HomeMy WebLinkAboutBLD2008-00007 4itUILDING PERMIT APPLICAN BLD08-00007
Review Type:
Jefferson County Department or Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00007 Received Date: 1/9/2008
SITE ADDRESS: 30-3 HARBORVIEW DR 1016
PORT TOWNSEND, 98368
OWNER: DOROTHY J DONAHOE PHONE: (425) 746-7113
5571 178TH AVE SE
BELLEVUE WA 98006-5933
KALA POINT CONDO#1
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 964900006 Section: 26 Township: 30 N Range: 01 W
CONTRACTOR: MYSTERY BAY WOODWORKS PHONE: (360) 379-0544
JEFF WHITTING
1111 GRIFFITHS POINT RD
NORDLAND WA 98358
Contractor's License MYSTEBW942N8 Expires 8/28/2008
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP INTERIOR REMODEL OF KALA POINT CONDO - RELOCATE STAIRS,
REPL PLUMBING FIXTURES..
APPLIANCES, CABINETS AND FLOORING
TYPE OF WORK 3-4 SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 48,000.00 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: 2 Exist: 2
Prop: 0 Prop: 0
Total: 2 Total: 2
Routing Date:
Type Amount Paid Bv: Date: (Receipt: Approved/Date
Permit $623.55 KAS 01/09/08 95697 APPROVEr
Plan Check $405.31 KAS 01/09/08 95697
State Building Code $4.50 KAS 01/09/08 95697 JAN 3A2002
Total: $1,033.36 Jefferson County Planning
&Building Department
Jefferson County Building Division Permit Number: BLD08-00007
Applicant: DONAHOE
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Framing
/o10
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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JEFFERSOI.DUNTY I
�� DEPARTMENT OF COMMUNITY DEVELOPME 1 4141117.
ID
W 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax JAN - 9 Zhu$
\/1 �p www.co.jefferson.wa.us/commdevelopment
�./ING
Master Permit Application JEEFEf1SI1N ��Y f 1 LO fl v D�+n
Project Description (include separate sheets as necessary): �
REttlel1t1.- /Al Ti LIOtz-- Sill-CZ - 4e1-0 !e ST //2-S % 2G-Pr tj IOI ildity: j=/X,14M- #4c,fI C t 116-15 le-Wr I/6,
Tax Parcel Property Cohn p�„IINr1A,i vN/i
Number: —1 00(, Size: (acres/square feet)
Site Address and/or Directions to Property:
(30- 3 f7/112-8012✓/ w 6124 tit- ii-
Lo r /016 Ire-cr4 /o>rvr
Property Owner(s)of Record: 0 O T-lM y OOA/f} Hoe
Telephone:'1 2.S- 7'I& - 7/1.3 Fax: email:
Mailing Address: . 3 7/ /7$" ltVF S e, /jeL-tiEvi, .,/f t,LiA, 1 g 006
Applicant/Agent(if different from owner): \J t// 1,01-//TTIN 6. /i i3/t My57 -7 tn,e2764✓0R4i i
Telephone:360--j 7y-0S-L11.) Fax: 36O 379 St-iL/ email: e-W/7 -/,I i Oly v✓..&'t
Mailing Address: I11 1 G(24 Fn TMj' PT. 12-6. t'voi2-4 tstyvbi P-'A • 9'3 8
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]**
X Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use ❑ Short Plat**
❑ Address ❑ Road Approach ❑ Binding Site Plan**
❑ Home Business 0 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 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 /TAlR/FN Al //OL- to act as my agent in matters relating to this application for permit(s).
CA
OWNER SIGNATURE, J Mi (rwr,44:t` Lfk uY rtik,,t} ,L;3,0E.: Date: /-7 -cr-
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 entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and any required later inspections. St ffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appli tin that he or she vita nor notice.
Signature: ���, Date: / -7'Ca
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 wit the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-traga le respe ity for, ring to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:\ Date: %-7-�,J
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
1110 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:
C.► e: l^JH i TTjiv G (5-)60) 3 7y-0S'-i ti (36O)3'79 -OsUJL/
MAILING ADDRESS: EMAIL:
Ill/ ��/G�i tits FT, 2c� wbe/ Tl'/iL7G �, OL,y/...,,t), 60,44
CONTRACTOR'S LICENSE WAINS
NUMBER: Myc rr is Cu 9' / Z AJ 8 NUMBER
ARCHITECT/ENGINEER: / PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New X Wood Existing: 2 ❑ Sewer
❑ Addition ❑ Steel Proposed: 0 Bank ACommunity System
Alteration/Remodel ❑ Concrete Total: Z. Height: ❑ Individual System
Li Repair ❑ Masonry SEP Permit#
Ci Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 1.. Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed:Total: )2. X Public
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:
I Underground Tank i 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 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 /O2 EH Bld App Review:
2nd Floor Heated S/ l Consistency Review: -
Other Heated JR T[�;�(7,E I VIP I Base fee: d3 .5
Mezzanine J�� `� I J Additional Section: J
Heated Basement JAN - 9 t DIJB Plan Check fee:
405.31
Unheated Basement State Surcharge fee:
JffFERS44 COUNIY DLL 5�
Other Unheated 1. � � of Water Review fee:
130
Garage/Carport SUBTOTAL I O55, 5(
Decks 911/Rd Approach fee:
Other TOIL: $ I033. 5&P
Receipt Number: "I 5 6 q 1
Cash/Check Number: /
ESTIMATEDt va_ COST(REQUIRED) Date: &OS
.Fair a e labor andmaterials foundation to finish
(` j 8 C�00 Initials:
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc