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HomeMy WebLinkAboutBLD2006-00297 tILDING PERMIT APPLICAT.N BL Revviewiew TyTy297 pe: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00297 Received Date: 5/30/2006 SITE ADDRESS: 260 WINDSHIP DR PORT TOWNSEND, 98368 OWNER: ROBERT J STEWART PHONE: (360) 385-5123 260 WINDSHIP DR PORT TOWNSEND WA 98368-2514 KALA POINT#1 SUBDIVISION: Block: Lot: 53 PARCEL NUMBER: 964700053 Section: 26 Township: 30 N Range: 01 W CONTRACTOR: K-DESIGNERS PHONE: (800)528-9543 8647 S 212T ST KENT WA 98031 Contractor's License KDESI**03305 Expires 09/01/2006 REPRESENTATIVE: WESTERHOFF CONSTRUCTION INC PHONE: (206) 818-8334 JEFF WESTERHOFF 181 E MOUNTAIN VIEW LN PROJECT DESCRIPTIOP REPLACE SIX EXISTING WINDOWS WITH NEW VINYL WINDOWS - NO MLA REQ'D TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 8,200.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: 51 lb(z) Type Amount Paid By: Date: Receipt: APP ".O . f. Er' Permit $167.25 KAS 05/30/06 83419 Plan Check $108.72 KAS 05/30/06 83419 JU c2 2006 State Building Code $4.50 KAS 05/30/06 83419 Jefferson County Planning Total: $280.47 1 1 &Building Department 411 I BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00297 Received Date 05/30/2006 SITE ADDRESS: 260 WINDSHIP DR Issue Date 06/2/2006 PORT TOWNSEND, 98368 APPLICANT: ROBERT J STEWART PHONE: (360) 385-5123 260 WINDSHIP DR PORT TOWNSEND WA 98368-2514 SUBDIVISION: KALA POINT#1 Block: Lot: 53 PARCEL NUMBER: 964700053 Section: 26 Township: 30 N Range: 01 W CONTRACTOR: K-DESIGNERS PHONE: (800)528-9543 8647 S 212T ST KENT WA 98031 (800) 778-6785 Contractor's License: KDESI**03305 Expires: 9/1/2006 PROJECT DESCRIPTION: REPLACE SIX EXISTING WINDOWS WITH NEW VINYL WINDOWS - NO MLA REQ'D 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. lO-t 3-ice 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 I:\F_B LD_Perm it_B u ild ng.rpt 10/29/1999 ,�41-9°N c©6, JEFFERSC.OUNTY (( `-� , to DEPARTMENT OF COMMUNITY DEVELOPM 1 C E1 E �1 `•' ` ''4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 1%.N��p0 www.co.jefferson.wa.us/commdevelopment MAY 0 2006 Master Permit Application JEFFERSON COM-141J No MLA 1: C.2I,D Project Description (include separate sheets as necessary): f t 5 i ILAC e __six gy,5!/w j t.t./,/V 2(Li e`)/%!-/A1/4 U) 1/!i✓// /L1,,VA cal Property Tax Parcel Number: Size: (acres/square feet) Site Address and/or Directions to Property: a6 6 co,Ai0S ,P 19�jf f 1/ /c'[:cGv'Si •--s•0. i.thw, Property Owner(s)of Record: L d s I24- e, S72 uiu t7 Telephone:360 3 fps 3 %.Z 5 Fax: email: Mailing Address: /41.� i.S, Z,,1Z V" Applicant/Agent(if different from owner): G`r/Aic, G/tiiofr Telephone:6 es-le ,,"s'-5 y Fax: email: Mailing Address: /fs"/ 1 j tied�' 'e_L,'AA' a',r, What kind of Permit?(Check each box that applies) ❑ Building ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat" ❑ Commercial* ❑ Binding Site Plan** Change of Use ❑ Long Plat** ❑ Address ❑ 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: j ) �' .DESIGNATION OF AGENT I hereby designate • VC/. /c1 ' )t/ to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE J?�/ C 1 F_'Lt�%�-' Date: S J15/ZUU(v 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. na. / Signature: ,,c;G S E e/C/�G Date: / 2 >/ 2(1C) , The action or actions Applicant will undertakeas 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 responsib.. for adhering to and complying wit the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: :, L - > .ei��Lfi- Date: .`-VZS f 20 U(o 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: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: /(- / �s�Jl, �45 (6O0 ) 528- v 4-5 (&° )7,V8 ( 7 MAILING ADDRESS: 6W 4 7 50 A, s/ A'e,v, (/i, EMAIL: CONTRACTOR'S LICENSE . _ t WAINS NUMBER: ' k C��'S.l 6,43 OS NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Li New Wood Existing: ❑ Sewer n Addition ❑ Steel Proposed: Bank Height: ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 11 Individual System LiRepair ❑ Masonry SEP Permit# Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Li 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: Heat Stove ❑ Cook Stove 11 Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ 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: 2"° Floor Heated Consistency Review: Other Heated �, R Base fee: r/_ '1• a 5 Mezzanine ,j'•\ E , �'C^)l / ional Section: I c[) - Heated Basement Plan Check fee: Y IoS , 1a Unheated Basement State Surcharge fee: 50 Other Unheated iEFFE S JN coup 40, ater Review fee: �^ Garage/Carport i1 SUBTOTAL asp. 4-1 Decks 911/Rd Approach fee: //54 r ei A Other TOTAL: $[ 3S1),L.11 Receipt Number: taL\1 to t Cash/Check Number: O max, ESTIMATED COST(REQUIRED) Date: C_5 r •Fair market value of all labor and materials foundation to finish C 1 O .)c gxe) 696 Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc ci i ---*, 7 .1-) 4 R ►411 4 )."' 0 Li. Igo cs1 ,il �. y ,�,;/ J t i Ns \d. P SR , 4:3 s,. ( '-- ,: 1111;spot c.--''I- X So -->,,/"- . ,;- ..,'"". •Z_) `._.•_-v.A /IV N.t ,/ J \. .• •" iwa• ,, tu \-; ) . 10 !\,.. \..„_\___ a 7.9 ?4,5 0111' -c,1 %. % C--1-1.)(:). 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