HomeMy WebLinkAboutBLD2008-00170 BUILDING PERMIT APPLICA1N BL v
Reviewiew T Ty170
ype:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00170 Received Date: 4/25/2008
SITE ADDRESS: 61 WINDROSE DR
PORT LUDLOW, 98365
OWNER: RAYDEAN H PATTERSON PHONE: (360) 437-9306
MERETTA D PATTERSON
61 WINDROSE DR
PORT LUDLOW WA 98365-9799 BAYVIEW VILLAGE DIV 1
SUBDIVISION: Block: Lot: 23
PARCEL NUMBER: 931900023 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: EDMAR DEVELOPMENT PHONE: (360)437-9326
103 DUNSMUIR RD
PORT LUDLOW WA 98365
Contractor's License EDMARD*066B0 Expires 1/23/2009
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP KITCHEN REMODEL AND INSTALL A/G 120 GAL PROPANE TANK
AND GAS PIPING
NO MLA REQ'D -WITHIN EXISTING FOOTPRINT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 6,000.00 ADD'L: HEAT TYPE: PRO
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: A I a8 log
Type Amount Paid By: Date: Receipt: AFP°àö\/ED
Permit $125.25 KAS 04/25/08 97331
Plan Check $81.41 KAS 04/25/08 97331
State Building Code $4.50 KAS 04/25/08 97331 APR z 9 Nog
Propane Tanks/Stoves $157.00 KAS 04/25/08 97331 Jefferson County Planning
Total: $368.16 & Building Department
Jefferson County Building Division Permit Nur> r: BLD08-00170
Applicant: PATTERSON
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 Airseal Iv r_ IL7\ G j�{iv1(L C'J
Gas Line: Interior 3 2 ;gyp Th
Propane Tank -�/I _'btu —
EAJ 10-402-C "gi-t-01,
FINAL INSPECTION 3.)(l O C
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
FILE COPY
It'*''\ ontact tng at
tw ti v (360) - 379-445UheBuildi prior toDepartment making changes
2,) i c`N\ 4 N. or n.v'MOOS to the approved plans.
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BUILDING PLAN REVIEW \`'J 23'
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APPROVED AS SUBMITTED 8RNFUTIL
0- APPROVED AS NOTED H
Date q,n-d S Reviewer PAW 2—CAR GARAGE
21.5 21.5
NOTICE:
Pl r s r, r cd excepting any
t ,.: ; ,~)s. Ali •.vorl: must Cl
., _Ii,,t: in conformance with 23'
:i:ii, _i,1e codes and regulations.
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APR 2 5 2008
-Windows/Sliding Doors U-Factor 0.35 min. t r a, 33
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-All windows and doors shall be air-sealed i
at interior R.O. framing to window frame. (X;)
(... ...-- ON 0,..,
RECEWED
i • JEFFERSOIUNTY S
rt7d\ A DEPARTMENT OF COMMUNITY DEVELOPMENT
ti `' ` '4 621 Sheridan Street • Port Townsend •Washington 98368 APR 2 5 2008
360/379-4450 • 360/379-4451 Fax
.1,9 A•0 www.co.jefferson.wa.us/commdevelopment Irrri-n^n41 rnitt!rry n )
limos
01. U U
Master Permit Application MLA: N Ok- BeQ I 1
Project'[ Descriptioé€ oe
nclude ss`'ep ate sheets as necessary):
S i 1 (lii� 1a-a-AC( O(� U� 'uLL� Z 1,p 1.Ccf
Tax Parcel / r Property I v
q 3( _ q O� _ OL-?j P Y 1 L6�' +� �uuc�'F�r.T
Number: Size: (acres/square feet)
Site Address and/or Directions to Property:
LA ,hd vbse_ _be, Pork-- LA1ou' C. ✓L142- erW [Is Lay Coa o1
Property Owner(s)of Record: Pdk'mvs Tov. Raydtavr, / (-tev trot /
Telephone: 340 — 437 , 13Ob Fax: / email:
Mailing Address: 6 t too,dvase._ 1Jr 1:14i-1` t.u,c 10Lo 1.044--e11P36L
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
❑Building 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]**
]I Single Family 0 Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)**
❑ Commercial* ❑ Boundary Line Adjustment
❑ Change of Use ❑ Short Plat**
❑ Address ❑ Road Approach 0 Binding Site Plan**
O Home Business ❑ Cottagelndustry ❑ Long Plat**
Iiii Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign 0 Plat Vacation/Alteration**
❑Allowed "Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
O Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance
❑Temporary Use ❑ 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:
' DESIGNATION OF AGENT
I hereby design ter`L ~' to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATUR `P Date: L.( 2 S —01?
By signing this application form, he 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 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 -•-Ica ion that he orls prior mice.---
Signature: . g..e • ri90 �;C ' Date: y —ZS —00
The action or actio 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-tra ra le responsi iti fo herig to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signatur Date: 41 _ZS--e,
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
• BUILDER STATEMENT IP
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 fJ tYME44&AtttER: PHONE: FAX:
6"AC-ra-4 - ,. ,m,A c_b,,,vv�(o >nA vT- (%V)4-37 1,32_4 ( ) ..S-e,nE_--
MAILING ADDRESS: 1,61 11s(ma-.r I: rt. (..CI(011) EMAIL:
CONTRACTOR'S LICENSE Lott-6ig36 S WAINS
NUMBER: /� ) M 1412, D C 066 e o NUMBER
CQnA-o C( C PHONE ( ) FAX: ( )
SCA#.611 iOJL i>tZvUp 04 t'J e. EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New $( Wood Existing: z• ❑ Sewer ,
❑ Addition El Steel Proposed: / Bank Community System
$ Alteration/Remodel ❑ Concrete Total: Z Heig . ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 2. etback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: X Public
Total: 2 Name of Systemm:
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_aldloE Appliance Installation permit,mark all items below that apply:
i Underground Tank Above ground
round Tank Size of Propane Tank: 140`l"tlp(,�
�i Heat Stove Cook Stov ) i s ove - Fireplace Insert i Hot Water Tank i PelletStove i Other
Is this appliance fig-installed in a Manufacture. 'o•ile 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: — _.
2nd Floor Heated Consistency Review: _-----
Other Heated Base fee: i 5 a 5
Mezzanine AUCtditiarral-Sectiont--
ropa►� 15�1-0
Heated Basement Plan Check fee:
APR 2 5 2008 el.
Unheated Basement State Surcharge fee: 4 c)
Other Unheated Pot Water Review fee:
i
Garage/Carport SUBTOTAL 3‘3,8 1
Decks 911/Rd Approach fee:
•
TOTAL: $ 3&13` l b
47--t;a44.. Q¢ Receipt Number: 9155 I
Nt21.�) • .'^e- /C9`'t'= - Cash/Check Number:
4�p(' ' tdma-
ETIAIAT ELL • T • - - D) Date:� 1 ��ID
O sriir m rket value of all a.• and materials foundation to finish 4
0 OC Initials: —
C------ I l
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
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