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Home My WebLink AboutBLD2006-00381 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00381 Received Date 07/7/2006 SITE ADDRESS: 150 S PALMER DR Issue Date 07/11/2006 PORT TOWNSEND, 98368 APPLICANT: PATRICIA GULICK PHONE: 3+w 3 �= �`b ` CHARLES W GULICK III 3808 E 19TH AVE SPOKANE WA 992235334 SUBDIVISION: CAPE GEORGE COLONY DIV 2 Block: 4 Lot: 13 PARCEL NUMBER: 938100413 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: OWNER BUILDER PHONE: PROJECT DESCRIPTION: Reroof-Tear off Shake Roof and replace with sheathing, paper, and composition shingles CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. F • g: F ation: St ater L Approval: U round Plumbing: rground Insulation: S In r g: PI Ing: Pr e Tank/Lines: ns�lattsn: S oc : Se ytem Final Approval MUST be obtained before final of structure can be attempted. Rgaproach Final Approval: ••: • inal Approval: cupancy Approva ALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPEC TION 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_BLD_Permit_Buildng.rpt 1 0/29/1 9 BBLDING PERMIT APPLICATIUP BLD06-00381 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00381 Received Date: 7/7/2006 SITE ADDRESS: 150 S PALMER DR PORT TOWNSEND, 98368 OWNER: PATRICIA GULICK PHONE: CHARLES W GULICK III 3808 E 19TH AVE SPOKANE WA 992235334 CAPE GEORGE COLONY DIV 2 SUBDIVISION: Block: 4 Lot: 13 PARCEL NUMBER: 938100413 Section: 12 Township: 30 N Range: 02 W CONTRACTOR: OWNER BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' Reroof- Tear off Shake Roof and replace with sheathing, paper, and composition shingles TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 3,800.00 ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $97.25 DJK 07/07/06 83763 APPROVED Plan Check $63.21 DJK 07/07/06 83763 State Building Code $4.50 DJK 07/07/06 83763 JUL I Total: $164.96 J Jefferson County Planning & Building Department (---;.0_. oN c �� JEFFERSONOUNTYra DEPARTMENT OF COMMUNITY DEVELOPMENT - 621 Sheridan Street • Port Townsend •Washington 98368 . . 360/379-4450 • 360/379-4451 Fax AM7 I q O www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: _17 Pc 40 Project Description (include separate sheets as necessary): -c c 0 Fig' o/✓) ,51-\P k-5, 5H *T1--1 , FAI7 / ft-D9t2Ly h►-1- 05Pr lc (G1V P, C� 7 100 q 1 - Property pgf3ccD Sit/�►C�E' Tax Parcel Number: -� 1 Size: I a L reS (acres/square feet) Site Address and/or Directions to Property: 1 50 S , ?PcLM 1✓1Z. Property Owner(s)of Record: C l-1 i-E`j p/3-Te2-t c 1 P C-,Cal L—i C Telephone( c(3 53- " / / 'j 2 Fax: $ ''I 117 email: 5,-4 Is a ,"v"' I` c'- c`•Y,c',i Mailing Address: 3`z3 0 8 (e- ,l/E-/ $ PO r `E L11 y 9 22 3 33 L . ,,r?, Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit? (Check each box that applies) Zuilding ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or CI** ❑ Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular 0 Short Plat** ❑ Commercial* 0 Binding Site Plan** ❑ Change of Use ❑ Long Plat** 0 Address Li 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 0 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: 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 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 inspect ons.Access and right of entry to this property shall be requested and shall occur only during regular business hours.Signature: tii'l�Z"'Lf.G//�� . 4 Date: 7/7/0 6 The action or actions Applicant II unde ake 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=ility for adherigg to co plying ith the ESA. The Applicant has read this disclaimer and s' ns nd dates it below. Signature: /vv' Date: '7 '7 49 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 res onsibility o e Ge eral C ntractor for the proposed project. Signature: aV Date: GENERAL CONTRACTOR 0 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: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank Height: ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: ❑ Individual System die—Repair ❑ Masonry Bedrooms: SEP P r it# e ❑ Demolition ❑ Other: Supply: Existing: Setback: ❑ 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 ❑ 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 BId App Review: N IA 2nd Floor Heated Consistency Review: 1`�n ' Other Heated Base fee: a5 Mezzanine Additional Section: Heated Basement Plan Check fee: 'a Unheated Basement State Surcharge fee: $a Other Unheated Pot Water Review fee: NIPr Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other r TO-AL: $ Receipt Number: ( --6 Cash/Check Nunalm �9 ESTIMATED COST(REQUIRE Date: .Fair market value of all labor and mate 'als foundation to finishOOI , Initials: 1:7 itCenter\FO RMS D Master Permit Application 12-30-05.doc . . _ -- — - - , ,- 11 . , •., • , „.. , .„ ..., . •. .,,•,‘, '',...,. .. .•• . c_ r- -cc), ,•C Z . , ....4 _-:,. ----. . n .- rn L , , c-- rv.• •- -L) ie-1 I., 4*4- '"..•':"t '''',1`".'.",:•.ip ,.. • r . . 9 0/ . . r I ,•'',..,',..4%,;,/i/,...4.40/'..,, , ., . ,--•,..-2=-__=.- • , -141-9- - - —-- -,• -. ••• .. .-.;:,;.;,,..;. ;,•:41.4...:!,' , ,„...0 .-';:,;.,-,• . - .:4-:740,11i•,`•• ,,,,•:„: ,•,•••••,.,••,•••••• - iv _-- -.r.:•:;,,k,,:•••,;', -.•,••••,:','•,-.- ,.;,,,,••,.:•,,-2,,,,,.:, •• •-,',..• :--'- (11 , . .,,,.., .. . , . + .. < I i ,,,,,,,/•,/ - 1 _____ ------i- ' '-'---\ '',,, /I ( i4 ....,,,..: Ei?iippf.7...x. _.- .., A \ \ .. . . ...,. .... . i \._.;....‘ ----------1 4111,------ ,s ------b. , , 1 . i Oit.C.e .-_. i' --..... _,,.., 1 I - .) afip .i,,7' / ' In v---•• ' ...----- ,, _ . . , . • ? , ,.... --:-.-------- t , ......, _,..... ,•••-- -T,RA.i/Nr--if;v.,-D ' -- •*- Vit' - - i . ... 1 t oi 1 • i . &"2-. li "i/ '• L_\...../ ..„..... 1 -,,,,n ,.... _....___... • to(* , .IF '• ,. 410,'•,:• L.0 T 4T I -3 • 'DIA,' ilr --z- •• . `/8 IN =• a Fr • . ,, • _ — f-.)9' ... 7 Ca7- Pe-Pisik I• • • • .•. • .0 • • , • , j i .D S O 0rn i ,-.-I lcm cP D o m C 6. — m d ;3' m ll \AN I V 0 ..v. 2 r. . o G \G m ti m 3 °-'-'° - 01 6 / 2A- G6 \ .• It tit ,i. z a C'' m ti 1a v 7) v ' ' 7 I _ t^ ^ c el b CO m b _v o p► '1 r- a 71 m d""1 V in N 4 -0 'n {a4 ( V _ ` CD 8 w z tA ,ter ON 33 co m 0 1C a ?i c ,z) 0 •v * - ixf o trl 1 Z w