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Home My WebLink AboutBLD2008-00303 411 BLD08-00303 UILDING PERMIT APPLICARN Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00303 Received Date: 7/8/2008 SITE ADDRESS: 50 MARINER PL PORT LUDLOW, 98365 OWNER: AUSTIN H GREEN TRUSTEE PHONE: NANCY M GREEN TRUSTEE 50 MARINER PL PORT LUDLOW WA 983659765 BAYVIEW VILLAGE DIV 2 SUBDIVISION: Block: Lot: PARCEL NUMBER: 931900002 Section: 16 Township: 28 N Range: 01 E CONTRACTOR: B PARKER ENTERPRISES PHONE: 206-818-4184 70 MERIDETH STREET PORT LUDLOW WA 98365 Contractor's License BPARKPE925BG Expires 1/7/2010 REPRESENTATIVE: CORY PARKER PHONE: 360-620-9318 B PARKER ENTERPRISES 6230 SUNSET AVE NE PROJECT DESCRIPTION RE-ROOF - NO MLA REQ'D TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 3,500.00 CODE EDITION: 2006 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $97.25 AMS 07/08/08 100521 APPROVED Plan Check $63.21 AMS 07/08/08 100521 State Building Code $4.50 AMS 07/08/08 100521 JUL ci 2008 Total: $164.96 Jefferson County Planning & Building Department Jefferson County Building Permit r P mit Numb Applicant: BUILDING PERMIT INSPECTION APPROVALS applicable Code: 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 FINAL INSPECTION (2-Q_6 7 re) FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 411 k444e ON Cb� , JEFFERSON SUNTY • �A��1 %I V y DEPARTMENT OF COMMUNITY DEVELOPMENT ` 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax JUL 2008 q` NO .O www.co.jefferson.wa.us/commdevelopment ,JEEffrsc�n ,' i,L:,,►'. Master Permit Application Ck MLA: �0 m C�� e Project Descripon (include separate sheets as necessary): R‹ rct. - Tax Parcel Number: ' . . Property Size: , I 1 (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: trr�e n Telephone: Fax: J _email: • Mailing Address: .' ' , . • • ? Lu t((:u i et i 5 6 5 Applicant/Agent(if different from owner): ; r k t� Telephone: .,,- , , . Fax: J email: Mailing Address: /.- . i 13. E.,,c Tian\ 1 J f�- ct(s. !/ What kind of Permit?(Check each box that applies dibBuilding 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C)** 0 Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach ❑Short Plat** ❑ Home Business 0 Cottage Industry ❑Binding Site Plan** ❑ Propane 0 Long Plat** ❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** 0 Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑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 ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **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 designate • . L V e ' / to act as my agent in matters relating to t is application for permit(s). OWNER SIGNATURE v /L G-� - — Date: (‘r 0,: By signing this application form,the owner/agent attests that the information provided herein,and in any attachmen , 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 inspe ions. Staffs access and right of entry will be assumed unless the applicant in orms he County in writing at the time of the applicati at h or a wants prior notice. Signature: .J, -e-, -- Date: 0 e The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impac upo 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 compli ce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer b a re onsibi' for adhering to and complying with the ESA. The Applicant has read this disci 'mer d signs and dates it below. Signature: /��/ Date: G:\PemutCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • 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 responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx: 13 c�.v-, e i Frt. 1—ccpIN;S C„ ( r_,A 2 , . i ( ) MAILING ADDRESS: 0 1,11 e r�cic;k pc,-`-4' i l r// Lu, l29335EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: ' EMAIL . Project Type: ame Type: Ba rooms: Shoreline: ype of Sewage Disposal: ❑ New ❑ ood Exist ewer ❑ Addition ❑ S el Proposed: Ba - 0 mmunity System ❑ Alteration/Remodel ❑ Co crete Total: Heig t: 0 Individual System ''S1,,Repair ❑ Mas ry SEP Permit# ❑ Demolition ❑ Other\ Bedrooms: Water Supply: Existing: Setback:' ❑ Private well ❑ Two Party Type of Heat: \ Proposed: ❑ Public Total: Name of System: 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,emplo s,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 perm mark all items below that apply: i Underground Tank i Above ground Tank Size Propane Tank: i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot ater 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 ite plan showing all of the buildings,all property lines,tank location and size, distances from the propane tank to all property li s,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: 2"tl Floor Heated Consistency Review: Other Heated Base fee: q 7 �� Mezzanine Additional Section: '\` Heated Basement Plan Check fee: CC . 1 Unheated Basement State Surcharge fee: r PO Other Unheated Pot Water Review fee: y �J Garage/Carport SUBTOTAL r C0- i q/'_ Decks 911/Rd Approach fee: t �C Other TOTAL: $ ) co C 67.) Receipt Number: I On 5 3N 1 Cash/Check Number: ash ESTIMATED COST(REQUIRED) Date: •Fair market value.o�all la or and materials foundation to finish n— U 1 3 Initials: CcIJ G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc