HomeMy WebLinkAboutBLD2008-00246 •ILDING PERMIT APPLICAT*1 B ReviewT0246
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00246 Received Date: 6/6/2008
SITE ADDRESS: 274 RAINIER LN
PORT LUDLOW, 98365
OWNER: PORT LUDLOW ASSOCIATES LLC PHONE:
70 BREAKER LN
PORT LUDLOW WA 983659766
PORT LUDLOW#1 AREA 4
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 990404104 Section: 8 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PORT LUDLOW ASSOCIATES LLC PHONE: (360) 437-2101
ROB COOK
70 BREAKER LN
PROJECT DESCRIPTIOF CONVERTING 268 S.F. OF GARAGE TO BEDROOM WITH A
BATHROOM
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 268
VALUATION 25,703.00 ADD'L: HEAT TYPE: EEE
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: SEW
WATER SYSTEM: LUDLOW
BEDROOMS: BATHROOMS:
Exist: 2 Exist: 2
Prop: 1 Prop: 1
Total: 3 Total: 3
Routing Date:
Type Amount Paid By: Date: Receipt: A proved/Date
Permit $401.35 AMS 06/06/08 'CO278 APPROVED
Plan Check $260.88 AMS 06/06/08 'CO278
State Building Code $4.50 AMS 06/06/08 'CO278 JUN b 2008
Total: $666.73 Jefferson County Planning
& Buildinn Department
-'GG JEFFERSOPOUNTY
.74
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend • Washington 98368
1 / 360/379-4450 • 360/379-4451 Fax
\14:kSFI p www.co.jefferson.wa.us/commdevelopment
I N G l
Master Permit Application MLA: nO YYIL-- req
Project Description(include separate sheets as necessary):
Convert 3rd car garage to bedroom with bathroom
Tax Parcel Property
Number: 990404104 Size: 16,254 (acre s requafeet))
Site Address and/or Directions to Property: 274 Rainier Lane, Port Ludlow, WA 98365
Property Owner(s)of Record: Port Ludlow Associates Ile
Telephone:360-437-2101 Fax: 360-437-2522 _ email: rcook@portludlowassociates.com
Mailing Address: 70 Breaker Lane,Port Ludlow,WA 98365
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
iBuilding ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a),C(d),or C]**
u7 Single Family ❑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 ❑ Binding Site Plan**
❑ Home Business ❑Cottagelndustry ❑ Long Plat**
❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑Sign ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑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:
/L///
DESIGNATION OF AGENT
I hereby designate /I}l4 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 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. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicati at he o she wants prior notice. J
Signatur. %U " Date: G_% c:'
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-transferable responsib y for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signatu : Date: 6
C:ADocuments and Settings\caral\Local Settings\Temporary]ntcrnct Files\i)l,K86\I\lastcr Permit Application 12-19-2006.duc
4 e •
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: "Vr 'iZ Date: (i--- 6- t,
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
Port Ludlow Associates Ilc ( 360)437-2101 ( 360 )437-2522
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 61 Wood Existing: 2 ✓1 Sewer
❑ Addition ❑ Steel Proposed: $ I Bank Li Community System
✓ Alteration/Remodel ❑ Concrete Total: 3 Height: ❑ Individual System
CI Repair ❑ Masonry SEP Permit#
Demolition ❑ Other: Bedrooms: 2 Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: I Ul Public
Baseboard/Electric Total: 3 Name of System:°""'°"""1et s'we"is ,, ,z ., ,,
Jr-
,_, „ .
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: C
Number of occupants(includes owners,tenants,employees,etc) Current Proposed Jut' 0 6 x08
IBC Occupancy: IBC Type of construction: _ Will you have Food Service? Yes / No [ j,
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: JEFF(Ff S� ' (: j
❑Underground Tank I1Above ground Tank Size of Propane Tank: tLiIJI ii ��`
❑Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 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 OfficeLJ,.se Only Amount Revision
Main Floor Heated � ' \EH Bld App Review: •
2434 Cf2 roM s 7o3. -.._,
2n0 Floor Heated 0 O Consistency Review: _
Other Heated Base fee:
Mezzanine 0 0 Additional Section:
Heated Basement Plan Check fee:
0 0
a60''
Unheated Basement 0 0 State Surcharge fee: Q
y
Other Unheated 0 O Pct Water Review fee:
Garage/Carport 809 _ t)�� SUBTOTAL 64(0,13
_
Decks 911/Rd Approach fee:
0 0 _ e) St+n
Other 0 0 TOTAL: $(06,60,73
Receipt Number: l O0a-1.6
2702 Cash/Check Number: S`I
ESTIMATED COST(REQUIRED) Date: ��Q((]]t
•Fair market value of all labor and materials foundation to finish
4 p 5-OO Initials: /+,
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
•
Jefferson County Building Division Permit Num BLD08-00246
Applicant: PORT LUDLOW ASSOCIATES LU
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
Underground Plumbing dA
Ext. Shear Wall Nailing N/
Rough-in Plumbing L, L , /
/ ✓ r bie cl taii iG/?a,/ 6 r r1,U/r/B/4)G �/14106
Framing 21 L,sO./
Airseal 4 2-7/e0 O '
Insulation:Walls 7/3/Pc? gd
JJ�� � e6ri/cif 47'c%
Insulation: Floors 7/3/6)8
Insulation: Ceiling
Wallboard Nailing 1/4_40B
FINAL INSPECTION 0/t5
44-
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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