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Home My WebLink AboutBLD2006-00104 • a BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00104 Received Date 03/8/2006 SITE ADDRESS: 9526 OAK BAY RD SUITE 300 Issue Date 03/21/2006 PORT LUDLOW, 98365 APPLICANT: NINETY-FOUR OAK BAY PARTNERSHI PHONE: 360-437-2400 % LOOMIS PROPERTIES 9500 OAK BAY RD PORT LUDLOW WA 983659204 SUBDIVISION: ALBERT LOOMIS IV SHORT PLAT Block: Lot: 3 PARCEL NUMBER: 821171009 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: DANIEL COOPER CONSTRUCTION PHONE: 360-316-9676 301 PIONEER DR PORT LUDLOW WA 98365 Contractor's License: DANIECC9520M Expires: 9/14/2007 PROJECT DESCRIPTION: REPAIR DOOR&WINDOW 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 MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: —4i(` -cjeQ,l 3 e b6 HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQ IRE PRICfR 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 W ILDING PERMIT APPLICA BLD06-00104N Review Type: i Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00104 Received Date: 3/8/2006 SITE ADDRESS: 9526 OAK BAY RD SUITE 300 PORT LUDLOW, 98365 OWNER: NINETY-FOUR OAK BAY PARTNERSHI PHONE: 360-437-2400 LOOMIS PROPERTIES 9500 OAK BAY RD PORT LUDLOW WA 983659204 ALBERT LOOMIS IV SHORT PLAT SUBDIVISION: Block: Lot: 3 PARCEL NUMBER: 821171009 Section: 17 Township: 28 N Range: 01 E CONTRACTOR: DANIEL COOPER CONSTRUCTION PHONE: 360-316-9676 301 PIONEER DR PORT LUDLOW WA 98365 Contractor's License DANIECC95:20M Expires 9/14/2007 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI REPAIR DOOR &WINDOW TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP VALUATION MAIN: CODE EDITION: 2003 ADD'L: HEAT TYPE: OCCUPANCY: R-3 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: „, 1 f vc Type Amount Paid By: Date: Receipt: ApAppive /Date Permit $139.25 LYK 03/08/06 79146 1L_�1�71 OE i Plan Check $90.52 LYK 03/08/06 79146 V r State Building Code $4.50 LYK 03/08/06 79146 MARa 12006 Total: $234.27 Jefferson County Planninc &Building Department C'82Q.A4.�r\ .&Q. .L, -„,,J, N JEFFERSON 11UNTY 4,4(7O4rZIN DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Part Townsend •Washington 98368 360/379.4450 • 360/379-4451 Fax „q - rn-1' 4 " www.co.jefferson.wa.us/commdevelopment N Q C� r Master Permit Application MLA: NUS f _e (D t D Project Description(include separate sheets as necessary,: L I I)U i ll L U U I I Y 0 .1 '� -/ /-/%e/Y T ��'ll/2.9_, 4/7/Y . f a / L. 0 ' . $21 — 1"1 1 — O Property '�// . Tax Parcel Number: t — Size, %4 a CA L- (acres/square feet) Site Address and/or Directions to Property: S2-to O& ._Ti ''Oac( /Po r - tA) - C Property Owner(s)of Record: At .D i1ti S� �ro�( fi r c/ .cr 00.k 0. eF Telephone: (.3(.t 137.- 240O Fax: (oo)4'1- oz10 email: iPrtt@_t (fir n�"+ Mailing Address: _ 460O O .... '�004/sort- L 01040 I ltl-Qt -!g3t0c. .__ ._...-.___ AppllcantlAgent(If different from owner): �0.r�1CPO )t r _, _ Telephone: (33(0 0 3 t(c -' 11(0 Fax: (3b0) 431 e 3 t'7 email: moue cOo Per(,Cri recic-Oh-r Mailing Address: 20 l ttoi.r Delve,%-P r* LAdloso WA...g G S'. What kind of Permit?(Check each box that applies) "itl Building 0 Variance(Minor,Major or Reasonable Economic Use) 0 Demolition Permit ❑ Conditional Use[C(a),C(d),or Cj** ❑Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑Garage Attached i Detached 0 Special Use(Essential Public Facilities)"* ❑ Manufactured Home ❑ Boundary Line Adjustment ❑Modular ❑ Short Plat"* RS.Commerclai* ❑ Binding Site Plan** • ❑Change of Use ❑ Long Plat" C Address• ❑ Road Approach a Planned Rural Residential Development(PRRD)/Amendments"* ❑ Propane 0 Plat Vacation/Alteration"* 0 Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions"" 0 Stormwater Management ❑Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance 0 Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑ Jefferson County Shoreline Master Program Amendment 0 Forest Practices Act/Release of SIX-Year Moratorium _ *May require a Pre-Application Conlferen ce ""Requires a Pre-AppllcaBon Confe►ence Please Identify any other local,state or federal permits required for this proposal, if known: T_ DESIGNATION OF AGENT — I hereby designate bQ,jkAC CP4?C ,,,, to,scras my agent in matters relating to this application for permit(s). 04 OWNER SIGNATURES --'•,/ -- ire i:% [Sate:......._..[_,.,. .. 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 or agents for the sole purpose of application review and any required later inspections. ccass and riqht of entry toproperty shall be requested and shall occur only during regular business ::ure; ��C- /•^�G%/ <j Date: 3(� �� 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 ha,she or it holds individual and non- transferable responsibility toradhering to and complying with the ESA. The Applicant has read this disclaimer and s gns and dates it below. Signature: . j ;.� , �, L� Date: C:\PeoracCenterr\FO17MS\Da.b FORMS\Master Permit Application 12-3O-O.f.doc ZB 39\ d (Iact 03 .id3I' T5bt'6LEESE 9 -TT 909Z/EZ/Z9 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: PHONE: ; , FAX: 4/I7/i (Oe, ' (Tars1'�' '( /7 ,V (.,i' (i)2/a:.96 74 (,W) 5`--'W-G' '/7 MAILING ADDRESS; 3( ,/G / /l� -F,e, ,e 70.'7`LG;afit EMAIL:___4'_l�iA,G�i4 j0 , e& -.__ CONTRACTOR'S LICENSE /�/ �� 14�WAINS NUMBER' 0 lQ 4 /e C( '�� V1--_ - NUMBER ARCHITECT/ENGINEER: So/ p/e/V �� / 9,C7 ' OI PHONE ( ) FAX:( ) MAILING ADDRESS: LJ i/Yf/ EMAIL Project Type; Frame Type: Bathrooms: Shoreline; Type of Siwatie tyfs or;a ii— ❑ New P-"Oood Existing: 0 Sewer O Addition ❑ Steel Proposed: Bank Height: 0 Community System ❑ _Alteration/Remodel Cl Concrete Total: ❑ Individual System Tr" Repair 0 Masonry - SEP Pemiit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: 0 Private well 0 Two Party Type of Heat: Proposed: 0 Public Total: Name of System: If this Is a Commercial Protect 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 ail items below that apply: ❑ Underground Tank 0 Above ground Tank Size of Propane Tank: _ O Heat Stove D Cook Stove 0 Woodstove 0 Fireplace insert C1 Hot Water Tank 0 Pellet Stove 0 Other is this appliance being installed in a Manufactured I Mobile Home? Yes I No When applying fior 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. A IPA , F V ,, � } `4 �i ��[l� 1 i1t11 Rd} B' p. , 1' � „h �'r� r °,.� ��Q•}Qf'� r �' r+t `r14�o �' ;�I �```'�r�l j!t'1 ° �?i�r 4��i R��'I f i7` ,�}{%��' ''j Square Footage Current Proposed V B� ' dzt�, frl' i i',. . !i'EP ,LAi�In'...!;._-.S 5....}M, : 1 .��.'..1f.�1s..d,;.it .L,..il'.l6 t, Main Floor Heated R 7`" f ,i tiY EH Bid App Review: r { '2 Floor Heated ` , ,.i; r,�o,',' , Consistency Review: 'ty ,,ti . Other Heated ,,, r Base fee: Mezzanine -` `•'' " ,it- w ' `l kY.' Additional Section: - ,. ;It''fiitit.°'.i.kd�. V,rv1' laP.�.,'.Mop,''Y IE(,I . .. _ --•- Heated Basement ,, t i„M,l;,".',c�'t'I`�' Plan Check fee: D r oZ S Surcharge f Unheated Basement ;,.,�.Iifiu"'`;�', ,�,�;:1, fate urc area ee: G Other Unheated "• ' 3 h r,; Pot Water Review fee: 1 r.1�, tiI a• rage/CarpOrt E ,,'�"�kI ra"i , SUBTOTAL 4----11 Decks ._ ;itstA;' 1',;i,, 911/Rd Approach fee: Other n<< TOTAL: $ , a / 1�iii �i;:xp lr.� _ j,'‘^.,,',t i'+'•��i;,;ty' Receipt Number I 1l,r 5 1` _29 u'° ,.�� , ', , �, Cash/Check Number. fre ' ESTIMA1°ED COST(REQUIRED) . �. Date: ') Jv t� k .Fair arket value of ail labor and materials foundation to flnlsh b! Initiate` / .. — G:\PermitCenterVO1tMS\DRD FORMS\Master Permit Application 12-30-03,doc 60 39Vd Gal OD .Jar Z9tt5LE09E 9Z:it 900Z/EZ/Z0 iJ ti 3 � J Y i O m w J F- P: :H 0 z o z ¢ a w a w C z O v a �1