HomeMy WebLinkAboutBLD2007-00410 0ILDING PERMIT APPLICATS BLD07-00410
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00410 Received Date: 7/25/2007
SITE ADDRESS: 140 TRAFALGAR DR
PORT TOWNSEND, 98368
OWNER: J M LACEY PHONE: (303) 329-3769
ELIZABETH LACEY
1820 BELLAIRE ST
DENVER CO 80220-1051 KALA POINT#4
SUBDIVISION: Block: Lot: 139
PARCEL NUMBER: 965000128 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: JOE BURSON PHONE: (360) 301-0590
100 NORTH BAY WAY (360)437-2244
PORT LUDLOW WA 98365
PROJECT DESCRIPTIOF CONVERT UNHEATED BASEMENT TO HEATED BASEMENT
ADD BATHROOM & BEDROOM (NO MLA REQ'D - NO CHANGE IN
FOOTPRINT)
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 101,640.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2006 HEAT BASE: 1,134 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: 3
Prop: 1 Prop: 1
Total: 3 Total: 4
Routing Date: 9ic)3
l6'"-1--112
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,004.95 KAS 07/25/07 91524 APPROVED
Plan Check $653.22 KAS 07/25/07 91524
State Building Code $4.50 KAS 07/25/07 91524
Total: $1,662.67 AUG I 2007
Jefferson County Planning
&Building Department
Jefferson County Building Dion Permit Nu•: BLD07-00410
Applicant: LACEY
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
Rough-in Plumbing
Framing
Airseal
Insulation:Walls
Wallboard Nailing
L��✓A-C— `t'S—/j -07 -
19
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
go'
JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
tip' '4 621 Sheridan Street•Port Townsend•Washington 98368
/ 360/379-4450 • 360/379-4451 Fax
vvww.co.jefferson.wa.uslcommdevelopment
Master Permit Application iMl: 1:
Project Description(include separate sheets as necessary):FINISH BASEMENT
Tax Pa el 965000128 Zr?Pry Approximately17543sqft
(acres/square feet)
Site Address and/or Directions to Property:
140 Trafalgar Port Townsend Washington
Property Owner(s)of Record: J.and Elizabeth Lacey
Telephone:303.329.3769 Fax: email:
Mailing Address: 1820 Bellaire Denver Colorado 80220
Applicant/Agent(if different from owner): Joe Burson
Telephone:360.301.0590 Fax: 3604372244 email:
Mailing Address: 100 North Bay Way Port Ludlow Washington
What kind of Permit?(Check each box that applies
1 lBuilding ❑Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a),C(d),or C]'"'
l Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use ❑Short Plat**
❑ Address 0 Road Approach 0 Binding Site Plan**
❑ Home Business D Cottagelndustry ❑ Long Plat**
❑Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Sign El Plat Vacation/Alteration*"
❑Allowed"Yes'Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
Stormwater Management 0 Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wreless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
0 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 JOe Burson to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE /r/ Date: 25 July 2007
By signing this application form,the'owner/agent attest at 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 a y 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 tater 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 he or she wants t. •
Signature: ," / r Date: 25 July 2007
The action or actions Applicant will and ake as a resul the issuance of this permit may negatively impact upon one or mere threatened or
endangered species and could lead to a potential"take't�dfof 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 responsibility for adhering to aAllf complying with the ESA. The Applicant has read this disclaimer and signs and dates it below,
Signature ✓� ^ L./7 Date: 25 July 2007
C:\Docunaits and Settings\carat\Local Settings\Tanporaty Internet Files\OLKBG\Master PemvtApplication 12-19-2006.doc
4
ID •
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 7rilibility,of the General Contractor for the proposed project.
Signature: A Date: 25 July 2007
GENERAL CONTRACTO R MANUFACTU OME INSTALLER: PHONE: FAX:
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER' NUMBER
g ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
J New U Wood Existing: 2.5 J Sewer
J Addition IJ Steel Proposed: 1 Bank ,1 Community System
,d Alteration/Remodel L Concrete Total: 3.5 Height Li Individual System
J Repair a Masonry SEP Permit#
Bedrooms:
J Demolition a Other Existing: 2 Setback: Water Supply:
U Private well J Two Party
Type of Heat Proposed: 1 rd Public
Heat pump Total: 3 Name of System:
Jf this is a Commercial Prolect 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: Wll you have Food Service? Yes / No
If this is a Propane Tank andlor Appliance Installation permit,mark all items below that apply:
❑Underground Tank °Above ground Tank Size of Propane Tank:
❑Heat Stove 0 Cook Stove 0 Woodstove Q Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 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 ell property lines,buildings and septic system components,
including the reserve area.
Square Footage _ Current Proposed For''Offitte Use Only: , .. . Amount:, Revision::; ;
Main Floor Heated 2722 m EH Bid App Review.
(3 , o0 _
2a0 Floor Heated Consistency Review:
Other Heated Base fee:
lc)U4(
Mezzanine Additional Section:
Heated Basement 1934 Plan Check fee: r
Co d 3.
Unheated Basement 1222 88 State Surcharge fee: �f �
Other Unheated Pot Water Review fee:
Garage/Carport i i SUBTOTAL ?3o'
Decks 911/Rd Approach fee:
Other TOTAL: $
Receipt Number:
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date:
.Fair market value of all labor end materials foundation to finish
Initials:
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EVANS— PAGE Kevls�ons' - Custom Building and Design
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= pat faw:saSWa 98368 Fax:(360)385�115