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HomeMy WebLinkAboutBLD2007-00380 •UILDING PERMIT APPLICA II N BL v Reviewiew T Ty380 ype: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00380 Received Date: 7/17/2007 SITE ADDRESS: 50 FOSTER LN PORT LUDLOW, 98365 OWNER: WILLIAM P COOPER PHONE: 360-437-4057 B COOPER %SP SYSTEM/LORAL 50 FOSTER LANE PORT LUDLOW WA 98365 PORT LUDLOW NO. 2 AREA 3 SUBDIVISION: Block: Lot: 61 PARCEL NUMBER: 990600361 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: HERS CONSTRUCTION ___fax-e- 1 Vi.wlez PHONE: (360-)30-4 10-70 37-1-BtSI1UP-HILL RD CHIMACUM WA 98325 Contractor's License BISHOBC033DG Expires 1tt'ti2009 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr REPAIR & REPLACE 400 SQ FT EXISTING 834 SQ FT DECK ( WITHIN EXISTING FOOTPRINT) - NC) MLA REQ'D t ,, St on -'i- /-11 - v't, , TYPE OF WORK NON SQUARE FOOTAGE: ( 1)1a-L'E 1110L-CALLA. '4 34i SECA(ST11361 TYPE OF IMP REP MAIN: I�a VALUATION 46;eee:$O496C.+` ADD'L: HEAT TYPE: UH CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routin Date: _ 1 f_ — Type Amount Paid By: Date: Receipt: Approved/Date PlanPermit $251.25 LYK 07/17/07 '91384 Check $163.31 LYK 07/17/07 91384 A PPROVED State Building Code $4.50 LYK 07/17/07 91384 JUL 17 20E17 Total: $419.06 Jefferson C9 & Buildin Department ng • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD07-00380 Received Date: 7/17/2007 SITE ADDRESS: 50 FOSTER LN Issue Date 7/17/2007 PORT LUDLOW, 98365 Expiration Date 7/17/2008 OWNER: WILLIAM P COOPER PHONE: 360-437-4057 B COOPER %SP SYSTEM/LORAL 50 FOSTER LANE PORT LUDLOW WA 98365 PORT LUDLOW NO. 2 AREA 3 SUBDIVISION: Block: Lot: 61 PARCEL NUMBER: 990600361 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: PHONE: 3(0c-a;f 2yo3 G L4 Pme) 162. Contractors License Expires ICE IZ t2 I PROJECT DESCRIPTION: REPAIR & REPLACE 400 SQ FT EXISTING 834 SQ FT DECK ( WITHIN EXISTING FOOTPRINT) - NO MLA REQ'D REVIS►cn y4Z'll _ r k_ TYPE OF WORK NON SQUARE FOOTAGE: 1 1Q <I31} ExtS1,L bat_ TYPE OF IMP REP MAIN: J VALUATION 15,000.00 ADD'L: HEAT TYPE UH CODE EDITION. 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $251.25 LYK 07/17/07 91384 Exist: 0 Exist: 0 Plan Check $163.31 LYK 07/17/07 91384 Prop: 0 Prop: 0 State Building Code $4.50 LYK 07/17/07 91384 Total: 0 Total: 0 Total: $419.06 Directions to Site: SEE DIRECTIONS & MAP IN FILE HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY Jefferson County Building Dirsion Permit Numi: Applicant: BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes -/ FINAL INSPECTION -1\\ c),12 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR co&� JEFFERSO,UNTY • ti DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �q p� www.co.jefferson.wa.us/commdevelopment S41.NO Master Permit Application MLA: 7.--- Project [ (.--- j Project Description(include separate sheets as necessary): _r ()CT f�rS/7 k16 Coori 2!JT„ Tax Parcel Q Property /22c- ." - Number: 9 0 600 3G L Size: 1y$,a' „ ram,.o� (acres/square feet) Site Address and/or Directions to Property: ' £o•STEYZ LAlJc /'7o 2T Luck0LJ hJ4 983405 Property Owner(s)of Record: LcJ;//i A✓►'t P /,3L'VE1Z-L-y s Coop�'►Z Telephone:360 y 3 7- go 5-7 Fax: email: C.oDf�'YLGJF e As:�.��M Mailing Address: ,j O �z�STCn Law�C tb"r G.eJbi-LJ,Cal �v 36S Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit? (Check each box that applies \ `„ �t �� 1 ❑Building 0 Variance(Minor, Major or Rea lion �`�i1e, ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or J ❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** i 200� ❑ Commercial* 0 Boundary Line Adjustment �i,,y, i ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** u\1�1 ) f di, ** ❑ Propane 0 Planned Rural Residential Develo b5/,� e m n s ❑ Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use 0 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 0 Tree Vegetaion Request *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: T//SAce 7 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 acc nd right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required r' spe s. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicatio e e wants prior notice. --Signature: Date: 7 .2007 The action o ctions Applicar 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 c liance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable re ib'i adhering to and complying with the ESA. The Applicant has read this disclgimernd signs and dates it below. signature: Date: 7 %� G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc . BUILDER STATEMENT 411 The signer of this state -•'does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that th:: ebe assum .. - re; sibility of the General Contractor for the proposedroect.: �. Date: 7 Lc- —200 7 GENERAL ONTRACTOR 0 ANUFACTURED HOME INSTALLER: PHONE: FAX: if,S/-43 �17.c.J S0Y1UGiTcu) ( ) ( ) 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: 0 "t ❑ Sewer ❑ Addition ❑ Steel Proposed: 0 Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 0 Height: ❑ Individual System • $Repair ❑ Masonry SEP Permit# /0 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: t., ❑ Public N/P, Total: C Name of System: /J/,a 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: i Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i 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 5 EH Bld App Review: �It'�l , 7.2� t 2nd Floor Heated Consistency Review: s 1v .5i 4-, W Other Heated Base fee: C' 0,75 Mezzanine Additional Section: ......----- Heated Basement Plan Check fee: - i7- fir/ 1 L,5. 1 IS 1'-`-1(3 Unheated Basement State Surcharge fee: s. 0 Other Unheated Pot Water Review fee: fl A Garage/Carport SUBTOTAL Decks .. 911/Rd Approach fee: 3,4 Other TOTAL: $, (C. cX, I 1 19 ,q 0 Receipt Number: et 13S if 1 a 3 ( Cash/Check Number: 059)4 37‘45 ESTI - EQUnd m t Date: It_t_ air market value of all labo nd m terials foundation to finish 9 (� ©,8'r ) rn Initials: �—` _ _ <, D _ f G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc -t7 • 7c) • _ 7--- C(1**.‘1°' . a. .. A/T.. ‘ EI--. - 3, --0 P 5 -01 c 1 0 ` -77 -1 44 _t- 7 F .,.c 74- i I -1 ----...„„ (5. V() . c.< g i , E: 5 . . ...._..........,_ ......... . , _t ),) C \ 1 — 9n C \ Fi. 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