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HomeMy WebLinkAboutBLD2008-00265 •UILDING PERMIT APPLICAN BLD08-00265eview Type: R Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00265 Received Date: 6/18/2008 SITE ADDRESS: 281 OLD SCHOOLHOUSE RD SEQUIM, 98382 OWNER: ROND'AUNN SIMPSON TRTEE PHONE: 918-625-3747 D'AUNN SIMPSON LIVING TR 5412 E 80TH PL TULSA OK 74136 SUBDIVISION: Block: Lot: T 22 PARCEL NUMBER: 002331022 Section: 33 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: JAMES WARD PHONE: 360-301-4792 1427 1ST ST PORT HADLOCK WA 98339 PROJECT DESCRIPTION INTERIOR REMODEL TO EXISTING SFR - NO MLA REQ'D -WITIN EXIST FOOTPRINT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 127,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 1 Total: 2 Total: 3 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date E D Permit $1,144.95 LYK 06/18/08 100455 AP P R®�Plan Check $744.22 LYK 06/18/08 100455 State Building Code $4.50 LYK 06/18/08 100455 SEP i 2008 Total: $1,893.67 Jefferson County Planning & Building Department Jo, -erson County Building •sion Permit Nun•r: BLD08-00265 Applicant: SIMPSON TRTEE 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 Setbacks (01 R — Foundation Footing t"�0 �/ J, q 3c) 31 t 0 a q6vilt(ir 1 Footing Drains Under Floor Framing Straps (hold downs) r Ext. Shear Wall Nailing 2" Abb ksc, Lc,.t�iv� �1c�cz Jc,.viTS - Rough-in Plumbing t_ I-r Framing Blocking ol/'L/eq Airseal =, r e)c'- Insulation: Walls Z//9/a9 /- Insulation: Floors O'er 12,-2 l IN 6>ffi 4-6 l Insulation: Ceiling �'! o ., ✓ojren eel i-/v O K Z/i9/a9# Int. Shear Wall Nailing y iZ ( d �J �09 Sto 6F Z SWan, �-gtr Wallboard Nailing Heat/Chimney Clearance Address Posted */tAi gyp,✓Ems— '7!a1J "3 -2. -L' FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 4 ' ' lid I Wli 1-7 ,, I • 0. .---. ,m.r._, . c? „I ,..., 1 I S r y -- O N 'II �:,s — — ci - �,-` 0 r- 1t t' I I I. / U Q' X 1 L' O p i in in1 'f co - 1t 14 in r\,,3 .c--4. zr, co - - til • �— -_ ! ;!J rn/ / I. \ >- c;1 LS- ri; 0. .F,--, Nx --, 1 1 1 M > 1:-----N I � — — �' '1 r , i ce , Q I0 .. I III � _._ ......,, 4 _ fir \,..,,, r• , _ �' ,r I ,y ' • 'f- i - ' '-'3.._:r- I > x 10 ,,,, / I I t z M 10 1 1 ` (..e.1 t3 S ot''\^,...., Mr ref � 1L -I I — i i- \- - -ii- - - - C‘l0 z - - I ,r.,...«R o O II I d / �• Csl i _ I I <l) MIII 1. i 1I 11 :'2) . 's .7 U c.l , '.5 OV06c, OVOb 7'14:Ld:Nc7 - -N- - c I I II 1 I 0 Q U_ ,, x �j tN •""'� - t -' - 4 — — _ _ ___ )444 _}��" I I lip 1 1I (4ONOJEFFERSOOUNTY 1111 ' g�co,_,,ra DEPARTMEN1 M COMMUNITY DEVELOPMENT 1, .' 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax gsN20 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: `)O - LA CA i1 Project Description (include separate sheets as necessary): Cx 7-0-611/ /N i E-7C/C &7ifo Pca , Sr9m r- Foo ►'n/w r ,- ', c c jg4c Tax Parcel Number: W 53 I O2Z Property Size: it• i cres quare feet) Site Address and/or Directions to Property: J 01.1) Sc ooLlior/s67 12oA1) , G`AKDc�C)2 , tii4 Property Owner(s)of Record: l�1 IQ S IQON f}U/d A/ 5/in P56 n/ Telephone: ? I 6,25- 3 7 1-/"7 Fax: email: , Mailing Address: 5'//� E E . k.o '�` rDL ,- TUAS 14 r O Applicant/Agent(if different from owner): J 4-e)/75 4a t Telephone: ,-Zit'b - 3C'/--li 7 1 a.. Fax: email: J Af713 Leg!ry 6- Mailing Address: I a 7 /44- .4* P r 9 r9-3 6 sf p'ji y t;;,'4f. C et i4i What kind of Permit?(Check each box that applies juilding 0 Critical Areas Stewardship Plan Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) liLSingle Family if 67140De.,0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** O Manufactured Home AD Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment O Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** ❑ Propane 0 Long Plat** ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: - r1 cr DESIGNATION OF AGENT I hereby designate ,� >^ / ('4/r7v MO to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE `i' V Qw---C�L/iLI �-00 Date: lv - /3 -C? 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 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 app' ation(�that he or she wants prior notice. / c Signature: W-� v.l.(,(, ®l.!� Date: 6, "/ 3 - (-, 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-transfe ��bl__ e responsibility for ad ing to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: urn L C � AAa �-CL� Date: (C /-- __ (T G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 0 BUILDER STATEMENT41 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 responsibilityof the General Contractor for the proposed project. \ Signature: v�;.,I ^4-`— �1,L Date: CO / d) ©' 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: ❑ New X Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System X Alteration/Remodel ❑ Concrete Total: 2 Height: k Individual System fi- ll Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: 2 Water Supply: Existing: c� Setback: ❑ Private well ❑ Two Party of Typeype Heat: Proposed: IPublic EL g;-sc-& D Total: r, Name of System: C141Q'64 CO✓1,?wn r-Iy 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 i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove i Woodstove i Fireplace Insert 1 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 i.3 0 . 1 EH Bld App Review: 265 Floor Heated Consistency Review: 7 � ll3lA Other Heated Base fee: 1 1 y q sci— Mezzanine Additional Section: Heated Basement Plan Check fee: '7q 4 2 Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: 4.).A Garagarport 14 l ° SUBTOTAL q (e3.(07/ Decks UN Db')2 3o' ,f r6N 911/Rd Approach fee: /57) L7 t/N G0(1131..61) IIJ,A Other TOTAL: $ 1q (Ql Receipt Number: 1 Ot-65— Cash/Check Number: ESTIMATED COST(REQUIRED) Date: . Oo .Fair ket value of all labor and materials foundation to finish • • Rar / "7 I 000 Initials: _ G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc C) a) G �uni lam' c.- , r�� -� a „, itL. 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