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HomeMy WebLinkAboutBLD2008-00021 r IRJILDING PERMIT APPLICATIN B RD08N Type: Jefferson County Department of Community Development 621 Sheridan Street Poit Townsend, WA 98368 PERMIT #: BLD08-00021 Received Date: 1/22/2008 SITE ADDRESS: 340 WINDSHIP DR PORT TOWNSEND, 98368 OWNER: DAVID G GOODING PHONE: 360-385-2653 SARA B GOODING 340 WINDSHIP DR PORT TOWNSEND WA 983682515 KALA POINT#1 SUBDIVISION: Block: Lot: 55 PARCEL NUMBER: 964700056 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: NELSON CONSTRUCTION INC PHONE: (360)385-3062 31 COMBS PL PORT TOWNSEND WA 98368 Contractor's License NELSOCI972C1 Expires 1/10/2010 REPRESENTATIVE: RICK NELSON PHONE: 360-385-3062 31 COMBS PL PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOF REPAIR FIRE DAMAGE TO FIREPLACE & CHIMNEY TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 100,000.00 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: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: 122-c)z Type Amount Pal 8V: Date: Receipt: Approved/Date Permit $993.75 LYK 01/22/08 95636 APPROVEP Plan Check $645.94 LYK 01/22/08 95636 State Building Code $4.50 LYK 01/22/08 95636 JAN 93 2002 Total: $1,644.19 Jefferson County Planning &Building Department Jefferson County Building Division Permit Num1Tr: BLD08-00021 Applicant: GOODING 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 clay'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 Foundation Footing =i ;owFuu►t-0,-,e f-juts Heat/Chimney Clearance V}7/0gJ�'�,OiNtpiNiA Miscellaneous FIREPLACE REINFORCING Miscellaneous FIREBOX/DAMPER INSPECTION Miscellaneous CHIMNEY 0*<<1/, 21 tioci, 6 4.` /GIs c 2/27/Ue #V 4' LIFT --ye4‘1411 2--2A-c( k,41 FINAL INSPECTION I . •1.0_19q1 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR �/ ON cO��G JEFFERSO UNTY • W S ,) DEPARTMENT OF COMAt��T1v,(� I w 3'in h ''� 621 Sheridan Street • Pckt wf en s I-- 8368 4.4 .. , 360/379-4450 •• 360/379-4451 Fax N`, INp� JJAAI�1 p www.co.jefferson.wa.us/comm�iel/�I�prel��08 itii mAitt-)b Master Permit Application MLA: kb Pr. ect Description (include separates eels a hecesiEfc9-6.Mitoki ar.S iliCatk, ��,�ppRSO-.--NnnCOUNTY DCD AASI O 4 ntylaitualifki V Tax Parcel Pr. erty ta Number: �4-�©0O Y Size: (acres/square feet) Site Address and/or Directions to Pro rty: , VV t r Property Owners)of Record: Ntalf Telephone: cn5— * Fax. e il: Mailing Address: l T • Applicant/Agent(if different from owner): _ Telephone: 3806'1040^. Fad email: VICkaltky 37r4SI LV' Mailing Address: r 5tt � bUi% , 1 W at kind of Permit? (Check eac(1 box that applies Hid Byitding (U_ Q1�1, >rr �1- 0 Variance(Minor, Major or Reasonable Economic Use) iff Demolition l ermiitt 0 Conditional Use[C(a), C(d),or C]** O Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification O Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** O Commercial* 0 Boundary Line Adjustment O Change of Use 0 Short Plat** O Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business ❑ Cottagelndustry 0 Long Plat** O Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** 0 Allowed "Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** O 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 0 Wireless Telecommunication* 0 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: WaiLi SIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: a -G�1 By signing this application form,the owner/agent attests that the i ormation provided herein,and in any attachments,is t and correct to the best of his,her or it's knowledge. Any material falsehood or any omis i 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. -r inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the a••IV io hat he •r e t io/r�,notice. Signature: . `� +�V Date: The action or actions Applicant will undertake as a result of the issuance of thispermit maynegatively impact uon one o ore threatened or PP 9 Y P 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 yo e in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non- a s a res }bilit' f herig to and complying with the ESA. The Applicant has read th" disclaimer and spnsajdates it below. Signature: Date: 6 " G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc , BUILDER STATEMENT The signer of thi statement dces ere y c i that the are the Owners of the parcel refere ed her n,that they are not licensed contractors and that they will be assu ing t respbnsi lit of e eneral ntti actor for the proposed project. V Signature" CX2- " Date: I m3 O2 NERAL CONTRAt &IAJ1.L R OR MANUFACTURED HOME INSTALLE . PHONE: FAX: WASVAuA (3i4L) )&8'S'30 61 (363 )397-306-i- MAILINGADDRESS: 2 ( P TCLAAA SAIO EMAIL: Vtckac j 3-1Q 0S1.1.COW\ CONTRACTORS LICENSE WAINS NUMBER: Nt-F LSOCIC`1 C t NUMBER ARCHITECT/ENGINEER: Iivh� PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New Yr Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑/Alteration/Remodel ❑ ,Concrete Total: Height: ❑ Individual System l0 Repair V' 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 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 1 Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /-o_ 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: N Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: ''II Unheated Basement State Surcharge fee: I Other Unheated Pot Water Review fee: tiA Garage/Carport SUBTOTAL I(; Decks 911/Rd Approach fee: Other TOTAL: $ i lctl 1. 1 q Receipt Number: q�/ Cash/Check Number: I CC��''rl^U ESTIMATED COST(REQUIRED) Date: ��ll ��``'' •Fair market value of all abor and materials fouejlation to finish ����"l.C) t.:,' P10©006 . - Initials: j G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc