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Home My WebLink AboutBLD2008-00494 OUILDING PERMIT APPLICA•N BL v Reviewiew T Ty494 ype: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00494 Received Date: 12/1/2008 SITE ADDRESS: 384 TALONS ROOST RD BRINNON, 98320 OWNER: PHILLIP G THENSTEDT PHONE: (360) 796-4456 DAWN M THENSTEDT PO BOX 552 BRINNON WA 98320 SUBDIVISION: Block: Lot: TX264 PARCEL NUMBER: 502112035 Section: 11 Township: 25 N Range: 02 W CONTRACTOR: HOCH CONSTRUCTION PHONE: 360-452-5381 4201 TUMWATER TRUCK RT. PORT ANGELES WA 98363 Contractor's License HOCHCI*16ONT Expires 4/12/2009 REPRESENTATIVE: HOCH CONSTRUCTION PHONE: (360)452-5381 4201 TUMWATER TRUCK RT (360) 452-5382 PORT ANGELES WA 98363 PROJECT DESCRIPTIOI NO MLA REQ'D - REPAIRS TO TRUSS DUE TO FIRE LOSS - NOT OUTSIDE FOOTPRINT TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 21,400.00 ADD'L: HEAT TYPE: CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: 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: Type Amount Paid By: Date: Receipt: Approved/Date Permit $349.25 KAS 12/01/08 102940 APPROVEDPlan Check $227.01 KAS 12/01/08 102940 State Building Code $4.50 KAS 12/01/08 102940 n•-•. 8 v Total: $580.76 Jefferson County Planning &Building Department Jefferson County Building •sion Permit Null,: BLD08-00494 Applicant: THENSTEDT 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 Framing -- bi FINAL INSPECTION (1J1-7 J 1)--),c FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • 4 ON cod JEFFERSON•LINTY • 5., 1,,-_,,,,:,._, ,:_„ „ D 4 ` DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend • Washington 98368 G C — 1 2008 :txt4y 360/379-4450 • 360/379-4451 Fax qSNC www.co.jefferson.wa.us/commdevelopment Master Permit Application JEFFE SON COUNTY HD MLA: Project Description(include separate sheets as necessary): (liJ i "�'l7tL> l-O /✓,'T TC S S . 7 f -t. r5 v/i r fotn-r- -7:-? _1,0 Gam`' Tax Parcel Number.. rj 0 2 1 1 20 35 Property Size: (acres/square feet) Site Address and/or Directions to Property: 38 Terns Roos-'r d. B � \N f nrLc -\, i- ct 83;(T) Property Owner(s)of Record: .to 'h s,lr.e - Telephone:3i,QO •7cil. • '+4Lp Fax: email: Mailing Address: P.D. 5'a PT ri nrtan,\Al A 9 R 3a Applicant/Agent(if different from owner): 1400..,h Cir 4 acd-cy\1 C. Telephone: .3(QO•1+6a• S, Fax:31QO.4• 2 ,G3S. a email: kp(40;bt4 inp Rs,rie- Mailing Address: O ^ Cie__ y �� )� S, U What kind of Permit?(Check each box that applies N3uilding "V\et.. Qtp,9-1 t2.— 0 Critical Areas Stewardship Plan X Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑Single Family ❑ Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 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** 0 Propane 0 Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑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 Please identify any other local,state or federal permits required for this proposal, if known: J `L\ \. \ D IGNATION OF AGENT vl P 't fe4act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE V V , Date:_1140 g 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 ight of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and an required later inspecti ns. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the pli IAA that he or sh w s prior notice. '/Signature l ,Q Q Date: ///s�/,� The action or actions icant 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 viol the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even' ou are in complian with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-tra frble responsibility f a ring to and complying with the ESA. The Applicant has read this disclaimT/er nnd igns and dates it below. L( Signature 4/ _ ,, Date: /17CT C:\PemvtCenter\###FORMS###\DRD FORMS\MagtPrPem„t Annl;rat;nn S_n.nu,i,,, • BUILDER STATEMENT • T 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: IAod' C c rk�• circa a .n.( c ).-f5� �3 _ MAILING ADDRESS: � EMAIL: CONTRACTOR'S LICENSE O t' ann. ¢ (/ ' Q c'&P S WAINS NUMBER: li-{C z I(aONT NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New )Wood Existing: 0 Sewer ❑ Addition 0 Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System Repair -9Qe., ❑ Masonry SEP Permit# Bedrooms: Water Supply: O Demolition ❑ Other: Existing: Setback: —. n Private well ❑ Two Party Type of Heat: Proposed: l i 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 / 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. t Ftia TI<ee kt ?. Square Footage Current Proposed For Office Use Only ,6;;,�f„ , „ ` `.Amount R�� fo1 1*l+r. ' Main Floor Heated - EH Bid App Review: 2n0 Floor Heated Consistency Review: Other Heated y iI Base fee: 34 Mezzanine =fit,• Additional Section: Heated Basement Plan Check fee: �ca� D� DEC — 1 ZnUt Unheated Basement ` ':'' State Surcharge fee: x A .5- O- ther Unheated 6'' Pot Water Review fee: Garage/Carport f W SUBTOTAL Q,� + Decks -i;i, �-1` 911/Rd Approach fee: ,, s}kr , O- ther 4 TOTAL: $ C) •• 1 ci„q ft Receipt Number: `D aG L D it* 1 Cash/Check Number: �n\0D ESTIMATED COST(REQUIRED) Date: a •Fair ma value of all►aborar` teriais foundation to finish Initials:' r_.\D......:r!'o..ro.\tfftffFrlR MCuftftf\rlRrl FrIR AXG\A,fnero.1:4...1.4 A....I;,.,:...,G_10_11R.1..,