HomeMy WebLinkAboutBLD2008-00140 •UILDING PERMIT APPLICAAN ML Ty 168
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00140 Received Date: 4/7/2008
SITE ADDRESS: 582 OLYMPIC RIDGE DR
PORT LUDLOW, 98365
OWNER: ALAN STEWARD PHONE: (360)437-2929
MARCIA STEWARD
582 OLYMPIC RIDGE DR
PORT LUDLOW WA 98365-9555 OLYMPIC RIDGE ESTATES
SUBDIVISION: Block: Lot: 11+
PARCEL NUMBER: 821355047 Section: 35 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI STAIRS AND LANDING ADDED TO EXISTING DECK
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 908.00 ADD'L: HEAT TYPE:
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 36 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date: LA 1 Q
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $38.75 KAS 04/07/08 97209 APPROVEr
Plan Check $25.19 KAS 04/07/08 97209
State Building Code $4.50 KAS 04/07/08 97209
Total: $68.44 JUN 2008
Jefferson County Planning
&Building Department
Jefferson County Building Derision Permit Nur,: BLD08-00140
Applicant: STEWARD
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
Erosion Control OASBMPs
FINAL INSPECTION ;0/0 "75/ 4
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD08-00140
1.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington to control stormwater, erosion and sediment during
construction. BMPs shall address permanent measures to stabilize soil exposed during
construction, and in the design and operation of stormwater and drainage control systems.
2.) It is the property owner's responsibility to comply with the Plat and CC&Rs for vegetation
and height restrictions in the view corridor easements, and buiilding envelopes.
3.) Excluding that area within the 20 foot tree height View Corridor Easement, tree stock &
vegetation on Lots 1-11 and 15-19 shall be limited to 6 feet in height except for existing
trees at time of recording (See covenants for details regarding all view corridor
easements).
� �5ON Coc JEFFERSOP UNTY •
ti �g DEPARTMENT OF COMMUNITY'';���EVELOPMENT
`� 621 Sheridan Street • Port Towngendt•Washington 98368
0.- 360/379-4450 • 360/379-4451 Fax
,s+ 0 www.cojefferson.wa.us/cornindevelo• w t_
7 2008
Master Permit Application MLA: o3 - /L.F
Project Description(include separate sheets as necessary): _
S74/ C L, kDLAIL' 4DDF To E l'>% /,/I/� .QE�7�
Tax Parcel t _
Number. �3 c� 9' _Property , A( /6�0
/ Size: .- - (acre/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record:4L4,0 A /h l,h �'L4 J/ _ Gi
Telephone:��(%-- ¢5�.. 2 `� 1 /�' Fax: A49 _ email: AL Zs ��/y f� / .
Mailing Address: � �• �/
Applicant/Agent(if different from owner):
Telephone: Fax:
email:
Mailing Address:
What kind of Permit?(Check each box that applies
jSBuilding 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]**
❑ Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
❑ Address ❑ Road Approach ❑ Binding Site Plan**
❑ Home Business ❑ Cottagelndustry 0 Long Plat**
❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
El Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ 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
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
El Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetation 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 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 its knowledge. Any material falsehood or any omission of a material fact rnade 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 required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appf n that he 6 nts_ . r n tice.
Signature: _ Date: VO
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 with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfer esponsibilityr fo ad ring too a mplying with the ESA. The Applicant has read this disclaime and igns and dates it below.
Signature: l/ �7�0 -
-. Date: �' g
G:\PcrrnirCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.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 assu ' e responsibility eneral tractor for the proposed project.
Signature: i --__� Date: 9-
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAx:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
V New Ell Wood Existing: U Sewer
❑ Addition ❑ Steel Proposed: Bank 0 Community System
❑ Alteration/Remodel ❑ Concrete Total: He l t:) ❑ Individual Syyte 70
❑ Repair ❑ Masonry �( SEP Permit# e/ —
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: j ) ,1� ❑ Public
Total: . /.1LL! 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 EH Bld App Review: 10 e
2° Floor Heated Consistency Review: ,-}r�
Other Heated Base fee: OD
APR -- 1 2008 3s-15
Mezzanine Additional Section:
Heated Basement Plan Check fee: a5 ICI
Unheated Basement State Surcharge fee: l"J
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL
:. __� a95 ./k 4
/ ( (T /
911 Rd Approach fee:
Decks A D O/VV C+ 6 ° 4 ct G�•r D —..
Other �`_— TOTAL: $
Receipt Number: 9-13
Cash/Check Number: 3L
ESTIMATED COST(REQUIRED) Date: ID
•Fair market value of all labor and materials foundation to finish
/,/l 00 0 O Initials: ,L..1�
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
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