HomeMy WebLinkAboutBLD2008-00480 • •
DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD08-00480 Received Date 11/12/2008
SITE ADDRESS: 10345 RHODY DR Issue Date 12/9/2008
CHIMACUM, 98325
APPLICANT: KYLE J BRINTON PHONE: 360-620-5842
JENNIFER A BRINTON
10345 RHODY DR
CHIMACUM WA 98325-8710 T 22
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901101014 Section: 10 Township: 29N Range: 01W
CONTRACTOR: OWNER/BUILDER PHONE:
OWNER, KYLE J BRINTON PHONE: 360-620-5842
if different: JENNIFER A BRINTON
10345 RHODY DR
CHIMACUM WA 98325-8710
PROJECT DESCRIPTION: DEMO EXSTING 840sf SHOP & 384sf SHED - NO MLA REQ'D
Directions SEE MAP IN FILE
To Site:
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 12/9/2009.
REQUIRED INSPECTION:
FinalApproval: `o Li tzi4A ' ' "q—U�
J
BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
HOT LINE AVAILABLE 24 HOURS A DAY
I:\F_BLD_Permit_Propane.rpt 10/29/19
•BUILDING PERMIT APPLIC/ION B RD08 OOeview p199
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00480 Received Date: 11/12/2008
SITE ADDRESS: 10345 RHODY DR
CHIMACUM, 98325
OWNER: KYLE J BRINTON PHONE: 360-620-5842
JENNIFER A BRINTON
10345 RHODY DR
CHIMACUM WA 98325-8710
SUBDIVISION: Block: Lot: T 22
PARCEL NUMBER: 901101014 Section: 10 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: SOUND BUILDING SYSTEMS INC PHONE: (360) 437-1219
3546 THORNDYKE RD
PROJECT DESCRIPTIOP DEMO EXSTING 840sf SHOP & 384sf SHED - NO MLA REQ'D
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP DEM
VALUATION MAIN:
CODE EDITION: 2006 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: DECKLE: 0 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
1 I- v -(-)�
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $52.00 LYK 11/12/08 102890 \pIDflJ\fE[)
State Building Code $4.50 LYK 11/12/08 102890 Total: $56.50 DEC '"I 2008
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Jefferson County Planninc
& Building Department
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Ltg ION
, �,, Olympic Region Clean Air Agency
f 4 ,. 2940-B Limited Lane NW
i e) Olympia,WA 98502 Residential
Ak e7. (360) 586 1044•FAX(360) 491 6308
4. j Port Angeles office(360) 417 1466
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Demolition Permit
ORCAA '�/ Raymond Office (360)942-2137
'<to--ti,. r *•s `' www.ORCAA.org
t,,„¶a41
This permit valid only for residential homeowner
residing in the dwelling after renovations
DEC - -
Permit fee:-.-$35 06,-Frcr structure: Non-refuudable.
PROPERTY OWNER
Name:. . .
��•�� L Phone: (36,4 d z 4d - S y t Email:
K. ( G J . l.3f't.4-10^+, FAX: ( ) Mobile: ( )
Mailing Address: City: State: Zip:
(O3`(5 CZtia v( .'i/e... CJ,‘%.•,ett0.1'N W4._ 76.2-S
Site Address:
S� - 'es A,law J City State: Zip:
DEMOLITION CONTRACTOR,[) Check if same as property owner information
Business Name: Phone: ( ) Email:
FAX: ( )
Onsite Contact Phone:
( ) Mobile: ( )
FAX: ( )
Mailing Address: City: State: Zip:
DEMOLITION INFORMATION
#rof Structures being demolished: Start Date: Completion Dat
—I •- Upon e‘Apl'ru J°t,r sue.
Asbestos present Yes_ N ' — Survey attached es_ No_X Has all identified asbestos bee
- p removed Yes_ No_
DEMOLITION PROJECT CATEGORY -- _
IX Complete Demolition t
[ ]Training Fire—Fire Agency:
[ ] Renovation,Alteration,Remodeling,Maintenance,or other Construction
I have read and will abide by the conditions set forth in this permit and any addendum thereto. I do hereby certify that
all identified asbestos has been removed and the information in this application and supplemental data described herein
is, to the best of my knowledge, accurate and complete.
/(‘A g, ,se-./. /-.01-, -7,r(AZD' /2-7-a-g
Applicant Name Signatur
Date
Date Api eceived Payment Info.� Approved Asbestos Permit
C&IVE ] Cash [ ] Disapproved Permit# ASBOO
eck: # 3 4 Demolition Permit
DEC 3 2008 [ ] Credit Card Review date: Z/1/ LA Permit#L-ToDEM00•04-Jaa
Receive date /3 /C58 Reviewed by:
09/19 08 Agency Use Only Agen se Only Agency Use Only
I --- OVER
--
\K'C
1
k��ggoN cb JEFFERSO OUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
`' 621 Sheridan Street • Port Townsend • Washington 98368 41111
360/379-4450 • 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: C n' ,E y t i.
Project Description (include separate sheets as necessary):
iDC fr1c) '=kis-hnip; _SI e,p q- .S - v k
Tax Parcel Property
Number: r1 l0 1 10 1 OH`( Size: 3`-! 'S 9 (acres quare f ee t
Site Address and/or Directions to Property:
/D3y5 Rhocly Lr,ve. Ck,rmacu,,, WA 1ff32S
Property Owner(s)of Record: K y I E Rr,nf-P,.
Telephone: 362o- 1.0.2.0- ,5 8'1 a. Fax: email:
Mailing Address: 1034S Iitnct y Drive. C1•1imae•u.,-t UTA etfl3--5
Applicant/Agent(if different from owner): Sound Rut)d1h4 5y5+err,.s Zi4c
Telephone: .3/00 - Li 37- l.L 17 Fax: 310o -937 - i.2 I b email:
Mailing Address: 3syt, iornAy ke_ loa,( Por•t" L,AA1ow, 1,0 A `383(n .-
What kind of Permit? (Check each box that applies
VBuilding 0 Variance(Minor,Major or Reasonable Economic Use)
Pt Demolition Permit 0 Conditional Use[C(a),C(d),or C]**
❑ Single Family 2/Garage Attached C6etache) 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"
❑Home Business 0 Cottagelndustry 0 Long Plat**
❑Propane 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Sign 0 Plat Vacation/Alteration**
❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions*'
❑Stormwater Management ❑ Shoreline Management Substantial Development**
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment
❑ 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.lo_ca_L, state or federal_permits required for.this proposal, if known:
DESIGNATION OF AGENT
I hereby designate Souh 8u, 3- t/-e,..t Tnc to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: `/-/, -0 y
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 requir-, ater in-.- ions. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applica-li' '- /�>• ,.41wants prior notice.
Signature: /�, „�•tI Date: /(- )Q- a p
The action or actions Applicant 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 of v. late 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 o lance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trarisfe r ' i for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: . Date: J/-2' • O X'
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
0 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
theye will be asssuumm' responsibiliyy of the General Contractor for the proposed project.
Si nature��" �/// `�— Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX: ( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
IV New tY Wood Existing: 0 Sewer
❑ Addition ❑ Steel Proposed: -b- Bank ❑ Community System
O Alteration/Remodel 0 Concrete Total: Height: CYlndividual System
❑ Repair ❑ Masonry SEP Permit#
Water Supply:
❑ Demolition ❑ Other: Bedrooms: PP Y:
Existing: Setback: 0 Private well ❑ Two Party
Type of Heat: Proposed: -0 - ❑ 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 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 i Hot Water Tank i Pellet Stove I Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes I 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. k
Square Footage Current Proposed a on a 08 n .0 ..e,,r _ ,.
Main Floor Heated E• H Bld App Review:' ' :5-t4.4i-"4 Ll crrivir c-1 , „,,,t.
2nd Floor Heated °t .::;,' Consistency Review:
Other Heated 4A = ' B• ase fee:
Mezzanine _ «` Additional Section:
Heated Basement M .n Plan Check fee:
Unheated Basement X,..1--IV State Surcharge fee:
Other Unheated 4:��, Pot Water Review fee:
firs,
Garage/Carport �� R*ram r SUBTOTAL ,
a 'fie .
Decks 14' 911/Rd Approach fee:
tip '`4.{'-i
—Other TOTAL: $, 1-,,
Receipt Number: c�'C'
; Cash/Check Number: I
N, k N FM
� 1C�
-"; I
ESTIMATED COST(REQUIRED) Date:.Fair market value of all labor and aterials foundation to finish _ 2 -(
Initials:
L
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
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