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HomeMy WebLinkAboutBLD2006-00540 41, • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00540 Received Date 09/19/2006 SITE ADDRESS: 52 E MOORE ST Issue Date 10/19/2006 PORT HADLOCK, 98339 APPLICANT: ROBERT HICKS PHONE: 360-379-9511 PO BOX 448 CHIMACUM WA 98325 SUBDIVISION: IRONDALE Block: 4 Lot: 16-17 PARCEL NUMBER: 961800406 Section: 34 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: CONVERT EXISTING CARPORT TO HTD BDRM - NO CHANGE IN FOOTPRINT 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: -51-O(o Plumbing: /A) A Propane Tankn / Lines: AO Insulation: tcj2SEAc. 2 /0/al p ,k[L/usuL /0k1 Sheetrock: /V/i4 Septic Sytem Final Approval MUST be obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: 44/6 /1S Oi6� HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQ IRED 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_BLD_Permit_Buildng.rpt 10/29/1999 • filitAtetfaii BUILDING PERMIT APPLICATION - Review Type: I Jefferson County Department of Community Development MIA Q't 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00540 Received Date: 9/19/2006 SITE ADDRESS: 52 E MOORE ST PORT HADLOCK, 98339 OWNER: ROBERT HICKS PHONE: 360-379-9511 PO BOX 448 CHIMACUM WA 98325 IRON DALE SUBDIVISION: Block: 4 Lot: 16-17 PARCEL NUMBER: 961800406 Section: 34 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: CANDIDA SNIVELY PHONE: 360-379-6475 1773 CAPE GEORGE RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTION CONVERT EXISTING CARPORT TO HTD BDRM - NO CHANGE IN FOOTPRINT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 288 VALUATION 18,801.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON _ WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 1 Prop: 0 Total: 3 Total: Routiinnn. Date: Type Amount Paid By: Date: Receipt: kpproved/Date V E ED Permit $307.25 LYK 09/19/06 84924 OCTt't 2006 Plan Check $199.71 LYK 09/19/06 84924 State Building Code $4.50 LYK 09/19/06 84924 Jefferson County Planning Total: $511.46 & Building Department kECEJEVED (‘‘..sON coG� JEFFERSON COUNTY SEP 1 9 200E W \y ,a, DEPARTMENT OF COMMUNITY DEVELOPMENT ti y � 04 M 621 Sheridan Street• Port Townsend •Washington 98368 4. $ 360/379-4450 . 360/379-4451 Fax JEFFERSON COUNTY ON„q www.co.jefferson.wa.us/commdevelopment S NO Master Permit Application MLA: (Y it Project Description(include separate sheets as necessary): F/h i. 1•A#1 2r1 Cl d uccf CarjCO-Z a S -612L1-S-,- bexi zoom -uy)d act cn ,J.LC_-fr;Cal cam..pracik Tax Parcel we et)04o&,€osj Property Number: Size: SD a , 1/45cb-F-6 (acres/square feet) Site Address and/or Directions to Property: 5 a g ., YYl CO IZ E, 5T, P r HAV L.Oc/G I,JI+ ' 3 3 cj Property Owner(s)of Record: TKO J0QJ2.-6 141 GK"S Telephone: (sO-31 q -9 I I Fax: email: Mailing Address: Applicant/Agent(if different from owner):-( LA rur 1(13 5n 1 OQJL1 Telephone:.3670-37c1 - Le q 7 S" Fax: �Z4-0 4(o email: prOnpor-l-li by p C Mailing Address: 17? " Capt_ C7QCS"1U �1 ) P+Tat..Jn ‘nrt L CL 3(o E rn5h • WI}at kind of Permit?(Check each box that applies) at uilding ❑Variance(Minor,Major or Reasonable Economic Use) d D molition Permit ❑Conditional Use[C(a),C(d),or C]** Ingle Family ODiscretionary"D"or Unnamed Use Classification El Garage Attached/Detached ❑Special Use(Essential Public Facilities)** Q Manufactured Home ClBoundary Line Adjustment El Modular tlShort Plat** ❑Commercial* InBinding Site Plan** ❑Change of Use in Long Plat** El Address 1 Road Approach iiPlanned 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** OSite Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance OTemporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment :Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment OForest 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: C.O. . _i_ 0 n 1 DESIGNATION OF AGENT I hereby designate ( / C.I(�� / /I,I, to act as my agent in matters relating to this application�J for permit(s). OWNER SIGNATURE (f1/,jJ Date: q— I ( — 0 6 By signing this application form,the owner/agent attests thatthat 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicatti hat he or she wants prior noticj Signature: 7' Date: q (7-- /Q ie 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 Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable r onsibili for adhering to a/pd/ alPlyin ith the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: � 1 -9L� 1?L 2�'C Date: /P—/7-- 0 6 D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc • 0 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 th eneral Contractor for the proposed project. Signature: e��/ (_/ I( l Date: `��//q��cY GENERAL CONTRACTOR OR MANUFACTURED HOME INSTAL R: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Fra ype: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ood Existing: �� _ ❑Sewer ❑ addition 0 Steel Proposed: --I?_ Bank C❑�Co�mmunity System ('/Alteration/Remodel ❑ Concrete Total: Height: j Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: _�_ Setback: n prwate well 0 Two Party Type of Heat: Proposed: _.I___ Wublic Total: :3 Name of System: 0 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: C]Underground Tank ❑Above ground Tank Size of Propane Tank: 0 Heat Stove 0 Cook Stove 0 Woodstove OFireplace Insert 0 Hot Water Tank 0 Pellet Stove p 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 qia tC l I? EH Bld App Review: Cp 6 _ 2"a Floor Heated Consistency Review: Other Heated Base fee: 2�u�Jj�cL�T• ���N� Jv I •� Mezzanine Additional Section: Heated Basement Plan Check fee: �qq. '�I Unheated Basement u41 State Surcharge fee: Jj 5b pp �'1• Other Unheated V Pot Water Review fee: crovert 4 , 9, Garage/Carport czee O SUBTOTAL 57 Decks 911/Rd Approach fee: e Other lC.lSl"( TOTAL: $5rk_ L.f-(1) Receipt Number: O Cl Cash/Check Number: 1 3 ESTIMATED COST(REQUIRED) IVOI Date: (� �`1�� .Fair market value of all labor and materials foundation to finish 1 5/ , D 0 Initials: D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc ,-1, ---/ h Z . _ _ .... .[- G-n, — ..... . 0 • ! . I GP , ....I Q7 ... '7 7 ---, ..._ ------"-1- --„, 1-t_ •-',. .-- - --....-, N.. 1 ..-, ..." -u• _ . ..!•11., • C) 4.. . Ill .... c>4 - -. - i v.) o . I l, .....,,S\\_. ! q.... ' ,,,--- r. 4 , _ 1 0, ..,.... .......„. .z...„... , ' 1 , f -Z. 4 . , , ...... .... •••••••• 1 Q ....-, c•-3 s'Ns . ,,,....., -..,›. 0 p -i- p -,..._ -i- c:.!,,,' It—•,..-- . _ VC) C.... ....r, --ri rin rn cr.) c.... -c, _ c... 11..4 C= CD = NJ = cm a..ic CT) ti = = Ci .-1-:...-11 h Z _ . . 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