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HomeMy WebLinkAboutBLD2007-00555 øj ILDING PERMIT APPLICAT N BLD07-00555 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00555 Received Date: 10/23/2007 SITE ADDRESS: 512 MALAMUTE LN PORT TOWNSEND, 98368 OWNER: ALLAN H VANCE PHONE: NANCY G VANCE PO BOX 6009 SAN RAMON CA 94583 MOUNTAIN VIEW VISTA SUBDIVISION: Block: Lot: 14+ PARCEL NUMBER: 974600014 Section: 8 Township: 29 N Range: 01 W CONTRACTOR: KNIGHT FIRE PROTECTION INC PHONE: 360-417-0505 2509 W 19TH ST PORT ANGELES WA 98362 Contractor's License KNIGHFP044LK Expires 5/24/2008 REPRESENTATIVE: KNIGHT FIRE SPRINKLERS PHONE: (360)417-0505 2509 WEST 19TH (360) 452-8074 PORT ANGELES WA 98363 PROJECT DESCRIPTIOI FIRE SPRINKLER SYSTEM - RESIDENTIAL TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 9,757.00 ADD'L: HEAT TYPE: 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: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: bi/O/7 Type Amount Paid By: Date: Receipt: AfiAdote 1 Permit $181.25 KAS 10/23/07 93387 Plan Check $117.81 KAS 10/23/07 93387 State Building Cocle $4.50 KAS 10/23/07 93387 NOV ! 2007 Total: $303.56 Jefferson County Planning &Building Department Jefferson County Building D•ion Permit NurrllTr: BLD07-00555 Applicant: VANCE BUILDING PERMIT INSPECTION APPROVALS applicable 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 Hydrostatic Test Flow Test Miscellaneous '1 14 Miscellaneous FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • RECEIVED ii CO6. JEFFERSON COUNTY A, '-` r DEPARTMENT OF COMMUNITY DEVELOPMENT OCT 2 3 1007 ,� 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax .n _ t1 vow/rn iPffPrcnn l•,o ,,c',nmmr'Ic‘inlnnmcn4 JEffERSQN COUNTY CO Master Permit Application MLA: No -114 I e O rb Project Description(include separate sheets as necessary): Tax Parcel ,,, . Property Number. 1 L O1 0l4' Size: i.3'fi � acres quare feet) Site Address and/or Directions to Property: K'jsjf c:d� b1ivy S r1- M►14 fl,)k 1411<. ,©( )4+,,t .1 2€ z/=�'�-ex/ � K✓ L-9+ J r fa r t Property Owner(s)of Record: 4 t%AC A-n p U.*.tc.j IJIAA a 721 e'er `� •4ic — Telephone: Fax: email: Mailing Address: -PQ I D- is ` cq►-1 a.tim0/1 i (t, K4C 3 Applicant/Agent(if different from owner): VP')1 1, H 1`—,rt. pro 4-Lvi-,0, (N, Telephone.0,404)1-6-SOS Fax — L email: tudclohi era..1,um Mailing Address: 25-zi ei k)C'sr 19 5T t %,°r . krY Le) t 4.131.3 What kind of Permit?(Check each box that applies ❑Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use[C(a), C(d), or C]** ❑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: Al'' 'L y,o DESIGNATION OF AGENT I hereby designate /� f/ T 1 to act as my agent in matters relating to this application for permit(s). �.Y" OWNER SIGNATURE �' \(/WJ-e Date: QC 2j/ 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 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 an ired later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the app n t or s e s prior notice. ` Signature: Date: 1.1 z.zld) 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 federai 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 ou are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf le res}f sibir adhering to and complying with the ESA. The Applicant has read this disclaimer signs and dates it below. Signature: Date: lel d) • C:\Documents and Settings\cactl\I.ocal Settings\Temporary Internet Files\()1,K86\Master Permit \pplication 1 2-1 9-311116.doc • • 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: Ktit 41 f- fla 'Test--trot) (.4?) ` /7-,-=:`77- (,T'd!,) '7`.('Z--Pe:?sL MAILING ADDRESS: 2}ic i. `L�_ 1 ICY 5 ,'_j'4 EMAIL: jlj�!-J�A„ e ' ( Ck.,07 CONTRACTOR'S LICENSE /. WAINS X NUMBER: �//h ii?c71/171/_k NUMBER ARCHITECT/ENGINEER: 5�/A-<.- PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: Sewer Addition Steel Proposed: Bank Community System Alteration/Remodel Concrete Total: Height: Individual System Repair Masonry SEP Permit# Demolition Other: Bedrooms: Water Supply: Existing: Setback: Private well Two Party Type of Heat: Proposed. Public Total: Name of System: If this is a Commercial Proiect 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: 0 Underground Tank 0 Above ground Tank Size of Propane Tank: ❑Heat Stove 0 Cook Stove 0 Woodstove 0 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 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 EH Bld App Review: ---- 2"Floor Heated Consistency Review: Other Heated Base fee: i 2145 Mezzanine R (.��(�,E I V I!:Illitional Section: Heated Basement Plan Check fee: I Unheated Basement OCT 2 3 2007 State Surcharge fee: 45© Other Unheated Pot Water Review fee: Garage/Carport JEF !ON COUNTY 8-C8 SUBTOTAL ()3. 5 G Decks 911/Rd Approach fee: (-C)`I S l n Other 121.-' ifxr-1111._ TO L: $ SDJ i 5(O 1',rt, c'eAkill-Ltiet Receipt Number: Cl )�1 Cash/Check Number: gi, ESTIMATED COST(REQUIRED) Date:d.m ` •Fair market value of all labgrana 1 te dation to finish 3101 Cc,1Sletle _ Initials: (::A1),cumcnts and Scttings\caral\L'cal Sohn;'y\ emh(ran.Inicrnct files\O1.1-N6\Master Pcrmit AppIicatum I2-19-21)I16A)c