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HomeMy WebLinkAboutBLD2006-0496 ItILDING PERMIT APPLICATIN MRLA06-004480 Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00496 Received Date: 8/25/2006 SITE ADDRESS: 1`•', BLUE RIDGE RD PORT TOWNSEND, 98368 OWNER: SCOTT B MC ADAM PHONE: (360) 385-5612 WANDA I LECLERC 605 D ST PORT TOWNSEND WA 98368-6412 DISCOVERY BAY RIDGE DIV IV SUBDIVISION: Block: Lot: 25+ PARCEL NUMBER: 001305025 Section: 30 Township: 30 N Range: 01 W CONTRACTOR: PHONE: PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW DETACHED GARAGE(768 SQ FT HEATED) W/UNHEATED STORAGE ABOVE(696 SQ FT) TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 0 VALUATION 65,903.00 ADD'L: HEAT TYPE: RAD CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: OTHER: 768 SHORELINE: CONST TYPE: GARAGE: 696 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: l510(e' Type Amount Paid By: Date: Receipt: Approved/Date Permit $755.75 KAS 08/25/06 83993 Plan Check $491.24 KAS 08/25/06 83993 State Building Code $4.50 KAS 08/25/06 83993 Total: $1,251.49 6 - 3 ( - 06 Cott cA-c_ Ada cos -b srt� "o rk- l O t".) t• / 1 ot w A ' 8, 3 l- o 6 � o v (of (��� e �o cat-LLe ( j/- / qqq e v L+"-! 13 1 D O - `r 6 _fJ.c T-a c.C,,eo( e 1A-A f e e c- y I f O , ✓l ley( f fin.e a cL Z pl S '-i r A e -- /0/"- RECEIVED JEEEERSbItI 0410 DCD • • NA:: - CoN COp. JEFFERSON COUNTY 1� �3 DEPARTMENT OF COMMUNITY bEVELOPMENT ` `4 621 Sheridan Street • Port Townsend Washington-98368 IiINO 360/379-4450 • 360/379-4451 Fax � www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: OCO-48D t "Sg Project Description(include separate sheets as necess rjl�' � , ! '',�!! 0 60 P. 4-C c�ne4 ct r — Tax Parcel O Property <(- Number: D 0 ( 3 c o Z.S Size:S /2�.- i S,0 3., 7 t' , (acres/square feet) Site Address and/or Directions to Property: (3 1 u - R, L, cf- , .� , (-of 2- Property Owners)pf Record: Sc c tt r 1. 0-,A ot .r,,,_ /t&" t ,et 4 L.e e le:-c, Telepho--- (360 1 38.5 Stpf i _Fax: email: Mailing.,,,„,,,.». , -i,y - • - ., - 605- b 54 . 1'r-{' Tow`1SC' € i.^) A. 8.36k 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) Q Demolition Permit ❑Conditional Use[C(a),C(d),or C]** 1a Single Family ❑Discretionary"D"or Unnamed Use Classification Garage Attached 114 ❑Special Use(Essential Public Facilities)** Q Manufactured Home °Boundary Line Adjustment El CIModular mmercial* °Short Plat** Q Change of Use °Binding Site Plan** °Long Plat Q Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments** ❑Propane ❑Plat Vacation/Alteration** DAllowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions** OStormwater Management ❑Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment OWireless 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 its 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 resul of or in consequence of the granting of this permit. I further agree to provi ccess and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any requi ater inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicat that he or she wants/prior notice. Signature: ,r4) 744_ ./�/t,t'• . _ Date: g - 9 ` 0 6 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 'II 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 in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferab esp nsibility for adheri to and complying with the ESA. The Applicant has read this dis imer and signs and dates it below. 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