HomeMy WebLinkAboutBLD2006-00242 •UILDING PERMIT APPLICAI4JN ML ReviewTy 230
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00242 Received Date: 5/9/2006
SITE ADDRESS: 110 E PRICE ST
PORT HADLOCK, 98339
OWNER: WILLIAM L MOLINA PHONE: (360) 379-0642
BARBARA ANN MOLINA
PO BOX 717
PORT HADLOCK WA 98339-0717 IRON DALE
SUBDIVISION: Block: 3 Lot: 1-4+
PARCEL NUMBER: 961800309 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION HEATED UTILITY ROOM ADDITION TO GARAGE - NO PLUMBING
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN:
VALUATION 5,500.00 ADD'L: HEAT TYPE: SL-J )""--
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE GARAGE: SHORELINE:
CONST TYPE SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date: 5 1 ct I o rc c
Type Amount Paid By: Date: Receipt: 4 A�ptoved/D ,te „
Permit $125.25 KAS 05/09/06 81171 . `'
Plan Check $81.42 KAS 05/09/06 81171
State Building Code $4.50 KAS 05/09/06 81171 JUN 33 2006
Total: $211.17 Jefferson County Planning
Cedluiltlinq Departure t
• •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00242 Received Date 05/9/2006
SITE ADDRESS: 110 E PRICE ST Issue Date 06/13/2006
PORT HADLOCK, 98339
APPLICANT: WILLIAM L MOLINA PHONE: (360) 379-0642
BARBARA ANN MOLINA
PO BOX 717
PORT HADLOCK WA 98339-0717
SUBDIVISION: IRONDALE Block: 3 Lot: 1-4+
PARCEL NUMBER: 961800309 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: HEATED UTILITY ROOM ADDITION TO GARAGE - NO PLUMBING
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY T Y r PROJECT.
SETBACKS: (�� -
UFFER:
/6e-1TJ �
Footing: ,L `- - CAL i1 / (.:t1,,-cKs4 —z (,AMk
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : DK '7�27 aL.,I,
i
Sheathin
Framing: (0—tO�o
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: U+O
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 # BLD06-00242
1.) 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.
2.) 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.
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.) Minimum setback from E Price St right-of-way is 20 ft. Minimum side and rear setbacks
are 5 ft.
7.) The building height is not to exceed 35 feet.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
r4SON co� JEFFER: I COUNTY I,a, DEPARTMENT OF COMMUNITY DEVELOPMENTi,` `4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
�/�,4-1-No(
0 www.co.jefferson.wa.us/commdevelopment +.`i7�
Master Permit Application J( F1r3SON COUN1PtIt
j 0 a:A-3
Project Description (include separate sheets as necessary):
J / ,
-d' - '('e- r"I} 61/W ,b2(/(1.` —f
"t/ ,--,(",, 4/r-) A,7 b-..?,/,-, ,
44"l —& 'o•_ 3 1 Property /
Tax Parcel Number: - Size: / 6z' S� l• `J (acres/square feet)
Site Address and/or Directions to Property: /f ,t--ii , / (�/., / c_ '� "
Property Owner(s)of Record: L I-ji////}/4t P 4 A F, /- I c'/i 'ti, Ci.
Telephone: 34'b ---`3 7 cr_P4 —V` ", Fax: ------ email: fii,/!/t L4✓- e< O't
%'���. r C
Mailing Address: l"l' 7;ir x '1 I
Applicant/Agent(if different from owner): ,../.,%4_ -
Telephone: `- Fax: L- c
email:
Mailing Address:L-- -
What kind of Permit? (Check each box that applies)
'' i';Building ❑ Variance(Minor,Major or Reasonable Economic Use)
V ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
�,
El Single Family ❑ Discretionary"D"or Unnamed Use Classification
.. ; ^Garage Attached/Detached 0 Special Use(Essential Public Facilities)**
'
r(" ❑ Manufactured Home ❑ Boundary Line Adjustment
❑ Modular t T Cp'$toryplat**
❑ Commercial* �%___ --4 l j Binding Site Plan**
❑ Change of Use ❑ Long Plat**
Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Propane i9 Plat Vacation/Alteration**
0 Allowed"Yes" Use Consistency Analysis ` ❑ Shoreline Master Program Exemption/Permit Revisions'"`
i -Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination (SP )-rrn r M r [1. o l fine Management Variance
-El--Temporary Use di. i LlISU t [i Comprehensive Plan/UDC/Land Use District Map Amendment
—Wireless Telecommunication* Ci 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 /t ff/` ' 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: �// 47 '' /` / -- Date: '1 ��*/G'rf'
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 ad enng to a d complying with the ESA. The Applicant has read this disclaimer and rgns nd Slates it below.
Signature:/) - 4 //i- Date: ' / 4' O L^
G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc
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:,,1«` !�f,/r ilf'i7 Date: /�
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE I WAINS
NUMBER: j NUMBER
ARCHITECT/ENGINEER: # PHONE ( ) FAX: ( )
MAILING ADDRESS: I EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
,P<, New A Wood Existing: G 2 /f ❑ Sewer
A Addition ❑ Steel Proposed: Bank Height: ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: b �`///t - ❑ Individual System A
❑ Repair ❑ Masonry SEP Permit# it
❑ Demolition ❑ Other: Bedrooms: Water Supply: f
Existing: r Setback: 11 Private well Two Party
Type of Heat: Proposed: °'` ' C_] Public ////1
Total: Name of System: IV /�
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 ownersfenants,employees,etc) Current Proposed
IBC Occupancy: IBC,T' pe 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 1 Above ground Tank Size of Propane Tank:
❑ Heat Stove 11 Cook Stove ❑ Woodstove ❑ Fireplace Insert H Hot Water Tank I1 Pellet Stove L I Other
Is this appliance being installed in4 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 �iJ �,L} Q tl� EH Bld App Review: Cl O
2"tl Floor Heated Consistency Review:
Other-II-Heated Base fee: G
Mezzanine IL Additional Section:
Heated Basement Plan Check fee:
vl , L �;
Unheated Basement 1 d L+� State Surcharge fee: IA t 0
JEt
Other Unheated (FEHSL IN CAN �,t, Pot Water Review fee: }
;,i_
Garaige/Carport SUBTOTAL 4 Ct,'1
Decks 911/Rd Approach fee:
Othe• TOTAL: $' AQat. 11
Receipt Number: % I I 7L I
Cash/Check Number:
I JO
ESTIMATED COST(REQUIRED) Date: (;
.Fair_mail�et value oi`aT1Tabor erials foundation to finish S q b GI
Qac Initials:
c n6Th e7 6-2 I-- - (I 1_)
G:\PermitCent r1 VOT 1 fS\DRD FORMS\Master Permit Application 12-30-05.doc
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