HomeMy WebLinkAboutBLD2006-00147 • •
40
BUILDING PERMIT APPLICATION MReview
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00147 Received Date: 3/30/2006
SITE ADDRESS: 40 HIDDEN TRAILS RD
PORT TOWNSEND, 98368
OWNER: JAMIE E KOZELISKY PHONE: 360-385-3215
KATHERINE E KOZELISKY
1112 S JACOB MILLER RD
PORT TOWNSEND WA 983689211
SUBDIVISION: Block: Lot: T 13
PARCEL NUMBER: 001084005 Section: 8 Township: 30 N Range: 01 W
CONTRACTOR: KOZELISKY'S HOME SERVICE INC PHONE: (360)385-3215
1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
Contractor's License KOZELHS027C3 Expires 1/6/2007
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW GARAGE ATT TO MH
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 10,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: 396 SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date: 2 r
Type Amount Paid By: Date: Y Receipt: Ap atjV F r
Permit $181.25 LYK 03/30/06 79300
Plan Check $117.81 LYK 03/30/06 79300 APR 2006
State Building Code $4.50 LYK 03/30/06 79300 Jefferson County Plannin•
Total: $303.56 & Building Department
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•
• BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00147 Received Date 03/30/2006
SITE ADDRESS: 40 HIDDEN TRAILS RD Issue Date 04/19/2006
PORT TOWNSEND, 98368
APPLICANT: JAMIE E KOZELISKY PHONE: 360-385-3215
KATHERINE E KOZELISKY
1112 S JACOB MILLER RD
PORT TOWNSEND WA 983689211
SUBDIVISION: Block: Lot: T 13
PARCEL NUMBER: 001084005 Section: 8 Township: 30 N Range: 01 W
CONTRACTOR: KOZELISKY'S HOME SERVICE INC PHONE: (360)385-3215
1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
Contractor's License: KOZELHS027C3 Expires: 1/6/2007
PROJECT DESCRIPTION: NEW GARAGE ATT TO MH
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS:
UFFER:
Footing: 5-i-g . L{a� T)G
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: 9—/'54o4
HEALTH DEPARTMENT ND 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 CASE A BLD06-00147
1.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
2.) The project shall adhere to the Best Management Practices (BMPs) 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.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) 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).
5.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
6.) The building height is not to exceed 35 feet.
7.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
8.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
9.) Minimum setbacks from Hidden Trails Road and South Jacob Miller rights-of-ways shall
be 20 feet. Minimum side and rear yard setbacks shall be 5 feet.
I:\F_B LD_Perm it_Bu ildng.rpt 10/29/1999
• OWNER BUILDER STATEMENT •
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that Ittregneeiseffiredtoritteetoris they will be assuming the responsibility of the General Contractor for the proposed project. and that
Signature: t sL �- -- Q�-�-, Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER PHONE: FAX
ICozE L_-S K� 's HU r S�R,-)L c.F Glv C)) `-�S-3 zlS ( ) S•9' Q_
MAILING ADDRESS: I I I'L S• _I p-C Jg inn-c I(r-t_ AO EMAIL:
CONTRACTORS LICENSE �V/�'�^ WAINS
NUMBER: F L"�-'E L�-C O2 -3-C ?j NUMBER Q QQ - (e
ARCHITECT/ENGINEER: PHONE ( ) FAX( )
MAILING ADDRESS: EMAIL
P❑ Neectt Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
X Wood Existing: - 0 Sewer
> Addition ❑ Steel Proposed: O_ Ba ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: _ Hei t: Jif"ndividual System
❑ Repair 0 Masonry SEP Permit# CIO , C
0 Demolition ❑ Other: Bedrooms: Water Supply:
Existing: _ Se ❑ Private well CITwo Party
Type of Heat: Proposed: ubiic
UP I-f F-, -TED Total: - F Name of System:�ENNE L ^sE'
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) Cuni'ent Proposed
IBC Occupancy: IBC Type of construction: Wi i you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance installation permit,mark all items below that apply:
0 Underground Tank 0 Above ground Tank Size Propane Tank:
D Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert 0 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 as property lines,buildings and septic system components,
including the reserve area.
Square Footage •For'OfficeU)se Pally T ry `� ", z,
Current Proposed •• �r ---M° ` ` w ti,
Main Floor y _ •f , i l ,fife i, 4'
2ra'Floor - ..' . : ,
3f0 Floor *011;
Nr (r.
3..
Mezzanine:
Heated Basement '` g Eae.: . ' ; r °=t�-
Unheated Basement , t
Other Unheated $1°' Apt tt fe 4 "ai.- ' {; �
Garage/Carport '
3�6 ,333
,1 T(
Decks �.:, _..� ..,,,
..� .:'-.r ak
xJ .-..
Other \ " t r fi 4.t. "y
,r�iElshiChOC` tg11
it .. r�l
ESTIMATED COST(REQUIRED)—.,�� r '' ~ ^^ t; ,.I .-' +' r�?
.Fair market value of all labor and mat -�O . '"foundation to finish fff
7 icip ip o 1"-12-'- '... - :. . _ , t t . ,
i ;i:��i�Y
G:\PermitCenter\FORMS\DRD FORMS\ er Permit Application 7-8-04.doc
SON L, 40
�� �� JEFF ON COUNTY
' 1.
A DEP ENT OF COMMUNITY DEVELOPMENT
' k4 `4 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450. 360/379-4451 Fax
4. �0 www.co.jefferson.wa.us/commde rr� t 2006
lk%
INGMaster Permit Application J MLA" (,(0— (40
..N CLUPMEN1
Project Description(include separate sheets as necessary):
A-T Taz$ ,8 x "" CAA- -r-co P. HO t ( X t S-7i A.,-(„)
Tax Parcel Property
Number: CO ( C%k -f C' Cr Size: S R-C � (acres/square feet)
I 1' N
L
Site Address and/or Directions to Property: O 1-}.-A s -112 ,4-I(-,S j? ) of S , JJ-cot v-I,i 1.0._
Property Owner(s)of Record: N t✓t'1 F .o Z C Lts le. y J
Telephone: (.o cam-3 e S'- 3 Z i t Fax: Sir vr-t,- email: 1G1)Z r n)C _ C A-b(e S Pc
Mailing Address: (I I Z S. _J A-c J> Iv t r u.L-a d-3 be i"To-..^*SRC-D t,c)p, e'j k 3 tie?. , C o.'-
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
8-3- wilding ❑Variance(Minor,Major or Reasonable Economic Use)
0 Demolition Permit ❑Conditional Use[C(a),C(d),or Cj**
❑Single Fa;:' 0 Discretionary"D"or Unnamed Use Classification
Et-Garage Attached •lathed 0 Special Use(Essential Public Facilities)**
❑Manufa« . . -• - 0 Boundary Line Adjustment
❑Modular 0 Short Plat**
❑Commercial* 0 Binding Site Plan**
❑Change of Use 0 Long Plat**
0 Address 0 Road Approach ❑ Planned Rural Residential Development(PRRDyAmendments**
0 Propane 0 Plat Vacaton/Alteration**
❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management ❑ Shoreline Management Substantial Development**
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
0 Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
0 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 ifs 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 attorneys 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 orof
review and any required later inspections.Access and rightof en to thisagents for the sole purposeegul business sstion
try property shall be requested and shall occur only during regular
Signature:4l _t (t) - Date: —G —
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 ES/ y ' sal,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 velopment code.The Applicant acknowledges that he,she or it holds individual
and non-transf . ' ty for a herring to and complying with the ESA The
,/� � Applicant has read this disclaimer and si and dates it below.
Signature: "``-�- Date:Z� —Ot
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc
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