/N/51/EO BASE/ENT 7a /A4: (11)6 / ea ADDS), /FA Al/LV is'oo, Z 64Th/S —
REMOVE /E3 AV/MOOS/ 'A J AM iN L£V 1 Prop rt r m ABLE '9 5 TA /a LL
Tax Parcel Number: 99Z300023 Size: / /tags. (acres/square feet)
Site Address and/or Directions to Property: /52 Soitebv6 Es ,LE ,e,o ET LttOLOW, I.)n 983b$
Property Owner(s)of Record: -J 41Es 4 I /'1gey 'INA/ ,Q ETTN FA;
Telephone: 360• 937. 7704 Fax: .360. •937. 77O-1 email: 1M6aLinered/recway,coM
Mailing Address: /S2 SoAR/N6 EAGLE ROAD, Ar LULLow, t 'fl 983g5
Applicant/Agent(if different from owner): ^/jA
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
Building ❑Variance(Minor, Major or Reasonable Economic Use)
u 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**
0 Commercial* ❑ Binding Site Plan**
❑ Change of Use ❑ Long Plat**
0 Address i 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
0 Temporary Use . 'i•` ,0 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 attorney'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 property shall be requested and shall occur only during regular business
hours.
Signature: C?11/6.l r f'fiiJ•�' /1Q� Date: /y D 6
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 tD 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: ji,; St,�,;, Date: /-/9•Q41
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
111.
BUILDER STATEMENT all
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: nt/�J Date: f-7 9-0,&
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: Shoreline: Type of Sewage Disposal:
❑ New id"Wood Existing: r ❑ Sewer
Cl Addition ❑ Steel Proposed: Bank Height: ❑ Community System
Iteration/Remodel ❑ Concrete Total: ---/ individual System
❑ Repair H Masonry 200 SEP Permit# 00-270
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: -- Setback: Private well ❑ Two Party
Type of Heat: Proposed: _ 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 I i Above ground Tank Size of Propane Tank:
r ❑ Heat Stove ❑ Cook Stove ❑ Woodstove X Fireplace Insert ❑ Hot Water Tank Li Pellet Stove ❑ Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No &'--)uS r'-vc. Soo 6-4L /3t'2 fL-7J 771-tiK
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. 'V•' t-4
Square Footage Current Proposed For Office Use Only Amount-
Main Floor Heated EH Bld App Review:
/087 `19
2nd Floor Heated Consistency Review:
Other Heated Base fee: al aQ� •; 41� I 0q9 15
Mezzanine Additional Section:
Heated Basement I�,3gg " an Check fee:
60 /iohi ' (S� 31
Unheated Basement Z/ --- State Surcharge fee:
tt fC, TL4 /28" 1
Other Unheated Pot Water Review fee: O� • '�
CIO
Garage/Carport SUBTOTAL
Decks Q6o 911/Rd Approach fee: E xriln5 -
nr1ec Other 6a0 1)MR: TOTAL: $ I f �'/. 51
W�YI `o a O�.J ,' " _ Receipt Number: 9 299 a
011V91
Cash/Check Number: 1 ---k---N
ESTIMATED COST(REQUIRED) Date: C
•Fair market value of all labor and materials foundation to finish , C I 19 C) as
Initials:
t25� � ..1ELOPME T
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc