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HomeMy WebLinkAboutBLD2006-00515 MLDING PERMIT APPLICATIP1 MLA06-00499 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00515 Received Date: 9/8/2006 SITE ADDRESS: 481 SNOW CREEK RD QUILCENE, 98376 OWNER: CURTIS D STACEY PHONE: 360-765-0106 481 SNOW CREEK RD QUILCENE WA 983769536 SUBDIVISION: Block: Lot: TX 39 PARCEL NUMBER: 802243012 Section: 24 Township: 28 N Range: 02 W CONTRACTOR: PARADISE BAY DESIGN & CONST PHONE: (360)437-9344 BILL IRWIN PO BOX 545 CHIMACUM WA 98325 Contractor's License PARADBD141 KW Expires 3/29/2007 REPRESENTATIVE: BILL IRWIN PHONE: ((360)437-9344 PO BOX 545 CHIMACUM WA 98325 PROJECT DESCRIPTION DEMO EXISTING MAN HOME TYPE OF WORK MOD SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: VALUATION CODE EDITION: 2003 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: -co0T-EpqiCSIOCO CZ_ Type Amount Paid By: Date: Receipt: Approved/Date Permit $0.00 CJZ 09/08/06 State Building Code $0.00 CJZ 09/08/06 Total: $0.00 12/O2/2010 10: 48 3503798056 HADLOJC:KREALT'`r' PAGE 02/02 i • Curtis Stacey 481 Snow Creek Road Quilcene, WA. 98376 November 30, 2010 Jefferson County- Department of Community Development 621 Sheridan Street Port Townsend, WA. 98368 This letter is to inform you that demolition permit #BLD06-00515, associated with parcel number 802243012 is no longer needed. The structure that was to be demolished is currently serving as affordable housing. Sincerely, Curtis Stacey 481 Snow Creek Road Quilcene, WA. 98376 • • _ .. 11 .‘Nt G I ,y i s a V �I l SEP - 7 2006 'ifrnsox•____"1 — ;' ";: i'.+ENT149" Notification of Demolition Permit It is unlawful for any person to cause or allow the demolition(or major renovation) of any structure unless all asbestos- containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the structure. Project Site Address: G ;( S'ivou (W e0 Coun tOcn,J �V City: i k lr l�;.�' tf State: Zip: Starting Date: 0 cl(0310`7 Completion Date: e:,G O 7 t 7 *(There is a 10 working kmg day advance notification period from receipt of permit application) Property Owner: ti Lr.S ST y Telephone:3 t3'7 kk Fax: Mailing Address: 48 I .t (i City: U k LGf l,)�C-, State: LUi Zip:Cir -7 Demolition Contractor itjLkO%ce V-Ai ( ti I-- State License#: Mailing Address: W 7—ity 4-14 V City: C t I tW Pr(ti N\ State:UtI Zip: g k3 L( Contact Person:41 U tEl (C-w tTelephone: g ,Tele hone: I ' P 7�()- � � 3`i g Fax: YES NO Demolition by Wrecking or Dismantling? ($25.00 fee)check# }fir Training Fire Demolition? (If yes,attach fire department request for training fire) (7`.' Renovation, Alteration, Remodeling, Maintenance, or other Construction? Asbestos found or suspected* *An ORCAA "Notice of Intent to Remove or Encapsulate Asbestos"form and appropriate fee must be submitted prior to any asbestos removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation 1 Article 14 for additional requirements that may apply. Asbestos Survey Completed by AHERA Certified Inspector Certification# This approved permit must be available at the job site Enclose$25 Certification of the Asbestos Survey must Processing Fee accompany this form 2940 B Limited Lane NW,Olympia,Washington 98502 360-586-1044 * 800422-5623 * fax 360491-6308 homepage:www.orcaa.org * email: info@orcaa.org Rev.07/11/02 , c06,, JEFFERSON�IJNTY I. (1,,V. ' y -DEPARTMENT OF COMMUNITY DEVELOPMENT • ` �4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • �.q p� www.co.jefferson.wa360/379-4451.us/commdevFaxe 'AN lopment Master Permit Application MLA: 1Y\1..)V142` 4�1 Project ocrrin+inn/: .1 ... +, ti a nnrGQ¢ M: • ( o cA ej()wt2, Zhu(,S-I �,.� G-(O/li t.T ..-. .+n/I, v-v '-'Clv — Lry ivv,,, �^L•- .. - Prope`rty Tax Parcel Number: O)—)-(13 9 Size: I,1. . l (acres/square feet) Site Address and/or Directions to nnProperty: 41. �N0IA, ( - --e-0 &tit C,C .ti`i-, Property Owner(s)of Record: lit. 'i c-c y / Telephone: 2 �3` Fax: ! email: Mailing Address: -\ y- . f�t V( ' Applicant/Agent(if different from'owner): '/7/ / ' 'l Telephone:' '? " ' ' 4-1 Fax:.567 -CO 7 7W email: Mailing Address: '" r C '(,1l WI A` G 1 c, 31( What kind of Permit?(Check each box t at applies) Li-fuilding ❑Variance (Minor,Major or Reso able Economic Use) 'Demolition Permit 0 Conditional Use[C(a), C(d),or C]** r Single Family 0 Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** — / 2006 0 Manufactured Home 0 Boundary Line Adjustment 0 Modular 0 Short Plat** j j 0 Commercial* 0 Binding Site Plan** 0 Change of Use ❑ Long Plat** ..,' ' „!ENT n Address 0 Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** 'Propane 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance 0 Temporary Use LI Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 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 ,0, iv\ � %�? to act as my agent in matters relating to t is a plication for permit(s). OWNER SIGNATURE L Date: u By signing this application form,the owner/agent attests that th 'nfor ation provided herein,and in any attachments,is t e 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. r•, I further agree to s ye,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs, reasonable attorney's fees and expenses which X i an ccrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to .r (i ccess an right of entry to Jefferson County and its employees, representatives or agents f r the s e purpose of application review and any il I er inspect ons.Access and right of entry to this property shall be requested and shall occur my du 'ng regular business hours. Signature: Date: (2 \ 010 The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon on or mo e 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 sp.cies regarding your action(s) even if you are'in compliance with the Jeffr,soa'County development code.The Applicant acknowledges that he,she or it cold individual and non- transferable r spbnsibility f 'adherieg.to Qom rng with the ESA. The Applicant has read this disclaimer and 7desftbelow. Signature: L �I �� Date: cri G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc • BUILDER STATEMENT • I The signer of st eme t does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that r they will be n e r sponsibility of the General Contractor for the proposed pro' ct. 7 2t�05 Signature: AlDate: , 1 ! GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: MAILING ADDRESS: s,Gr; 'j 4 i .5 �i�Ime:(66,4\ Gad 3Lk' EMAIL: CONTRACTOR'S LICENSE { " WAINS NUMBER: 1241- 4-'P, 0 C L 2) C_..f NUMBER ARCHITECT/ENGINEER: -4,,fl PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL P,ject Type: I F-ame.Type: Bathrooms: Shore;Re: Type of Sewage Disposal: New �/ood Existing: - Cl Sewer ❑ Addition ❑ Steel Proposed: _ _ Bank eight: ❑ Co unity System ❑ Alteration/Remodel 0 Concrete Total: —_ dividual System O Repair ❑ Masonry _ SEP Permit# G('CX 2 76) Demolition ❑ Other: Bedrooms: - Wa-Supply: 1 Existing: + Setback: it;'Private well ❑ Two Party Type of Heat: , Proposed: — CI Public -orr -fit Sri-j;f e 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 ap ly: i I Underground Tank . \bove ground Tank Size of Propane Tank: )-\C Li Heat Stove COOK Stove ❑ Woodstove ❑ Fireplace Insert 4 of Water Tank ❑ Pellet Stove I i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes r;{Jo 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 y 3:~ . Main Floor Heated EH Bld App Review: t 2761 Floor Heated Consistency Review: sr V__. Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: ( _ _ — Unheated Basement State Surcharge fee: 4 Sc" Other Unheated Pot Water Review fee: ._ Garage/Carport SUBTOTAL Decks I 911/Rd Approach fee: 3 Other TOTAL: $ — Receipt Number: 1 Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish 4 .cM- i✓ '1 4 r j Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc r f / fd t �'N % / / ^� 4 e�� / \. S 2'50'35"W 463.60' ,/ /: �I a ,, k 4i- /., N cri CJl C7 n D —� n N I-, a C. rS. co s toCo � PO 0 L-'3 �o�R� 'Ao90 can 0 G 0 • N z Co � / a 6) � omA / ,P D n 0 n cgo / c.", i A. \i / CPS \c / 10 , ,..,\ ______ 9.1 / / \ , I / to a 'e\i„, . 0\ ‘4'41k . \74;1) 4( sr ..."1,c1f,‘ , --... -------.---.'-----*---- \ C. 7/ 4 0 or: ‘<et.,.....k 71...) i f, .. INVifcCil C \‘(1 __,2 A 6 F r 4 ). \ 1 ° r° x> \ -- ..---"(7 V \4( . v QIS ‹e,i 1, 1 :.: %� Of, �, , ! . � �po,� p gp .,, m • el 1 rit/pil'.b 21 if 1(/16\\,( Gt. ckaktisfr. ih 1 . N //,\ ‘ /1134k J G N Z 11 o�� m D o rn ( t -1 .. /to ( g° c: 0 ) Fn o lt. V. CO- _ >v © O 11 CI 0 rti g S 'l N ITI rn , , 0,0 O m v CD C C� ,r O a +� I: � � N CURTIS STACEY REVISIONS -DATE --er-- _ TILLMAN N OVERALL SITE PLAN ENGINEERING, INC. g $ PARCEL # 802-243-012