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Home My WebLink AboutBLD2006-00219 06- IUILDING PERMIT APPLICATION MRL Review Ty 209 ype Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00219 Received Date: 4/28/2006 SITE ADDRESS: 345 BLUEBERRY HILL DR QUILCENE, 98376 OWNER: HORIZON HOLDINGS PHONE: 360-796-4234 PO BOX 1220 CAPT HOOK HI 96704 BLUEBERRY HILL LARGE LOT SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 601105001 Section: 10 Township: 26 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr NEW POLE BARN - NO HEAT, NO PLMB TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 17,388.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: 1,080 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date C//f(yo Type Amount Paid By: Date: Receipt: A P at E r Permit $293.25 LYK 04/28/06 80995 V Plan Check $190.61 LYK 04/28/06 80995 MAY la 2006 State Building Code $4.50 LYK 04/28/06 80995 Jefferson County Planning Total: $488.36 & Building Department C1 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00219 Received Date 04/28/2006 SITE ADDRESS: 345 BLUEBERRY HILL DR Issue Date 05/12/2006 QUILCENE, 98376 APPLICANT: HORIZON HOLDINGS PHONE: 360-796-4234 PO BOX 1220 CAPT HOOK HI 96704 SUBDIVISION: BLUEBERRY HILL LARGE LOT Block: Lot: 1 PARCEL NUMBER: 601105001 Section: 10 Township: 26 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NEW POLE BARN - NO HEAT, NO PLMB 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: rY✓ oft1D-(t r: Plumbing: I 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: �t°�_ P0.0611107 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 SPECIAL CONDITIONS APPLY - SEE REVERSE • SPECIAL CONDITIONS FOR CASE t BLD06-00219 1.) A setback of 100-feet, measured perpendicularly from the wetland edge, shall be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its buffer is allowed. 2.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall contain the following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation." 3.) A permanent physical separation along the upland boundary of the wetland buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 4.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through #12 of the Department of Ecology's Stormwater Management Manual for Western Washington 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. 5.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 6.) 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). 7.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 8.) Blueberry Hill Drive setback is 20 ft, rear setback is 150 ft from Coyle Road, side setbacks should be no less than 5 ft and the sum of the side setbacks should be at least 15 ft. 9.) The building height is not to exceed 35 feet. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 * ON C • •. _._. --- o JEFFERSON COUNTY n - ti h ' s.- DEPARTMENT OF COMMUNITY DEVELOPMENT ._. • 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax APR 2 8 2006 4.14,. K,O" www.co.jefferson.wa.us/commdevelopment Master Permit Application __MLA: �(0 act.. Project Description (include separate sheets as necessary): Pc try 3 A- rt.NN! 4-id I7/ 19-%—/1)(-) ,e__z_fin A / 111(,) / t) Property 6 Tax Parcel Number: 0 ) —1 0 c ^ 0 I Size: S AL (acres/square feet) Site Address and/or Directions to Property: 3 L{ I- 3 L. u is 13 -rz y l-f t cc., b 3L Property Owner(s)of Record: c' iL t N 4-4 t LP /hr G Telephone: C( L — (( 2.--3 (I Fax: email: SA41-0.0I � GwtglL, Mailing Address: p.0 O. 3-ty x 12'2 0 C A p f CDt) iL / 14 / ? G D SF CDeti Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) Building ❑Variance(Minor,Major or Reasonable Economic Use) n Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification XGarage Attached Detach ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address Cl 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 ❑ 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: v DESIGNATION OF AGENT I hereby designate /1 EA to act as my a ntt in matters relating to this application for permit(s). OWNER SIGNATURE `-'as ' " 7 t4 te: 47 d 6 t 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 prov.de access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any requ.ed later inspections.Access ht of entry to this property shall be requested and shall occur only during regular business hours. n Signature: `-A---� , C—S r Pk&r Date: 2- Lf a' GC 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 he,she or it holds individual and non- transferable res onsibility for .dhering to and co plying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: -a Date: 1 0- VO6 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc ! e BUILDER STATEMENT The signer of this statement does hereby certify at they are the Owners of the parcel referenced herein,that they are not licensed contractors and cat they will be ass mi the responsibility of the neral Contractor for the proposed project. Signature: Date: it.-I -(AM- a Co GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( `) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: r New Wood Existing: ❑ Sewer ❑ Addition Steel Proposed: Ban eight: I i Community System ❑ Alteration/Remodel 0 Concrete Total: CI System ❑ Repair EL Masonry SEP Permit# 0((./'^ O Demolition f 1 Other: Bedrooms: Water Supply: Existing: S back: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ 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 [] Above ground Tank Size of Propane Tank: [i Heat Stove I Cook Stove [I Woodstove I Fireplace Insert 11 Hot Water Tank I I Pellet Stove Ci 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: (0c pQ 2"°Floor Heated Consistency Review: { 53 , !UO Other Heated Base fee: 293 .45 Mezzanine Additional Section: r9( 1ry Heated Basement Plan Check fee: O ,7CA Unheated Basement State Surcharge fee: i"� O y • 5 Other Unheated Pot Water Review fee: Garage/Carport JO�'0 ' t bC6� SUBTOTAL —1 dtp • 3 Decks \ 9 /Rd Approach fee: Other ;-TOTfi : $ 701e Receipt Number: N �� Cash/Check Number: ESTIMATED COST(REQUIRED) R D 'tt: 2 $ 6 13() •Fair market value of all labor and materials foundation to finish J 1/08/042 Sj o D D — Initials: i, E.l' Y'-�.� G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-36'05.doc OY rei H CI) Ux i' r, c7 1 i . ir..) V- -07 O t0 // .., ...., O i r4 oi c. at ` ld '�' 4 Ii to A, li r "di° R' a ^ 0 y 11 . ..,1 --! ''.-4r11 ; \` i —.. 'V C J \ \ s-----°"'Il"Ill.IIIIIIIIIIIIIIIII"IllillIl oa . 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