HomeMy WebLinkAboutBLD2008-00317 UILDING PERMIT APPLICAAN MLA08-00348
Jefferson County Department of Community Development Review Type: I
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00317 Received Date: 7/17/2008
SITE ADDRESS: 3001 CAPE GEORGE RD
PORT TOWNSEND, 98368
OWNER: LEE H EHRHEART PHONE: 206-200-8930
PO BOX 17521
SEATTLE WA 981271221
SUBDIVISION: TX 30
PARCEL NUMBER: 002131021 Section: 13 Township: 30 lock:
Range: 02 Wt
CONTRACTOR: OWNER/BUILDER
PHONE:
REPRESENTATIVE: BJORN LUNDE PHONE: 206-780-1443
620 DEERCLIFF RD
BAINBRIDGE ISLAND WA 98110
PROJECT DESCRIPTIOP NSFR W/ A/G 5 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION 131,046.00 MAIN: 672
CODE EDITION: 2006 ADD'L: 622 HEAT TYPE: EEE
HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3
OCCUPANCY: UNHEATED: # OF STORIES:
CONST TYPE: 5N OTHER:
CONST TYPE: GARAGE: SHORELINE:
DECK: 275 SETBACK:
SEWAGE DISPOSAL: ALT BANK HEIGHT:
WATER SYSTEM: 2WELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 1
Total: 2 Total: 1
Routing Date:
I" I ( (
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,172.95 LYK 07/17/08 100679
Plan Check $762.42 LYK 07/17/08 100679
State Building Code $4.50 LYK 07/17/08 100679
Potable Water Application $59.00 LYK 07/17/08 100679
Total: $1,998.87
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4‹. SON c�G JEFFERSON COUNTY
' DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street I Port Townsend,WA 98368 l Web:www.co.iefferson.wa.us/communitydevelopment
SKr o Tel:360.379.4450 l Fax:360.379.4451 I Email:dcd aa..co.iefferson.wa.us
‘A \I- l 2,
Building Permits&Inspections l Development Consistency Review I Long Range Planning l Watershed Stewardship Resource Center
S
October 18, 2012 ( ,• •
LEE H EHRHEART fVLO
PO BOX 17521
SEATTLE WA 981271221 6 _
RE: SITE ADDRESS: 3001 CAPE GEORGE RD 62, 5 - 1 v �'r � C3'e
CASE#: MLA08-00348
;-.1\rt.S0-133-'//4_
) V3-\ \3)-<)-
Dear LEE H EHRHEART:
The Department of Community Development is in the process of reviem}in0 . .__.^�.,^ L.rf1 pcb
following information is needed to continue review of your project. 111
FINAL NOTICE ' I `.. ( NOV 201
2
Your pending building permit is now over four years old. My January 11, i 11 letter regeusted the
below information to be submitted or the permit would be cancelled/ D 'kirk
reviewing these old permits for cancellation and I thought I would give oPrrz9g tisilunfiiiwEttOitr
cancelling it. If you intend on proceeding with the permit process, the following in orma ion is n
for Environmental Health to approve the potable water:
1. A good bacteria sample test needs to be submitted to Susan Porto for review and determination
of adequacy.
I can be reached at 360-379-4457 or email at mfarfan@co.jefferson.wa.us if you have questions
regarding the permit itself. If you have questions regarding the bacteria test sample, you can reach
Susan Porto at 360-385-9404 or email at sporto@co.jefferson.wa.us.
Please submit the above information to the Department of Community Development by January 16,
2013. Pursuant to Jefferson County Code (JCC) 18.40.110(3) and (6), if the applicant refuses to
submit the additional information or does not request additional time to submit the required
information within the ninety (90) calendar day period, the application will be considered abandoned
and therefore withdrawn and the applicant shall forfeit the application fee. The Department of
Community Development shall not be responsible for notifying the applicant of an impending
expiration.
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Sincerely,
Department of Communi eve o.ment Staff
c: File
\\tidemark\data\forms\F_MLT_Addlnfo_Requst.rpt • 10/18/2012
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�gON Co R u;�'�.E `1 t
�w JEFFERSON COUNTY44
4 el, JEFFERSON
OF COMMUNITY DEVELOPMENT
.-' `` `� , 621 Sheridan Street •• Port Townsend •• Washington 98368 JUL 1 / illf
_ 360/379-4450 •• 360/379-4451 Fax
�q �p www.co.jefferson.wa.us/commdevelopment
s�NG� ,,,,,Asp,„„Ty ����
Master Permit Application MLA: OR - 1l
Project Description(include separate sheets as necessary):
G\,''ILO i.:6i‘,/ 1 j e l<)$A >I Net l'l�u1 iW�I j C-C-;
Tax Parcel Property
F.
Number: C O 2-/ 31 GZ 3 ,A.,,,_-
'ct• /' -O 5 cr
Size: j � .3�D (acres/square feet)
Site Address and/or Directions to Property:
&oi CA-PC gE---DrzqG (2M-O po.2 'T6 -<. L Piclv) kvl}
Property Owner(s)of Record: E G 412 H
Telephone<Z/Xv)•ZCC..Igq 7-d 60 '7 'ax 70l3
email:
Mailing Address: (2o AtA ("75-2-1 , ( , L(JA 4;gil'7
Applicant/Agent(if different from owner): ?UJ Q(2-p} L U;U,D6 -
Telephone: ZO(o-70 t 44-3 Fax: email: 6 LA frU (Q 46 e
Mailing Address: (tiz0--Drzet-ti R j -0 t Pam.fNO p yc j W/l '1 81 I yahoo• cc
ttA
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 CI**
6Q Single Family ❑Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat'"
❑ Address ❑Road Approach ❑Binding Site Plan**
0 Home Business ❑Cottagelndustry 0 Long Plat**
X Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis LI Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
0 Temporary Use 0 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:
57 - E r t c<1-L.
DESIGNATION OF AGENT
t .k)2 I hereby designate r�.1 LU ../ . to act as my agent in matters relating to this application for permit(s).
OW ��u
OWNER SIGNATURE .�A . G _ Date: 13 U o 200 6
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct 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 appliccttierr a or she wants p r notice.
Signature: r Date: .7/17 /O$
The action or actions Ap nt 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 ! ons> .fora ering to and complying with the ESA. The Applicant has read this disci imer a d signs and dates it below.
Signature: , �,;(_ /
Date: 177aV
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
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BUILDER STATEMENT i,
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors AV*
they will be assuming the responsibility of the General Contract f the proposed project. r'
Signature:
a E Date: 2,2 `S' 20 0(i3,
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx:✓r ,T
MAILING ADDRESS: EMAIL: , .
417
CONTRACTOR'S LICENSE WAINS 4/:?,/.
NUMBER:
NUMBER </ '.*
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New A Wood Existing: s Sewer
❑ Addition ❑ Steel Proposed: I Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: X Individual System _
S Masonry SEP Permit# C j -001-75
❑ RepairBedrooms: Water Supply:
• Demolition ❑ Other. . Setback:
Existing: C ❑ Private well X Two Party
Type of Heat: Proposed: 2 ❑ Public
e ici-a-t C. a a Total: y Name of System:
It witt. Ur317T4
If this is a Commercial Prolect 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%Above ground Tank Size of Propane Tank: .5- IC(f
❑Heat Stove RCook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank 0 Pellet Stove ❑Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes /U
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 6 72 tf ci L�5i EH Bld App Review. c-To -
2"°Floor Heated t�..Z Z r-5C3�^�.c 2 Consistency Review: r%r
l� � l
Other Heated Base fee: fl
I - l2 1 __
Mezzanine Additional Section:
Heated Basement Plan Check fee: r-- 21(
Unheated Basement State Surcharge fee: j 3 )
Other Unheated Pot Water Review fee: i L' )
Garage/Carport SUBTOTAL ]
Decks 2
911/Rd Approach fee:
�5 �r�'i = , '__x(.311
Other TOTAL: $ 2:214
Receipt Number: t 0010-1C1
(foic. cash!Check
- Number: --1 _ 44
ESTIMATIED COST(REQUIRED) --Date: -7 _,
'Fair market value of all labor and m rials foundation to finish -+ (�?`�Q
(30, coo ±- Initials:
C:\Documents and Settings\cam\Local Settings\Temporary Internet Files\OLKBG\Master Permit Application 12-19-2006.doc
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