HomeMy WebLinkAboutBLD2008-00446 BLD08-00446
liEUILDING PERMIT APPLIC41103N Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00446 Received Date: 10/13/2008
SITE ADDRESS: 90 ADMIRALTY LN 340
PORT LUDLOW, 98365
OWNER: RICHARD HARDING PHONE: 505-670-2480
KANITA C HILLS
2899 SKI TRAIL LANE
STEAMBOAT SPRINGS CO 80487 THE ADMIRALTY#2
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 990300214 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI INSTALL NEW WINDOW (IN A CONDO) - NO MLA REQ'D
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 2,000.00 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. (:)\, ( 0
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $69.25 AMS 10/13/08 102690 APPROVEr
Plan Check $45.01 AMS 10/13/08 102690
State Building Code $4.50 AMS 10/13/08 102690
Total: $118.76 NOV
Jefferson County Plannin,
& Building Departmpn..
Jefferson County Building •ision Permit Neer: BLD08-00446
Applicant: HARDING
BUILDING 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
Framing IL/24/06
Miscellaneous iz/i916B 1.1-Value M/1/ETA/iv5D ham,./5-r 33
G( 1�ALuE
FINAL INSPECTION i"-
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
72.8749 I
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�,,w paw JEFFERSONOUNTY •
W g� ra DEPARTMENT OF COMMUNITY DEVELOPMENT O C T 1 3 2E8
"N s:-.. 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
kgSNp�p* www.co.jefferson.wa.us/commdevelopment JEFFERSON COUNTY DCO
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Master Permit Application MLA: n0 yr' tc re. d
Project Description (include separate sheets as necessary): 1
Th•,t"t&l) new' witMock) I ILVt rig v n1
Tax Parcel Number: Cf 9O 3 00,.,2/V Property Size: ('undo 12- O Q (acres/ quare fee
Site Address and/or Directions to Property: %�
ciD �'dn►tral -j t e _ lint t 3j4D t"d/t Li4 oLA , tdo,_ cig3Iv
Property Owner(s)of Record: R.iCH ARC j i i)s Albs v C.A-A.t TA Hi t_LS
Telephone: �7 49.7CU -2400 Fax: email: Kirin eji(u.ix.netuvuoin
Mailing Address: 7 1 S.:-i �✓qi I Lan€_ j -C it 016J�ii SPQ3n�� CD fi q 7
Applicant/Agent(if different from owner): rV/
Telephone: Fax:_ email:
Mailing Address:
What kind of Permit?(Check each box that applies
)(Building MS./0/ ricw' 4.:,,u./&La.' ❑ 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]**
O Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
O Address 0 Road Approach 0 Short Plat**
❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan**
❑ Propane ❑ Long Plat**
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
❑Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
0 Forest Practices Act/Release of Six-Year Moratorium 0 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 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 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 requiredshter inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application thaSttbr s nts p for notice. l . ?
Signature: Etc,- 4 tiv� u�C (?',-1 1 I6C Date: C/
The action or actions Applicant will undertake as 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 a in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfera re, nsi nsi ili y fora e(ng to and c,omply/ing/with the ESA. Th Applicant has read this discla'mer and`signs and dates it below.
Signature: ',--j' al i" Y b("i�/k C i1�� Date: %�vt�ptJ
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• BUILDER STATEMENT •
The signer of this st ment does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assur�t( U re nsibility of the G' nerral Contractoor for tthe proposed projects. J
Signature: / u L�'Ut (TT, 114 Date: / /0/-
GENERAL CONTRACTOR OR MANUF URED HOME INSTALLER: PHONE: FAX:
0tAINP/2 &ul 62 (s-eSr(70 -ot fo ( )
MAILING ADDRESS: �7t(�'q cr4 �- Ai i ka nln EMAIL: i Gk @ J x. k elam , CQ,v
CONTRACTOR'S LICENSE steel/4m,401v,,,� exj WAINS
NUMBER: l NUMBER
ARCHITECT/ENGINEER: '<l op_ goj le e 4/ae) +c r PHONE (34,d 3J3=61 y0FAX:( )
MAILING ADDRESS: c Opj aNI Srl QrTo-ur LSen[�,(4.JApx.3,EMAIL arch i+cc-EJort-gt',S•T ner'
Project Type: Frame Type. Bathrooms: O Shoreline: Type of Sewage Disposal:
❑ New �. Wood Existing: Z r4/,+_ ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
,A Alteration/Remodel ❑ Concrete Total: -Z Height: ❑ Individual System ma
❑ Repair ii'DD ❑ Masonry NO a-4 4e- SEP Permit#
❑ Demolition 1,d ❑ Other: Bedrooms: Water Supply:
kit�� Existing: 2 Setback: 7 Private well ❑ Two Party
Type of Heat: Proposed: — ri/ft 0 Public WO
EL.R._14 Q,0r170 Total: Ti Name of System:
If this is a Commercial Project you must answer the following: N 0
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: N D
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:
2na Floor Heated Consistency Review: `�____,
Other Heated Base fee: G 9 . ra,---3
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee: Lt.- 5 0
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL
Decks 911/Rd Approach fee:
\
Other TOTAL: $ 1 ( g , `�G,
Receipt Number: kO ci°`O
Cash/Check Number: C oo‘<\
ESTIMATED COST(REQUIRED Date: �
.Fair m 7 o all labor and matena undation to finish I 0) I 1 D`V
/ �.00O.- X Initials: CA,0
G:\PemritCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc