HomeMy WebLinkAboutBLD2008-00377 IPJ
ILDING PERMIT APPLICA1N MLA08-00392
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00377 Received Date: 8/20/2008
SITE ADDRESS: 741 SEAL ROCK RD
BRINNON, 98320
OWNER: JOHN S PHILLIPS JR PHONE: 206-818-3259
PO BOX 26
BRINNON WA 983200026
SUBDIVISION: Block: Lot: T 4+
PARCEL NUMBER: 602264002 Section: 26 Township: 26 N Range: 02 W
CONTRACTOR: R.G. FORESTRY CONSULTANT PHONE: 360-490-1560
PO BOX 681
HOODSPORT WA 98548
Contractor's License RGFORC*159KP Expires 4/19/2009
REPRESENTATIVE: KIM SCHAUMBURG PHONE: 253-884-5776
BIORESOURCES LLC
10112 BAY VIEW RD. KPN
VCivhjrin u`TA oit3c1 Lk
PROJECT DESCRIPTIOP REPAIR EXISTING BULKHEAD/PATIO
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP REP MAIN:
VALUATION 25,000.00 ADD'L: HEAT TYPE:
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:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
Q0 S1°- /D7
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $391.25 AMS 08/20/08 100784 APPROVED
Plan Check $254.31 AMS 08/20/08 100784
State Building Code $4.50 AMS 08/20/08 100784 DEC It) 2008
Total: $650.06
Jefferson County Planning
& Building Department
Jefferson County Building •sion Permit Null:
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 ;I.)
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
CONDITIONS for Building Permit# :BLD08-00377
1.) Flood hazard reduction measures are to be used as required by the Jefferson County
Flood Damage Prevention Ordinance 07-0515-06 (Jefferson County Code Chapter
15.15).
2.) Construction Materials and Methods of Construction to Reduce Flood Hazard
(i)All new construction and substantial improvements shall be constructed with materials
and utility equipment resistant to flood damage.
(ii)All new construction and substantial improvements shall be constructed using methods
and practices that minimize flood damage.
3.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
4.) Prior to commencing development activity, proponent is responsible for informing the
Washington Department of Fish and Wildlife (WDFW) in order for WDFW to determine
whether this action is subject to the Washington State Hydraulic Code (Chapter 220-10
WAC). Hydraulic Project Approval (HPA) is required for all hydraulic projects, which are
defined as construction or performance of other work that will use, divert, obstruct, or
change the natural flow or bed of any of the salt or fresh waters of the state.
5.) In addition to Jefferson County permit conditions, the project proponent shall comply with
all conditions set forth by the Washington Department of Fish and Wildlife through
Hydraulic Project Approval.
6.) Prior to commencing development activity, the proponent is responsible for informing the
US Army Corps of Engineers (COE) in order for COE to determine whether a Department
of the Army permit or review is required. Generally, review is required for construction
and dredging in or around navigable waters of the US and for work or fill in hydrologically
connected wetlands. Contact the US Army Corps of Engineers, Seattle District
Regulatory Branch, PO Box 3755, Seattle WA 98124, (206) 764-3495, for more
information.
7.) Exterior flashing, moving, or blinking lighting is prohibited, except as required by local,
state, or federal standards.
8.) All noise emitting machinery that cannot in any other way operate below the maximum
permitted noise level shall be housed in a sound-attenuating structure.
9.) Residential developers and individual builders shall be required to preserve shoreline
vegetation and reduce the associated risk of erosion during construction and any future
activity which may impact the stability of the shoreline.
10.) Remove and properly dispose of any treated timbers at a permitted facility. If
contamination is currently known or observed during construction, sampling of the
potentially contaminated media must be conducted. If contamination of the soil is readily
visible, or is revealed by sampling, Ecology should be notified. Contact the environmental
report tracking system coordinator at the Southwest Regional Office at (360)407-6300.
For assistance and information about subsequent cleanup and to identify the type of
testing that will be required, contact Mr. Chuck Cline at the phone number given above.
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liormik-s°1406, JEFFERSON UN1Y • RECEIVED
I; DEPARTMENT OF COMMUNITY DEVELOPMENT
o 621 Sheridan Street • Port Townsend •Washington 98368 AUG 2 0 2008
360/379-4450 • 360/379-4451 Fax
Is, N0,0� www.co.jefferson.wa.us/commdevelopment
IIIJEFFERSON CHNEY DCO
Master Permit Application MLA: 3( r)---
Project Description(include separate sheets as necessary):
P?- Dp ex r St/11) P44 I kL e,9 D/,g 11'o /Tax Parcel Number: 4 G 2.-2- 4 yQ 0 Z_ Property Size: Ar/.6% , ��0%'/ (acres/square feet)
Site Address and/or Directions to Property: / / S.f.
7V/ �-4)1 / # L4 12d / g/L/,-,n cn-. 9172
Property Owner(s)of Record: TO /I N S jiff, it s f
Telephone: 2-4 6 eye - 3Z S Fax: >" email:
Mailing Address: pa /3u Z 6 R Ain ei o'L (,4tg 9g 3 z p_ Oo z 6
Applicant/Agent(if different from owner): / /fir Al SCJ4k r,194k
Telephone: ZS? Ca I(—S-7 7 6 Fax: S 4-1-`a email: Kl. m- d 31ga Ce4 f my
Mailing Address: /o/ / - /3A yt/,2-6„ R b KPN , V 6 v 6 Hti 9g"39 y /. Ne
Wait kind of Permit?(Check each box that applies
uilding Q"Critical Areas Stewardship Plan
0/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]**
❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* ❑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 0 Planned Rural Residential Development(PRRD)/Amendments**
0 Allowed"Yes"Use Consistency Analysis ❑plat Vacation/Alteration**
0 Stormwater Management gShoreline Master Progra I Exemption! ermit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Su•s an la •evelopment**
0 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
Plea e identify any other local, state or federal permits required for this proposal, if known:
0 — t o Ftu ) US ,1LOE f (.Mcr
//� DESIGNATION OF AGENT
I hereby designate /M '/c id4-4114 �Lr/ty to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE ii "� - S /G o Cj
ttt Date: c�/ o 4 I�
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 ent to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later' ections. s ccess and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application t at she want r tice.Signature: Date: -7--- G p/d 'Q Q
The action or actions App scant 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 tile 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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature:
Date:
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• •
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: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
ROki GO/OP (Au) V90 —1560 ( )
MAILING ADDRESS: /2 G i l a x v g/ N i Jc JEf EMAIL:
CONTRACTOR'S LICENSE `d_� -i y'r WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New ❑ Wood Existing: ❑ Sewer
0 Addition 0 Steel Proposed: Bank ❑ Community System
Iteration/Remodel CI Concrete Total: Height: ❑ Individual System
Repair ❑ Masonry SEP Permit#
0 Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: 0 Private well 0 Two Party
Type of Heat: Proposed: 0 Public
(jQo G� Total: Name of System:
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:
i 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 4) ,. _ A. Nam,IRO rgpt -4. n_.-
Main Floor Heated EH Bld App Review: -____________
2nd Floor Heated • Consistency Review: `� 0 0
5 to'th l nc ex ,1/7/sue (i
Other Heated Base fee: 3 q' 2-S
Mezzanine n: f 76 a o
Heated Basement Plan Check fee: 25y 31
Unheated Basement State Surcharge fee: II.��
Other Unheated Pot Water Review fee: �._
Garage/Carport SUBTOTAL (G 3
Decks 911/Rd Approach fee: 1
Other TOTAL: $ 1"/3 ,06
Receipt Number: I OM 61—i
Cash/Check Number: 3L1 —1 0
t
ESTIMATED COST(REQUIRED) Date: ,
(OZ
•Fair mprfc-i value ot'`alt or and materials foundation to finish
2 0J Initials: Clo
G:\Pe tCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc