HomeMy WebLinkAboutBLD2007-00503 BUILDING PERMIT APPLICA1N BLD07-00503
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD07-00503 Received Date: 9/14/2007
SITE ADDRESS: 60 WASHINGTON ST
QUILCENE, 98376
OWNER: KATE WELCH PHONE: 360-452-8201
40 MONROSE PL
PORT ANGELES WA 98362
HAMILTON'S 5AC TRACTS
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 956100028 Section: 13 Township: 27 N Range: 02 W
CONTRACTOR: B & L ENTERPRISES PHONE: 360-683-8173
PO BOX 633
SEQUIM WA 98382
Contractor's License BLENT**120CP Expires 3/6/2008
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr NO MLA REQ'D - CONVERTING EXISTING UNHEATED SPACE TO
LIVING SPACE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 743
VALUATION 48,503.00 ADD'L: HEAT TYPE: GAS
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 1 Exist: 1
Prop: 0 Prop: 0
Total: 1 Total: 1
Routing Date: ,,/,,j
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e2(
Type Amount Paid By: Date: Receipt: Approved/Date
State Building Code $4.50 CJZ 09/14/07 93224 APPROVED
Permit $633.65 CJZ 09/14/07 93224
Plan Check $411.87 CJZ 09/14/07 93224 SEP. 62007
Total: $1,050.02 Jefferson County Planning
& Building Department
Jefferson County Building Drill ion Permit Num. BLD07-00503 '
Applicant: WELCH
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 /
Foundation Footing r0s67 ,,, -
Footing Drains
Straps(hold downs)
Ext. Shear Wall Nailing t\-&07 ('i
Framing .,
1. 3-0i bo mrt.soAk. ?ripe'f'o 1 tJ C Jt..44-I0")
Airseal k l✓ )—0)
Insulation: Walls 1),---.C.'01 V---
Insulation: Floors
Insulation: Ceiling
Wallboard Nailing
`4`— I -lye
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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_r onr(01,-ii \f* JEFFERS OU TY , . -_ - z., .
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DEPARTMENT OF COMMUNITY DEVELOPMENT
I-- .\ 14 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
,gS, N��pI www.co.jefferson.wa.us/commdevelopment
Master Permit Application ^ir n 1 4rig
MLA: NORe ci Lot
rnt Pc
Project Description (include separate sheets as necessary): ePaii" LJa+ar olan)a8e. fr, eJt5f,r78 zit' 4rnttj
Dr
residence (w V*ti rL e xtSirt rZg -foo ?Putt5
Tax Parcel Property Approxim. t'
Number: ci%[OOQ,2�y Size: �� !t.Z acres (acres/square feet)
Site Address and/or Directions to Property: 0 i rect1 ags : 44 1 ufaNN tat N +kro k c ut[ceen,
bo WaSh t n8tar� St. Quit Irene IA Wv'S!' o k ithtsktingtat. ,
Property O ner(s)of Record: K Welch,
Telephone: 3LoC 452-S2pi F x: email: kdann Welt .ah�rmatl.Coit
Mailing Address: 401\1. YVI O.CD5e- Pi. Yof'k An te5 WA C18�2
Applicant/Agent(if different from owner): d�
Telephone: Fax: email:
Mailing Address:
W t kind of Permit?(Check each box that applies
Building 0 Variance(Minor,Major or Reasonable Economic Use)
Demolition Permit ❑ Conditional Use[C(a),C(d),or C]**
+)Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)**
❑ Commercial* r(ee-- ❑ Boundary Line Adjustment
❑ Change of Use, 5i i AitA ❑ Short Plat**
,� Address ❑ Road Approach 0 Binding Site Plan**
❑ Home Business 0 Cottagelndustry ❑ Long Plat**
❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑Storniwater 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* 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:
Bu A 1dt r1,i (Pe r►�ttt
�7 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 require. later inspections.in Staffs access and right of entry will be assumed unless the applicant informs the C�o[unty in writing at the
time of the ap•licatio• that fyr Cpe wa is rior notice. /T Q�
Signature: „�ate-- Date:
The action or actio s 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-transf ra leonsibilit r heri g to and complying with the ESA. The Applicant has read this disc) er and signs and dates it below.
Signature: i Date: /' /5" .---
/
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.d9c
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 assumi tg the responsibili �ofthe�General Contractor for the proposed project.;
Signature: _I?: 4.. _ Date: t'It ft'71" -
GENERAL CONT CTOR OR MANUFACTURED HOME INSTALLER: PHONE: Fax:
134-L E i-etp'Ses (3.0) `83-St'3 ( )
MAILING ADDRESS: e5O St a C' Ave, / Sei u,e+t v.1 A EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: F me Type: Bathrooms: Shorelinp: Type of Sewage Disposal:
❑ New Wood Existing: I N/A 0 Sewer
❑ Addition 0 Steel Proposed: 0 Bank ❑ Community System
€,Alteration/Remodel 0 Concrete Total: Height: Individual System
Repair 0 Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 1 Setback: A Private well ❑ Two Party
Type f Heat: Proposed: = ❑ Public
( 2 S Total: I Name of System:
If this is a Commercial Protect 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:
i Heat Stove i 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 propan• tank to all property lines,buildings and septic system components,
including the reserve area.
Aau: 1.iirk .. ' .
i:, � ; Y, i.t«
Square Footage Current Proposed � rp,gr _„e ;A,„ t� �, c„l;;iop ' _ . .. _
Main Floor Heated O' H BId App Review: „_____�
s4� - 9$ 5o3.
2nd Floor Heated N/A ,`Consistency Review:
tr
Other Heatedn, " x1 Base fee:
Mezzanine NM '.* Additional Section: e_____.----
Heated Basement NiA ,. ;`: Plan Check fee:• 1 el
Unheated Basement o-�; State Surcharge fee: Dr....
i
Other Unheated VI ` r ,�.,, : Pot Water Review fee:
Garage/Carport �, $ 7 ; SUBTOTAL q�
F qC 1 s l i1 r" I.�iT
4,1
Decks k i,a 911/Rd Approach fee:
- : Y
Other " TOTAL: $
5A-42•-' Receipt Number: O 2) aazi.
..:._ .... ..
cash/Check Number: 3G\
ESTIMATED COST(REQUIRED) Date: Q /q O�
•Fair market value of all labor and materials foundatiorj to finish _t f
* ti 00b I i Initials: Cr ).--
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