HomeMy WebLinkAboutBLD2006-00292 RILDING PERMIT APPLICATION MLA06-00271
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00292 Received Date: 5/24/2006
SITE ADDRESS: 389 ARCADIA WEST
PORT TOWNSEND, 98368
OWNER: LONNIE E HOLBROOK PHONE: 360-381-0158
REBECCA R HOLBROOK
PO BOX 946
PORT TOWNSEND WA 983680004
SUBDIVISION: Block: Lot: TX351
PARCEL NUMBER: 001171015 Section: 17 Township: 30 N Range: 01 W
CONTRACTOR: BUILDING BROKERS CONST PHONE: (360)683-6216
P 0 BOX 3831
SEQUIM WA 98382-5071
Contractor's License BUILDBC011MG Expires 7/8/2006
REPRESENTATIVE: BUILDING BROKERS INC PHONE: (360)683-6216
PO BOX 3831
SEQUIM WA 98382
PROJECT DESCRIPTIOP NEW POLE BLDG - UNHTD, NO PLMB
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 9,200.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: 864 SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:94 —D?Olirt,0 - CZ
S`24IC(o
Type Amount Paid By: Date: Receipt: Aroved/Date
Permit $237.25 LYK 05/24/06 81246
Plan Check $154.21 LYK 05/24/06 81246 JUN O
State Building Code $4.50 LYK 05/24/06 81246 Jefferson Lt,uiyty Planning
Total: $395.96 & Building Department
•
BUILDING PERMIT •
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00292 Received Date 05/24/2006
SITE ADDRESS: 389 ARCADIA WEST Issue Date 06/29/2006
PORT TOWNSEND, 98368
APPLICANT: LONNIE E HOLBROOK PHONE: 360-381-0158
REBECCA R HOLBROOK
PO BOX 946
PORT TOWNSEND WA 983680004
SUBDIVISION: Block: Lot: TX35-
PARCEL NUMBER: 001171015 Section: 17 Township: 30 N Range: 01 W
CONTRACTOR: BUILDING BROKERS CONST PHONE: (360)683-6216
P 0 BOX 3831
SEQUIM WA 98382-5071
360-683-6001
Contractor's License: BUILDBC011MG Expires: 7/8/2008
PROJECT DESCRIPTION: NEW POLE BLDG - UNHTD, NO PLMB
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: fle- -)-@-
UFFER:
Footing: tQ_$c _- (--ci=
Foundation:
Stormwater FINAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall :
Sheathing:
Framing: 90(i
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: // L-t -D&
HEALTH DEPARTMENT AAVD 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 CAIIPA BLD06-00292
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.) Minimum setback from Arcadia West right-of-way shall be 20 feet. Minimum side and
rear yard setbacks shall be 5 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.) The building height is not to exceed 35 feet.
10.) PRIOR TO ISSUANCE OF A BUILDING PERMIT FOR A SINGLE FAMILY RESIDENCE
AND/OR ANY OTHER PERMIT ON SAID PARCEL, THE PROPONENT SHALL APPLY
TO JEFFERSON COUNTY FOR A STORMWATER PERMIT WITH SEPA FOR
ISSUANCE OF A CLASS IV FOREST PRACTICES PERMIT BY DNR.
I:\F_BLD_Permit_Buildng.rpt 10/29/1999
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DEPARTMENT OF COMMUNITY DEVE:LOPMENT __ ,
`' .„ `s4 621 Sheridan Street• Port Townsend • Washington 98368
, . 360/379-4450 • 360/379-4451 Fax AY 2 4 2006
`WING' www.co.Jefferson.wa.us/commdevelopnlenr
• I
Master Permit Application
LV iV�LAr.J-`S ( - 31 I
"'
Project Description(include separate sheets as necessary): ''-
4,.(4 ki ( ' `J)')
Property
Tax Parcel Number: CO I \1 I 0 13 Size: (acres/square feet)
Site Address and/or Directions to Property: 3(.-q I ci.-,0,c,, u,,,C...j-{
Property Owner(s)of Record: Y.j?.YY°,C.(LA ( Dr . i P 1.-i- i -r1n IL
Telephone: `2)100 3`61 -MS.V Fax: email:
Mailing Address: -kl• 0. 3� cjt-I to
Applicant/Agent(if different from owner): ,vvi I 0 i rvci e r i)(9�
Telephone: S(y�0 (o . - (r)t (j, `' Fax: .� tii) (95 ,�- (00O 1 email: r'i,t.I 0 i,'X/ b14,-(3 C,Ohlreilr.C.Cikt,
Mailing Address: -?.-0. 6v/` ''',(j t 3('1 t,Lv(Y),
What kind of Permit?(Check each box that applies)
i Building i Variance(Minor, Major or Reasonable Economic Use)
I Demolition Permit i Conditional Use[C(a), C(d), or C]**
i Single Family i Discretionary"D"or Unnamed Use Classification
Garage Attached/Detached i Special Use(Essential Public Facilities)**
I Manufactured Home I Boundary Line Adjustment
i Modular i Short Plat**
i Commercial* i Binding Site Plan**
i Change of Use i Long Plat**
I Address i Road Approach i Planned Rural Residential Development(PRRD)/Amendments**
i Propane i Plat Vacation/Alteration**
i Allowed"Yes"Use Consistency Analysis i Shoreline Master Program Exemption/Permit Revisions**
I Stormwater Management i Shoreline Management Substantial Development**
i Site Plan Approval Advance Determination(SPAAD)* i Shoreline Management Variance
i Temporary Use I Comprehensive Plan/UDC/Land Use District Map Amendment
I Wireless Telecommunication* i Jefferson County Shoreline Master Program Amendment
I 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 )-0 1,-' .0 O(ig t- ':) to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE t �/ Date: . /23/0 to
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 3f 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 pier inspection Access and rig entry to this property shall be requested and shall occur only during regular business
hours. p�l
-
` Signature: !M •, v Date: 5 /L3/0 h
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 Jeffers County development code.The Applicant acknowledges that he,she or it holds individual and non-
transferable responsi i i for adheri gfo complying with the ESA. The Applicant has read this disclaimer and signs a d datesit below.
Signature: Date: (--- li 7d
C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-30-05.doc
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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:
MAILING ADDRESS: 0 ; Yi>4 ,2. K-A I EMAIL: �l/l N 1(5 1 A S 1 Db-I e ri l/ /l'L(7l
CONTRACTOR'S LICENSE WAINS J
NUMBER: £jA 11 J RC 1.1 M(0 NUMBER
ARCHITECT/ENGINEER: PHONE S3e0 )b 3. kg j 60 FAx:(3j0/�)&y3 - cod/
MAILING ADDRESS: EMAIL kg
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
rJ New yr Wood Existing: ❑ Sewer
li Addition ❑ Steel Proposed: Bank Height: ❑ Community System
❑ Alteration/Remodel ❑ Concrete r- ❑ Individual System
❑ Repair ❑ Masonry SEP Permit# 06 iz (
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
T e Hea
t: Proposed: ❑ Public
yp v0 Total:— Name of System:
If this is a Commercial Proiect 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:
i Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i 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. (5
L,
—� Consistency Review.
2 Floor Heated 1 5.3
Other Heated Base fee: '1 3 vat
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee: .5,)
Other Unheated Pot Water Review fee:
Garage/Carport 4(� SUBTOTAL c7*
� i 13,115. 13
Decks 911/Rd Approach fee:
Other TOTAL: $
--Receipt Number: 2 t a'eSt c
Cash/Ceck Number: 80\ 3
tIAY 2 4 2006
estemomasupparstam
Date: i
.Fair market value of all labor and materials foundation to finish _-1 .5 J 0
�fZ . `,�� Initials:
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