HomeMy WebLinkAboutBLD2008-00403 tILDING PERMIT APPLICA•N BLD08-00403
Review
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00403 Received Date: 9/10/2008
SITE ADDRESS: 113 WATERHOUSE LN
PORT LUDLOW, 98365
OWNER: STEPHEN J MINER PHONE: (360)437-9866
KAREN MINER
PO BOX 65221
PORT LUDLOW WA 98365-0221 LUDLOW COVE DIVISION 1 PHASE 1
SUBDIVISION: Block: Lot: 1+
PARCEL NUMBER: 968800001 Section: 17 Township: 28 N Range: 01 E
CONTRACTOR: SOLAR FLARE DESIGN PHONE: (253) 846-2239
18225 80TH AVE E
PUYALLUP WA 98375
Contractor's License SOLARFD962B2 Expires 2/22/2010
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP INSTALL SUN CANOPY OVER EXISTING SOUTH DECK
NO CHANGE IN FOOTPRINT - NO MLA REQ'D
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 3,413.00 ADD'L: HEAT TYPE: OUH
CODE EDITION: 2006
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: 135 SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: LUDLOW
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
lib 108C -
Type Amount Paid By: Date: Receipt:
Permit $97.25 KAS 09/10/08 102499 APPrROVED
Plan Check $63.21 KAS 09/10/08 102499 SEP IS 20t18
State Building Code $4.50 KAS 09/10/08 102499
Total: $164.96 Jefferson County Planning
&Building Department
Jefferson County Building Million Permit Num.: BLD08-00403
Applicant: MINER
BUILDING PERMIT INSPECTION APPROVALS \pplicable 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
Foundation Footing q/4;J4[ ,/jy�
Framing /0// 0� //IL/
Miscellaneous /%4/e6 Fully Tempered Glass
FINAL INS7ECTION ,o/l40 -rev
i! FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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O ~4„ ° JEFFERSON.UNTY •W DEPARTMENT OF COMMUNITY DEVELOPMENT , ,,,)
-J ` '-4 621 Sheridan Street • Port Townsend • Washington 98368 SLr
1 0 2uu8
ilsop360/379-4450 • 360/379-4451 Fax
kgs N�K•O www.co.jefferson.wa.us/commdevelopment JErFERCQN COUNTY DCD
Master Permit Application MLA: n0 ►1'1LA TRe4`P
Project Description (include separate sheets as necessary):
3 157M4ter/A•l/ Or f3-Su./ a/w1roPy B c8 5aul 1 ZIC(ac/ 7/4/‘)
Tax Parcel gig 0 CO/ Property
Number: Size: (acres/square feet)
Site Address and/or Directions to Property:
Property Owners of Record: i< j J—TEP N 1?yE/C C/ r cbvscre- 10 aW-ef 0)
Telephone: ,3�0). 3 "-ff j Fax: g3q—�d(p9 email:
Mailing Address: �"0 X /0502a-1 'Par Gefoca.✓ 4/4- �F345
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
❑Building ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]**
❑ Single Family ❑ Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular ❑ Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use 0 Short Plat**
❑ Address 0 Road Approach 0 Binding Site Plan**
O Home Business 0 Cottagelndustry 0 Long Plat**
O Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign ❑ Plat Vacation/Alteration**
❑Allowed`Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
0 Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance
O Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
O Forest Practices Act/Release of Six-Year Moratorium 0 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:
NDit/tr //,VO WA✓
DESIGNATION OF AGENT
I hereby designate /(// to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date:
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 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 d rig of nt will be ass med unless t e applicant informs the unty in writing at the
time of the application that he sheyrant ri notice. r c /5 , QLi 47 '1J//$Tsie—. :� -
Signature: v/T,L , Date: .g / 2 L •OTt5
i
The action or actions Applican 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 respo ibis f ad iiii •,. and com I • with SA. The Applicant has read this disclaimer and signs and dates it below.
Signature: %, i Date: � / L/L €?7)- tf
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.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:
5'oMieruleeb /eri✓ (,26'32'V(. Z 31 (^ )
MAILING ADDRESS: /�r ' �/ 67 EMAIL: .1f ewli(p( C C,$J j/C
CONTRACTOR'S LICENSE !K y4'L 4/D 9,r375 WAINS
NUMBER: 5-ohoterDapg.),'Z CZOioey4 NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New 25-Wood Existing: 40- I Sewer
41' Addition ❑ Steel Proposed: Bank LI Community System
❑ Alteration/Remodel ❑ Concrete Total Ieht: f1 Individual System
❑ Repair LI Masonry �,, SEP Permit#
Li Demolition ❑ O er: Bedrooms:, ,/(k— v Water Supply:
Existing: et ❑ Private well ❑ Two Party
Type of Heat: CAS Proposed: ❑ Public
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 havelood 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 1 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:
2nd Floor Heated Consistency Review:
Other Heated Base fee: CI a�
Mezzanine Additional Section:
Heated Basement Plan Check fee:
(03. al
Unheated Basement State Surcharge fee:
4 w50
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL ' lD�-{I ,1 '9
Decks �� 911/Rd Approach fee:
'—� ` Eft51- trt
Other5,aw of"
py /355 3�}Ia. $D TOTAL: $ l 6� 1Etool-/ 6?c✓5,49 2- Receipt Number: Oa`tqq
roorg
Cash/Check Number:
6l°
ESTIMATED COST(REQUIRED) Date: o•Fair market value of all labor and materials foundation to finish/,,oX screfo� Initials:
-
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc