HomeMy WebLinkAboutBLD2007-00401 likUILDING PERMIT APPLICA ICN 13LD07-00401
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00401 Received Date: 7/20/2007
SITE ADDRESS: 80 HELM LN
PORT LUDLOW, 98365
OWNER: JOHN W ZALAHA TRUSTEE PHONE: 360-437-0306
LORNA M ZALAHA TRUSTEE
46 VILLAGE WAY PMB 182
PORT LUDLOW WA 983659762 PORT LUDLOW NO. 1 AREA 1
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 990400125 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NO MLA REQ'D - INTERIOR REMODEL, HEAT PUMP & 250 GAL A/G
PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 40,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2006 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: LUDLOW
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date: 1 ( c / 0
1
—
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $542.75 CJZ 07/20/07 91442 APPROVED
Plan Check $352.79 CJZ 07/20/07 91442
State Building Code $4.50 CJZ 07/20/07 91442 JUL � 2007
Total: $900.04
Jefferson County Planning
& Building Department
Jefferson County Building COPsion Permit N.ur: BLD07-00401
Applicant: ZALAHA TRUSTEE
BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Setbacks NA
Straps(hold downs) N/AP
Ext. Shear Wall Nailing 7/26/2007 N A
Rough in Plumbing IZ b
/ 5f110144z PIA) OK 1V/Y61a7
FramingPAM Az1
/
Airseal 12-/610
Insulation:Walls
i) /O 2) ZX a3
Insulation: Floors !j/0-2 ill'
�T Q 3D ove2 aA,eAI.4,-
Insulation: Ceiling //0fr g-3b Llo -ril/g<
Wallboard Nailing f//7/07 # oK-
Gas Line: Interior 1/1167
Gas Line: Exterior /J/A
Propane Tank 4/Sike G;
Fireplace Insert y/3/D$" el(
/�
Address Posted gX/yT
FINAL INSPECTION 0/0r ,6 / . /K -f r LM
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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0-) pN o� JEFFERSOUNTY _
,� DEPARTMENT OF COMMUNITY DEVELOPMEt4T
` `4 i 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
G p� www.co.jefferson.wa.us/commd Wlop tLbj
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�`rIfIN `). dUL 2 0 2007 '
Master Permit Application I , M ` : No mLP,,_.
Project Description (include separate sheets as necessary): r bEYEi_UfMtNT
interior Remodel
Tax Parcel A Property
Number: .(�J�T V 4Oa 125
J Size: .38 Acres (acres/square feet)
Site Address and/or Directions to Property:
80 Helm Lane Port Ludlow, WA 93365
Property Owner(s)of Record: J L.o Z ee F
Telephone: MO) 437-03`o'6 Fax: email:Zdlctrla. @ ix.nelcom.com
Mailing Address: � way Ul gage 8y PM8 1$2 Port Ludlow, WA 983
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit? (Check each box that applies
liBuilding ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a), C(d), or CJ**
❑Single Family ❑Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)**
❑ Commercial* ❑ Boundary Line Adjustment
❑ Change of Use ❑Short Plat**
❑ Address ❑Road Approach ❑ Binding Site Plan**
❑ Home Business ❑Cottagelndustry ❑ Long Plat**
❑ Propane ❑Planned Rural Residential Development(PRRD)/Amendments**
❑Sign ❑ Plat Vacation/Alteration**
❑Allowed"Yes" Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑Shoreline Management Substantial Development**
❑Site 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 ❑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:
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 appli tion that he M.
sheh�wants prior notice. /� r�
Signature: / / J. Date: J u I M� 20, 2.00-7
1
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-transfe ble,responsibility
for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
ib
Signature: c l/l G(.t.f / 1. rall4 Date: Jul9 2.01 20 CR
• 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:f Jr / / /�� Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
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 6( Wood Existing: 3 ❑ Sewer
Addition ❑ Steel Proposed: Bank ❑ Community System
si Alteration/Remodel ❑ Concrete Total: A Height: Individual System
Repair ❑ Masonry SEP Permit# 69_,6
Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well Two Party
Type of Heat: Proposed: ❑ Public
Electric Heat pump Total: Name of System:
Propane fireplace insert
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 I No
If this is a Propane Tank and/or Appliance Installation permit, mark all items below that apply:
I Underground Tank Above ground Tank Size of Propane Tank: 250
i Heat Stove 1Cook Stove i Woodstove `✓Fireplace Insert ] Hot Water Tank i Pellet Stove ] 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 I261 EH Bld App Review:
L No E
2n°Floor Heated O Consistency Review: I e4
/ `IU 2m- un
Other Heated 0 Base fee: 5Aa. I S"
Mezzanine a Additional Section: _—
Heated Basement 750 Plan Check fee: 3 e
Unheated Basement 33 State Surcharge fee: 50
e
Other Unheated O Pot Water Review fee: N
Garage/Carport //2"C 7 SUBTOTAL goo OA
Decks 911/Rd Approach fee: goo
!r XtStns —
Other TOTAL: $
Receipt Number: ! 1,g4a
a Cas Chec Nurnbe�: �
ESTIMATE COST f 2�EQUIRED) D —Dale: I; -1 O
.Fair�ket vlue of all labor aterials foundation t5 rn l I
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Section R313 - Smoke Alarms.
To be located in each sleeping room
and outside of each sleeping area in the
vicinity of the bedrooms. Interconnected
110 volt with battery backup.
L►v►n� room / ►ni►�g Room
Ceiling +o be Yaksed -Fo
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Section R310, as are to
CD �"'y All sleeping areas are to be provided
t� ./! with egress opening shall have a
r minimum of 5.7 sq. ft.
minimum height of opening, 24"
s BATH + minimum width of opening, 20"
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0 � MASTER PED ROOM
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