HomeMy WebLinkAboutBLD2008-00154 •
BUILDING PERMIT APPLIOION ML ReviewTy 139
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00154 Received Date: 4/21/2008
SITE ADDRESS: 6193 FLAGLER RD
NORDLAND, 98358
OWNER: STEPHEN FRENZL PHONE: 360-385-6100
430 MEADE RD
NORDLAND WA 983589618
SUBDIVISION: Block: Lot: T22
PARCEL NUMBER: 921051023 Section: 5 Township: 29 N Range: 01 E
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: C.D. GALLUP PHONE 1=866=882=®fi g
2726 PACIFIC HWY E
TACOMA WA 98424
PROJECT DESCRIPTIOP NEW SFR W/ATTACHED GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,286
VALUATION 400,000.00 ADD'L: 667 HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: '1,286 HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5-1HR OTHER: SHORELINE:
CONST TYPE: GARAGE: 676 SETBACK:
DECK: 584 BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PUD
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 3
Total: 3 Total: 3
Routing Date:
/ i/ c
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $2,673.75 CJZ 04/21/08 97'218
Plan Check $1,737.94 CJZ 04/21/08 97218
State Building Code $4.50 CJZ 04/21/08 97218
Potable Water Application $59.00 CJZ 04/21/08 97218
Total: $4,475.19
•
July 2, 2008
ATTN: Kathy Anne
Department of Community Development
621 Sherman Street
Port Townsend, WA 98368
Dear Kathy Anne:
Thank you for the phone call today.
Per your request, this is to advise you that I am cancelling the building permit
BLD 08-00154 for property located at 6193 Hagler Road, Nordland WA 98358
efferct.te immeJi-at&y
You have advised me that of the fees paid for various services, an unused
balance will be refunded to me in the amount $3824.94.
Please mail check to:
Stephen Frenzl
430 Meade Road
Nordland, WA 98358
Thank you very much to all of you in Community Development for your
understanding and assistance.
Sincerely,
Steve Frenzl
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From:Gallup BuildinJesibn 253 922 9351 419/2008 00:28 #059 P.002/002
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J JEFFERSON COUNTY AP
DEPARTMENT OF COMMUNITY DEVELOPMENT 2OO$
621 Sheridan Street• Port Townsend•Washington 98368 I
360/379-4450• 360/379-4451 Fax
� ,ZINCI O www.co_jefferson.wa.us/commcievelopment
•
Master Permit Application MLA: O 0 13?
Project Description(include separate sheets as necessary):
Al' i4) •S' , tic O✓sz s.7,e LJ C T,
Tax Parcel Property
Number, f 0/ 6/5./ 0 Z 3 Size: MO 0 a (acres/square feet)
Site Addressdr end//o-rDirections to Property:
3�� -/ '^/qLdo/Zy , D, Igo cites' AI• 9Qjdc'
Property Owner(s)of Record: Frc.a2c e i „5 d E / z c_,
Telephone: 206 '09-- 4p 9 3 Fax: email:
Mailing Address: 4'a ,byJccfq,c7 f7p, �(0.,e0=.4.40A) 7 `(/,q- If3Sg -
Applicant nt f different from owner): r .,q1,- c")p
Telephone: SS op —Srtcg --�j-71 S- �F1ax: pc?^922 — b2,,ao email: g 4����Scr� �.7-, C,6.07
Mailing Address: 3?26 9"`Acrr rc. /L y C- T c"0.,y6 A4 c7Q424.
What kind of Permit?(Check each box that applies
6�$uilding 0 Variance(Minor,Major or Reasonable Economic Use)
0 Demolition Permit ❑Conditional Use[C(a),C(d},or CI**
Ga"Single Family IS Garage eche, /Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular ❑ Special Use(Essential Public Facilities)"
0 Commercial* 0 Boundary Line Adjustment
0 Change of Use ❑Short Plat**
LI Address E°(Road Approach ❑ Binding Site Plan'"
❑Home Business 0 Cottagelndustry n Long Plat"
❑Propane ❑ Planned Rural Residential Development(PRRD)/Amendments**
O Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions"*
Cl Stormwater Management ❑Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑Forest Practices Act/Release of Slx-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:
DESIGNATION OF AGENT
I hereby designate C mac.u P to act as my agent in matters relating t t application for permit(s).
OWNER SIGNATURE l 7 —_ ' ram Date: ./ - %A-�^
ii By signing this application form,the owner a bests that the Information provided herein,and in any attachments,is true and correct to the best of
I his,her or it's knowledge, Any material false ood 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
4,...
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 application t or she wants pri r nape.
Signature; :: Date; / 2//O 4
The action or actions Applicant will un a ake 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 wilt not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)evert if you are in compliance with the Jefferson County development Cods,The Applicant acknowledges that he,she or it holds individual
and non-transferable dnsib JJ for adherl to and complying with the ESA The Applicant has read this died yner nsigns nd dates It below.
Signature; -- C �`
Date; X
C:\Documents and Settings\caml\Local Settings\Temporary Intcmct FiJes\OLKS6\Master Permit Application 12-79-2006.doc
• 0
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: i, ,-- Date: 7//�"//O S
GENERAL CONTRACTOR R 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:
New E"Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: 3 Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: 3 Heights ❑ Individual System
❑ Repair ❑ Masonry ° SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply.
Existing: Setback: ❑ Private well o Party
Type of Heat: ,/ Proposed: _ . IV'Public
�L �T /�� Total: 3 Zoo Name of System:4OtMtPaa._
t/JAIGIL 5Vsr154
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:
❑Underground Tank In Above ground Tank Size of Propane Tank:
❑Heat Stove 0 Cook Stove 0 Woodstove ❑ Fireplace Insert 0 Hot Water Tank ❑ 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 ni_EH Bld App Review:
2"d Floor Heated 6 6 7 ggConsistency Review.
(.3 og t.
Other Heated Base fee: r�2 1�
s IJ a _
Mezzanine Additional Section:
Heated Basement `Z�� la3 Plan Check fee: C 931
1 1 �I i J
Unheated Basement State Surcharge fee: -q
Other Unheated 1.5 -
Pot Water Review fee:
�v 6ct 4- 3
Garage/Carport '�o SUBTOTAL
67.6 i p55. ` rl32 11
Decks jg 1M.3�g11/Rd Approach fee: E` kl n
•
Other " tIg _
Sei TOTAL: $
34q yga. Receipt Number: w Aa`O
Q
Cash/Check Number: a
ESTIMATED COST(REQUIRED) _ p k : Date: lD
•Fair market value of all labor and mate . Is foundation to finish —it al l o B
Inikm 2 1 2008
43-16
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\QLK86\Master Permit Application 12-19-2006.doc
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I. SEE FIRST FLOOR FRAMING PLAN FOR FIRST FLOOR BEAM and
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2. L.G.H. IS NOT RESPONSIBLE FOR ANY DESIGN and/or MATERIALS
CALLED OUT AS N.I.C. (NOT IN CONTRACT) or BY OTHERS.
3. ALL ELECTRICAL WIRING and FIXTURES, PLUMBING FIXTURES, APPLIANCES,
and CABINETS ARE N.I.C. and ARE SHOWN FOR REFERENCE ONLY.
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4. ALL INTERIOR PARTITIONS ARE 2x4 6 Is" O.G., UNLESS OTHERWISE NOTED.
5. REFER TO DOOR and WINDOW INSTALLATION PAGES FOR DETAILS.
6. INTERIOR WALL LINER IS 1/2" GYPSUM WALLBOARD (N.I.C.), TYPICAL.
GREENBOARD (N.I.C.) IS USED BEHIND PLUMBING FIXTURES FROM
FLOOR LEVEL TO 4' ABOVE FLOOR LEVEL and THROUGHOUT TUB
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2. L.G.H. IS NOT RESPONSIBLE FOR ANY DESIGN and/or MATERIALS
CALLED OUT AS N.I.G. (NOT IN CONTRACT) or BY OTHERS.
3. ALL ELECTRICAL WIRING and FIXTURES, PLUMBING FIXTURES, APPLIANCES,
and CABINETS ARE N.I.G. and ARE SHOWN FOR REFERENCE ONLY.
4. ALL INTERIOR PARTITIONS ARE 2x4 6 IS" O.C., UNLESS OTHERWISE NOTED.
5. REFER TO DOOR and WINDOW INSTALLATION PAGES FOR DETAILS.
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_ 13 -4 13'-4" _
AREA
MAIN
1256 5Q. FT.
SECOND
66'1 SQ. FT -
TOTAL
1953 SQ. FT.
BASEMENT
125ro 5Q. FT.
GARAGE
518 SQ. FT.
DECK
554 5Q. FT.
BALCONY
54 SQ- FT.