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Home My WebLink AboutBLD2008-00266 • BLD08-00266 BUILDING PERMIT APPLICAItN Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00266 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 DESCRIPTIOr ADD BATHROOM TO EXISTING GARAGE - NO MLA REQ'D -WITHING EXIST FOOTPRINT-nDD F 1cO . PIA, -}o utSTI YkItly TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP ALT VALUATION 2,100.00 MAIN: Ektsalil(,7 ADD'L: HEAT TYPE: CODE EDITION: 2006 / L1 �LE,� OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OTHER: CONST TYPE: SHORELINE: CONST TYPE: GARAGE: L l00 ekt&11 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 1 Total: 0 Total: 1 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $83.25 LYK 06/18/08 100455 APPROVED Plan Check $54.11 LYK 06/18/08 100455 State Building Code $4.50 LYK 06/18/08 100455 SEP ZZ 2008 Total: $141.86 Jefferson County Planning &Building Department • • CONDITIONS for Building Permit# :BLD08-00266 1 ) 10' Separation required between water line and septic effluent line entering/leaving garage. Permit Nur,: BLD08 00266 Jefferson County Building Division Applicant: SIMPSON TRTEE BUI!..DING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Rough-in Plumbing 11—c—to FA Framing .1-9, to- sue.l �� 2 <f yi (Al,,5 rirS Insulation:Walls Insulation , cea �r ` k 6 I FINAL INSPECTION ) 'S_ I t;"'N FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR ( ON \.\ JEFFERSON•UNTY DEPARTMENT OF COMMUNITY DEVELOPMENT I' \ 4 � 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax q Z-ZINGp"� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: _ Project Description(include separate sheets as necessary): /19 D Mini IN Pc- ? ic.'l-f&D v o, Tax Parcel Number: CO233/022 Property Size: ./ . 9 4140 quare feet) Site Address and/or Directions to Property: - ( di,D sC r( /-/u - t<u/tD Property Owner(s)of Record: /12 9 / OA, d `/4'-Ji4N gill,PS dAl Telephone: `/ 6,2-5 32'/7 Fax: email: Mailing Address: 5/-/,2- E. PO ra p4.71-C& . T C)is. SR- O r Applicant/Agent(if different from owner): s,1 tork Q, Telephone: 3 'O - 3C�I '`)t?a2. Fax: email: J r in6-5 (41t' i ' L'' Mailing Address: /T 2 ( " . rz.)1 r j e 01y 144gr , c d M'/ What kind of Permit?(Check each box that applies t�$uilding ❑ Critical Areas Stewardship Plan ❑ Demolition Permit FcD 5i 7?I 0 Variance(Minor, Major or Reasonable Economic Use) ElSingle Family Garage Attached/ etaci 0 Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑ Binding Site Plan** ❑ Propane 0 Long Plat** 0 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** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** El Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium El 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: 1 . \ DESIGNATION OF AGENT I hereby designate ,t,�t A \N-) to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE)' ' 1^ � Date: (0 - 1.3 " 0 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 application that he or she wants or\notice. Signature: X 0M-,-,..— V 1 ( Date: (s, - ( -) OR 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 rga\ponsibility for adheri g to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: >t e-CzA V Ct- -A-,-,--- CAA. Date: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 0 BUILDER STATEMENT 0 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 rresponsibility of`he General Contractor for the proposed project. Signature: )L ( Y Pak\U(-)-^"'-'-' /0.--- Date: - i 2' 0 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: D New Wood Existing: 0 ❑ Sewer ❑ Addition ❑ Steel Proposed: —/-- Bank ❑ Community System x Alteration/Remodel ❑ Concrete Total: / Height: WIndividual System ❑ Repair ❑ Masonry S P Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: fV I-t Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: x Public Total: - Name of System: AIN-4 . If this is a Commercial Proiect 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 EH Bld App Review: KDIA ;11(p- 2na Floor Heated Consistency Review:- 0I A Other Heated ^a9 Base fee:(00 5 ,85 23 25 /(PQ •WO Mezzanine `t Additional Section: Y� Heated Basement Plan Check fe Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: _ 0lh Garage/Carport — "' V SUBTOTAL c Decks r 911/Rd Approach fee: 'le /) O er i'' �nn ""�� TOTAL: $ 11'I'I go Receipt Number: 1 Cash/Check Number: I 1 CO ESTIMATED COST(REQUIRED) Date: ici ,it ,^g •Fair market va/uj of all labor and materials foundation to finish "72 , 15400 Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc NEW FLtoR PLAN • SCALE 1/4" = 1' ‘f , ... . . / \ I I v. - Elec. 0 o W/D ..- Panel Fan , I 'IN\ ' . r -,-o Fan /2 -I L.co - 1 2 Kennel Mud Room/ re 01 .cv -...-... •:-- Bathroom \N,,,_,_ (-----) i r.---------, k( n )) -V-- , 71 Mini Bar t:r GAASCb. _. os 1 , 0 0, Rec Room Garage •o 0 .ct tn 0' to :. o . 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