HomeMy WebLinkAboutBLD2006-00623 6
BUILDING PERMIT APPLICATON ML view Type: i
Review I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD06-00623 Received Date: 10/31/2006
SITE ADDRESS: 31 GUN CLUB RD
PORT TOWNSEND, 98368
OWNER: BERNT P ERICSEN PHONE: 360-385-4281
MARLENE J ERICSEN
2281 HASTINGS WEST
PORT TOWNSEND WA 98368 IRVING PARK
SUBDIVISION: Block: 23 Lot: 1-3+
PARCEL NUMBER: 963302301 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: HI-LINE HOMES PHONE: 253-804-1849
11306 62ND AVE E
PUYALLUP WA 98373
Contractor's License HILINH*981E3T Expires 2/10/2008
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NSFR W/ATT GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 884
VALUATION 177,346.00 ADD'L: 884 HEAT TYPE: EEE
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: R 3 UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 528 SHORELINE:
CONST TYPE: DECK: 273 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: CITY
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 3
Total: 2 Total: 3 _
Routin Date:
1013► Id
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,430.55 LYK 10/31/06 85225 Plan Check $929.86 LYK 10/31/06 85225 APPR OVED
State Building Code $4.50 LYK 10/31/06 85225
Potable Water Application $55.00 LYK 10/31/06 85225 NOV of 2IJ06
Total: $2,419.91 JefI car.,(ounfilplanni„
if 84.41; perrk-m(,�
• •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD06-00623 Received Date 10/31/2006
SITE ADDRESS: 31 GUN CLUB RD Issue Date 11/28/2006
PORT TOWNSEND, 98368
APPLICANT: BERNT P ERICSEN PHONE: 360-385-4281
MARLENE J ERICSEN
2281 HASTINGS WEST
PORT TOWNSEND WA 98368
SUBDIVISION: IRVING PARK Block: 23 Lot: 1-3+
PARCEL NUMBER: 963302301 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: HI-LINE HOMES PHONE: 253-840-1849
11306 62ND AVE E
PUYALLUP WA 98373
Contractor's License: HILINH*981 BT Expires: 2/10/2008
PROJECT DESCRIPTION:�/ NSFR WI ATT GARAGE
CALL IN FOR THE REQ101RED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: ,,,,//
UFFER:
Footing:
Foundation: .c- (- 2--(7
Stormwater INAL Approval:
Underground Plumbing:
Underground Insulation:
Shear Wall : �/a, 6ofror< <Stc.z- WI) G -L-0- M-441 f /tA 1 9101-3
Sheathing:
Framing:•Rei/V,]P L i ,v Lk-1%p.t'-tempi`c'311,51614,,. .1-,,1.-Q.c_d--L"o7 `f /G'7
Plumbing: Alt) Ui �J�, ��/ Y�`� .\tb purAL 12- /C i`U 3 l
Propane Tank/ Lines:
Insulation: _ J I'GLS y t 3107
Sheetrock: 4 i✓�
Septic Sytem Final Approval UST be obtained before final of structure can be attempted.
Road Approach Final Approval:
Zoning Final Approval: n
Final/ Occupancy Approval: (if-
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
SPECIAL CONDITIONS APPLY - SEE REVERSE
•
SPECIAL CONDITIONS FOR CASE BLD06-00623
1.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
2.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington to control stormwater, erosion and sediment during
construction. BMPs shall address permanent measures to stabilize soil exposed during
construction, and in the design and operation of stormwater and drainage control systems.
3.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
4.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened
from view of neighboring dwellings and rights-of-way. Such screening shall meet all
applicable performance and development standards specific to the district in which the
storage is kept, and shall be in keeping with the character of the area. Screening shall
meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an autormobile wrecking
yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter
18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile
wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor
vehicles be stored in a critical area.
5.) Minimum setback from Gun Club Road and South Jacob Miller Road rights-of-ways shall
be 20 feet. Minimum side and rear yard setbacks shall be 5 feet.
6.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
7.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
8.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
9.) The building height is not to exceed 35 feet.
10.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
11.) THE ROAD APPROACH PERMIT (RAP05-0001) MUST BE INSPECTED AND
FINALLED BY THE JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS PRIOR
TO THE FINAL INSPECTION/CERTIFICATE OF OCCUPANCY OF THIS RESIDENCE.
CONTACT TERRY DUFF OF THE DEPARTMENT OF PUBLIC WORKS AT
360-385-9159 FOR THE FINAL ROAD APPROACH INSPECTION.
I:\F_BLD_Permit_Buildng.rpt 10/29/19
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4SON RECIT`7T2A0
S,rI T�sy ot,� JEFFERSON COUNTY '' A DEPARTMENT OF COMMUNITY DEVELOPMENTh r"' `4 621 Sheridan Street• Port Townsend •Washington 98368 uC 3 06
360/379-4450• 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
fINO`t° fit)
Master Permit Application f fi r� � f
pp cation MLA:
Project Description(include separate sheets as necessary):
i 1i-'i.a. Steil at, 61,-m4.4.1 R-e6—ac.44c4,-
Tax Parcel Property
Number: q t,, 7? 3 0 L -3 o 1 Size: /42,f4 K j i Q,go=11107P (acres/square feet)
Site Address and/or Directions to Property: i! Q ILA L `.lieQ. fort TOuivI5eytcdj -wk. if3g
Property Owner(s)of Record: B{,rVl,,t- ,( Mrtrie4,►� Ertcse ti
Telephone: 3 40- M`5"- tj 2-i 1 Fax: 3 9 S- (o 9 30 email: at b.t4-1c....“ , a.e ea,p4 • "WI
Mailing Address: L.2$1 LStIt 04 . tA)tst. Arne T61.Jylsew21 10,,... ete3 4,
Applicant/Agent(if different from owner):
Telephone:_ _ Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies)
NBuilding ❑Variance(Minor,Major or Reasonable Economic Use)
d Demolition Permit ❑Conditional Use[C(a),C(d),or C]**
M.Single Fa ' ❑Discretionary"D"or Unnamed Use Classification
Garage d= /Detached ❑Special Use(Essential Public Facilities)**
Manufac u -. 'ome °Boundary Line Adjustment
d Modular °Short Plat**
❑Commercial* °Binding Site Plan**
Q Change of Use ❑Long Plat**
Q Address i Road Approach °Planned Rural Residential Development(PRRD)/Amendments**
I:1 Propane ❑Plat Vacation/Alteration**
DAllowed"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
❑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:
DESIGNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE 12RAIht 14.tiii,'-* Date: /O -30-0 6
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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that h r she wants prior notice.
Signature: '' f Date: Il9"30--0(,
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 responsibili for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: '- E -e.4.14,. Date: I t9 `30-O h.
D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc
• •
i
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:
1 litc, 4415vnLS (36)) 3 79-4o0 (3iv) 3 79- 4(71
MAILING ADDRESS: q i.a J� pert T.., nse i] EMAIL:
8tut.,-t-�I, f Tod C L7C/'�dC.
CONTRACTOR'S LICENSE WAINS
NUMBER: 1-1 I�,j n h 6/ 1`g T, NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
RI New p Wood Existing: ❑Sewer
❑ Addition nil Steel Proposed: 24. Bank 0 Community System
❑ Alteration/Remodel ❑ Concrete Total: 2-h., Height: gt Individual System
❑ Repair ❑ Masonry SEP Permit# OS- tO
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well 0 Two Party
Type of Heat: Proposed: Publice Total: Z Name of System:-Poet
p Townc i ad .
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 0 Above ground Tank Size of Propane Tank:
d Heat Stove 0 Cook Stove 0 Woodstove ❑Fireplace Insert 0 Hot Water Tank CI 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 `79232g2 EH Bld App Review: (0563
2"0 Floor Heated S� �9Z_3Zg2,. Consistency Review:
)‘°
Other Heated Base fee: I 430
.55
Mezzanine Additional Section:
Heated Basement Plan Check fee:
q aq. 8/4)
Unheated Basement State Surcharge fee: .50
Other Unheated t"
Pot Water Review fee: ge
Garage/Carport 5 9.g t2441 I(o SUBTOTAL a��_
Decks • it ' �icy+ 911/Rd Approach fee: �
C_hor. tw.(Ae-vdow-S > 7 U -�n1
Other CANtxti tniyy A01 4—r37T1 TOTAL: $atom q t
Receipt Number: 35
225
Cash/Check Number:
LOOS
ESTIMATED COST(REQUIRED) 177,346 Date: (��`��
.Fair market value of all labor and materials foundation to finish
I2,S,0001 Initials: �
D:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05-2.doc