HomeMy WebLinkAboutBLD2008-00157 BUILDING PERMIT APPLI TION BRLD08-00pe157
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00157 Received Date: 4/23/2008
SITE ADDRESS: 50 A ST
PORT HADLOCK, 98339
OWNER: CHRISTOPHE M MAC DONALD PHONE: 360-379-0496
CHERLYN MAC DONALD
PO BOX 891
PORT HADLOCK WA 983390891 SOUTH PORT TOWNSEND
SUBDIVISION: Block: 8 Lot: 7-8
PARCEL NUMBER: 996400805 Section: 2 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr ENCLOSE CARPORT & CONVERT CARPORT & GAR TO HEATED
SPACE, REMODEL 2ND FLOOR
TYPE OF VVORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 65,677.00 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: 3 Exist: 2
Prop: 0 Prop: 1
Total: 3 Total: 3
Routing Date: <I l a 3/02
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $755.75 CJZ 04/22/08 97219 APPROVED
Plan Check $504.24 CJZ 04/22/08 9:7219
State Building Code $4.50 CJZ 04/22/08 97219 MAY 15 200B
Potable Water Application $59.00 CJZ 04/22/08 97219 Jefferson County
Pianninp
Total: $1,323.49
&Building Department
Jefferson County Building D` sion Permit Nunit: BLD08-00157
Applicant: MAC DONALD
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 days 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
Setbacks c 23_bg
Foundation Footing S--3 -6.3
Foundation Stem Wall
Ext. Shear Wall Nailing � -'L_,c* b b mot to* N1"J
Rough in Plumbing 4//iy�FrE�ik n #/fr
1.)v-�t„dt. gji l�YJ/&8,4'7Hn;- 3/46[ 4"
Framing ///+lot /
Airseal G/ii/De 11/
Insulation:Walls G/„/Og Oi
Insulation: Floors /OA
Insulation:Ceiling /A,
Wallboard Nailing
FINAL INSPECTION ‘'1.e t✓
is
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
40
CONDITIONS for Building Permit# :BLD08-00157
1.) A MINIMUM OF 10' MUST BE MAINTAINED BETWEEN BUILDING FOUNDATION AND
EDGE OF DISPOSAL COMPONENT.
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�,;�¢SON C°& JEFFER.J COUNTY
rt ii�y DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
.yS, N0A•0 www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: No 1'Y\L;tt -Ae%A "
Project Description (include separate sheets as necessary):
CONEICr+ 6AR2p►6.E —RD f(CAriga 5'A4E 6RVCLOSE C-ARPOter
Tax Parcel n n Property
Number: -I LIDO S05 Size: 1 30 X I ).0 (acres/square feet)
Site Address and/or Directions to Property:
5D A 5b e A Pori NacL ock ,wa q 833G CC�� 1
Property Owner(s)of Record: 1 h Yt S el f1fl C.heA t n loW t o of a i�
Telephone: 3 n
- q Fax: email: l vtfX Lb►rt 7/d)(},.('fyrt
Mailing Address: P.O. l?c g4 t or}- t 1n 1? / 1.c.)�'1 g833�[ u
Applicant/Agent(if different from owner): a)Al2E-EN /jER jQ/.SCg _ -TEA/ Lc>ARA /M/C,/AEL&KOR A/
Telephone: _�(oO-77-I-6,206 Fax: email: r,dlww//q/,909,14W
Mailing Address: PO GOJz GZt.e, e</) V &iM. GOA 9fl5Z3"
What kind of Permit?(Check each box that applies
❑Building ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]**
J.l Single Family repApA%L, ❑ 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 El Binding Site Plan**
❑ Home Business ❑ Cottagelndustry ❑ Long Plat**
❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign ❑ 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)* ❑ Shoreline Management Variance
❑ Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑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:
.A.M-R12.010 v. irEgi Is > DESIGNATION OF AGENT
I hereby designate + , " 1 _e 1 : to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: Li-l a-CocS
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 of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and a r uired la r'nspe ns. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the pli on th r sh 1 r notice.
Signature:
Date: `"t -1 2--(�,
The action or actions Applicant wil 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-tra 1e ble r s onsibil for adhering to and complying with the ESA. (The Applicant has read this disclaimer and signs and dates it below.
Signature:( (I (�Iy�] C-44r� ,D SLQ Li-12_b$
VVV --117�`I-� `- ._".`I�-� Date:
7
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-1 9-2006.doc
• BUILDER STATEMENT •
The signer of this statement d hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be min . elres ns ility o neral Contractor for the proposed project.
Signatur . 1 Date: c
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: Imo:o13 c ,
WARQ6/t/ C4I-TgQPRL - - /e l 4c.7RRI) (3100) 981-93` 8 ( 0)771-l-6zo&
MAILING ADDRESS: 1:, &i X 6,2:(j, G N/MA Ctl ti7 EMAIL: r id a w 19l09 ® n sA/.('QI1YI
CONTRACTOR'S LICENSE d /� y+ 9gj2° WAINS , 1 ,
NUMBER: GdAi?ReG 4 Zjr,sg e j ThimBEity 'i .
ARCHITECT/ENGINEER: PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
LiNew Ili Wood Existing: '\ '12_, ii Sewer
❑ Addition ❑ Steel Proposed: \ Bank Cl Community System
V Alteration/Remodel 0 Concrete Total: U `/z Height: Individual System
❑ Repair ❑ Masonry SEP Permit# g(P• /
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: C [IPublic
eft('eC tv c Total: Name of System: pup
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 �'` $0 EH Bld App Review: Cv
1 �o q�-In �5n� 77
2n°Floor Heated I ��n Consistency Review: IJWii-ilLt'1 EXIST 1"7
H AT or-
Other Heated Base fee: 55, r1 r
Mezzanine Additional Section: ----
Heated Basement I Plan Check fee: 504
Unheated Basement 2J State Surcharge fee: 21
Other Unheated @ Pot Water Review fee: q 3 00
Garage/Carport ef ID SUBTOTAL I 1 4 a6\..q \
Decks 911/Rd Approach fee: l
Other TOTAL: $
Receipt Number: �",�--AA` \
Cash/Check Number: C
00 ") `
ESTIMATED COST(REQUIRED) Date: ;J \ ,1 �` )
•Fair market value of all labor and materials foundation to finish _ A •D \v
l Initials:
G:\PemlltCentccr\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
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