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HomeMy WebLinkAboutBLD2007-00469 • MLA07-00486 BUILDING PERMIT APPLICATION Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00469 Received Date: 8/24/2007 SITE ADDRESS: 543 SILENT LAKE RD QUILCENE, 98376 OWNER: MARK A ANDERSON PHONE: 425-277-8915 KAREN A ANDERSON 12716 SE 189TH PL RENTON WA 980587961 SILENT LAKE LARGE LOT SUBDIVISION: Block: Lot: PARCEL NUMBER: 701355003 Section: 35 Township: 27 N Range: 01 W CONTRACTOR: LITTLE & LITTLE CONSTRUCTION PHONE: (360)385-5606 2009 4TH STREET PORT TOWNSEND WA 98368 Contractor's License LITTLLC157C5 Expires 2/28/2009 REPRESENTATIVE: LITTLE & LITTLE CONSTRUCTION PHONE: 360-385-5606 2009 4TH ST PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI NEW SFR W/ ATTACHED GAR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,271 VALUATION 500,000.00 ADD'L: HEAT TYPE: PRO CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 1,227 SETBACK: DECK: 645 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date:8 01 0 7 Type Amount Paid By: Date: Receipt: Approved/Date Permit $0.00 CJZ 08/24/07 Plan Check $0.00 CJZ 08/24/07 State Building Code $0.00 CJZ 08/24/07 Potable Water Application $0.00 CJZ 08/24/07 Total: $0.00 • June 16, 2008 Jefferson County Community Development 621 Sheridan Street Port Townsend, WA 98368 Parcel Number: 701355003 Property Address: 543 Silent Lake Road Quilcene, WA 98376 Dear Sir or Madam, The purpose of this letter is to request withdrawal of the building permit that was applied for on our behalf by Little and Little Construction on August 24, 2007. If there are funds left over from the application on 8/24/07, please return to: Little and Little Construction 2009 4th Street Port Townsend, WA 98368 Thank you for your attention in this matter. Please call or email if you have any questions. Sincerely, 62(UcCt Mark and Karen Anderson 12716 SE 189th Place Renton, WA 98058 425 277 8915 frapaday@hotmail.com cc: Bob Little, Little and Little Construction JUN 1 7 2008 Jj r :.: . ` LQ{,:;+[NT III n n, fi i �, � �� �iI ,tl c� & JEFFERSON COUNTY ( --;,i,---,s°1.4 \ �,a DEPARTMENT OF COMMUNITY DEVELOPMENTV�1+"}' lV v ''4 621 Sheridan Street• Port Townsend•Washington 98368 3601379-4450- 360/379-4451 Fax S�I # www.co.jefferson.wa.us/commdevelopment �` ING� Master Permit Application MLA: Oil ` . k2b Project Description(ind parate sheets as necessary): ; � FM&A .; I y 5; Pi.LA._ w �. Tax Parcel �7 d C. z Property Number. 1 7_) .� //00 1.-' 1 Size: 3 1 f CAC-lie 5 1(acres/square feet) Site Address and/or Directions to PProperty: ,C)`'I �1 1 f7(-�-- L4 It - l' OLtci/ X\A y C_c-tr�-Q___-___ Property r(a)of Record:_ 1L'14., t I ((-. .�<-P_-e'--) }`�'"V -f' K t )r~l _ Telephone 15 21 - --is� ) 1 Fax email: K.YY'1C Ct-r.lot &) AA S 6'' . f-t.)o-t Mailing Address: 1 2.:1 t Lp -; i C"r+-i--, e / -✓rfV rl r 1 Zs''O� App�lieant/AgeRH#d L. '•�owner): i� '�� L i- -i "ri.^ Telephone:31(PO •" ex: -':773 tzjrm eail:Ct(C ,_ ► _ e 1tt+lee ce Malin ress: 0.01 q+4'.• 5 A- i�o✓4- ( b W 1.,....ryC Pl. What kind of Permit?(Check each box that applies) i Building i Variance(Mirror.Major or Reasonable Economic Use) r i Demolition Permit .1 Conditional Use(C(a),CO),or C)" Single Fa e•'• , Discretionary'D•or Unnamed Use Classification Garage Attached D- ached ' Special Use(Essential Public Facilities)—i i Manufactu -ore Boundary Line Adjustment 'i Modular . Short Plat•• i Commercial' I Binding Site Plan** Long• Plat" Change• res Use i Road Approach i Planned Rural Residential Development(PRRD)/Amendments" Propane i Plat Vacation/Alteration" Avowed'Yes"Use Consistency Analysis i.i Shoreline Master Program Exemption/Permit Revisions" Stomiwater Management rm Shoreline Management Substantial Development" Site Plan Approval Advance Determination(SPAAD)• I i Shoreline Management Variance Temporary Use I i Comprehensive Plan/UDC/Land Use Dishier Map Amendment Wireless Telecommunication• 'I Jefferson County Shoreline Master Program Amendment I Forest Practices Act/Release of Six-Year Moratorium •May require a Pre—Application Conference "Requires a Pro-Application Conference Please identify any other local,state or federal permits required for this proposal,if known: r t DESIGNATION OF AGENT I hereby designate Lt �lG i 4"4"(-R-- to act as my agent in matters relating to this application for permit(s) OW ER SIGNATURE ��.�•' ^�l1 N --��(,/t�I 1------ Date: ._7/ ( /c-: 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 its knowledge. Any material falsehood or any omission of a material fad made by the over/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 attorneys 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 i�pections.Acceys and rig of entry to this property shall be requested and shall occur only during regular business hours. iT'� � Ili��• Signature: -... Date: b 1 ( z4i 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 Ara'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 Prance with the Jefferson County development code.The Applicant acknowledges that he,she or It holds individual and non-trarrable Witty for a herine and complying with the ESA. The Applicant has read this disda• Znd signs and dates it below. ' Signature: �-, A. Date: O'7 1 1 C\I)ocumcrtts and Settings\mochil\Desktop\Master Permit Application 7-t1-04.doc ) ..l!UV,Y ! ! 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: iL-i 4-4-LL + L i A4-t_._ G :r.s.k-w c.\,v,.N, (34( 3t35—$(,t . a3 0) 31S5=4 7 33 MAILING ADDRESS: j oql i4 " ea itv a t. rig,- i;{.He,.co,. CONTRACTOR'S LICENSE vv� WAINS NUMBER: LTD1% 040 I 5'1 G5 NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: XNew `Wood Existing: _0 ❑ Sewer ❑ Addition ❑ Steel Proposed: Z Bank i I Community System ❑ Alteration/Remodel ❑ Concrete Total: Z- Height: X Individual System ❑ Repair ❑ Masonry 'SEP Permit#'j0903'CV{3Z. ❑ Demolition ❑ Other: Bedrooms: ,./ Water Supply: Existing: 1e7 Setback: >( Private well 1 1 Two Party Type of Heat: Proposed: Z. f1 Public ' ;,G,n,4- —L!' Total: Z. Name of System: 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 ArAbove ground Tank Size of Propane Tank: S(7( ❑Heat Stove ook Stove 0 Woodstove 0 Fireplace Insert Hot Water Tank 0 Pellet Stove gOther I4 yI vo. 'c- (.1 ea. . Is this appliance being installed in a Manufactured/Mobile Home? Yes / No /I ♦ sata 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 On y Amount Revision Main Floor Heated Zt�,.,�, ^oa rMr] EH Bid App Review: I 2na Floor Heated �t .7�1't Consistency Review: 1p 153 Other Heated Base fee: 3 a33.1 e Mezzanine Additional Section: ✓ Heated Basement Plan Check fee: 1 LDL . 6i4 Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Gil J 2 Garage/Carport SUBTOTAL C\ Decks �I , � I�n^J n�• 911/Rd Approach fee: E k t!1 iry Other '— TOTAL: $ Receipt Number: CI a° VI. Cash/Check Number: -G ESTIMATED CQST-(REQUIR Date: y'��.°' 51 1 Ja�7��'7 .Fair ma alue of all labor and materia undation to finish p�3/(! l 500 Initials: AUG 2 3 2007 C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc • 4 L :ME ♦ 1 •♦ y aaI � • • 19 '' /J •I •♦♦ • . • \ \\\ II ♦♦♦♦ 11 IIS C __il C� ` \ § I, o \ \ 4 • • / ♦ • • \ L J /' I '` 'I • ♦ t ob ,�r • , L Y Ar ♦ i .0040/, ,,, * \\, 4 8 ii er 4-------f7" e/ D''' ,oes 'n \vv alb , ;'�, 4,4 ,- , t ,..-. ,- ,•1-,-10004/01 • r ,- ,y.,,, I_ \\ .. \ ♦ Z • ♦ 74110' • • • \ . \<' ' 1. 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