HomeMy WebLinkAboutBLD2009-00015 UILDING PERMIT APPLICADN BRD09-00eview 0e15
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00015 Received Date: 1/22/2009
SITE ADDRESS: 2327 HASTINGS AVE W
PORT TOWNSEND, 98368
OWNER: SUSAN M OHLSON PHONE: 360-774-0750
WILLIAM R CURTSINGER
PO BOX 1162
PORT TOWNSEND WA 98368-0962 SYNDICATE
SUBDIVISION: Block: 24 Lot: T 64
PARCEL NUMBER: 997600013 Section: 5 Township: 30 N Range: 01 W
CONTRACTOR: SOULE WOODWORKING & CONSTRUCTIO PHONE: (360) 643-3530
JAKE SOULE
1466 30TH ST
PORT TOWNSEND WA 98368
Contractor's License SOULEWC935JL Expires 4/13/2009
REPRESENTATIVE: SOULE WOODWORKING & CONSTRUCTIO PHONE: (360)643-3530
JAKE SOULE
1466 30TH ST
PROJECT DESCRIPTIOr INTERIOR REMODEL OF EXISTING HOUSE AND NEW DECK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 116,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 180 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUBLIC
BEDROOMS: BATHROOMS:
Exist: 3 Exist: 2
Prop: 0 Prop: 0
Total: 3 Total: 2
Routing Date:
k\-N—\\UG\
Type Amount Paid By: Date: Receipt: r d/Date
APPROVED
Permit $1,088.95 KAS 01/22/09 105282
Plan Check $707.82 KAS 01/22/09 105282
State Building Code $4.50 KAS 01/22/09 105282 FEB ? 2009
Total: $1,801.27 Jefferson County Plannin[
& Building Department
• BUILDING PERMIT •
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD09-0001 5 Received Date: 1/22/2009
SITE ADDRESS: 2327 HASTINGS AVE W Issue Date 2/2/2009
PORT TOWNSEND, 98368 Expiration Date 2/2/2010
OWNER: SUSAN M OHLSON PHO E: 360-774-0750
WILLIAM R CURTSINGER
PO BOX 1162
PORT TOWNSEND WA 98368-0962 SYNDICATE
SUBDIVISION: Block: 4 Lot: T 64
PARCEL NUMBER: 997600013 Section: 5 Township: 30 N Rang : 01 W
CONTRACTOR: SOULE WOODWORKING & CONSTRUCTION PHONE: (360) 643-3530
JAKE SOULE
1466 30TH ST
PORT TOWNSEND WA 98368
Contractor's License SOULEWC935JL Expires 4/13/2009
PROJECT DESCRIPTION: INTERIOR REMODEL OF EXISTING HOUSE AND NEW DECK
TYPE OF WORK RES SQUARE FOOTAGE
TYPE OF IMP ALT
VALUATION 116,000.00 MAIN:
CODE EDITION: 2006 ADD'L: HEAT TYPE: PRO
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: 180 BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUBLIC Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $1,088.95 KAS 01/22/09 105282
Exist: 3 Exist: 2 Plan Check $707.82 KAS 01/22/09 105282
Prop: 0 Prop: 0 State Building Code $4.50 KAS 01/22/09 105282
Total: 3 Total: 2 Total: $1,801.27
Directions to Site:
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR Ilf MUST BE PROPERLY RENEWED
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
Jefferson County Building Pision Permit Nu, : BLD09-00015
Applicant: OHLSON
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 clay'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
Rough-in Plumbing
B l
Framing 1 y Oct
Airseal
Insulation: Walls ��Y�O�'
_Insulation:Floors.__--
91�I0
insulation: Ceiling—
Gas Line: Interior 4/10(EP
Gas Line: Exterior-
Propane Tank
Address Posted
FINAL INSPECTION !{ 't
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING B LING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
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i ,,t, JEFFERSOI�OUNTY 0
W \q r} DEPARTMENT OF COMMUNITY DEVELOPMENT
`' v � `< 621 Sheridan Street • Port Townsend •Washington 98368
360/379 4450 • 360/379 4451 Fax 1
4' pti www.co.jefferso•n.wa.us/commdevelopment
I`�I3INCI
Master Permit Application MLA: O �LA REQ ID
Project Description(include sepf rate sheets as necessary):
�J1� ,o./ ( z:•'to JAL / eX(c relic\ VlO-tJ5-Q.--
Tax Parcel Number: A 97(c X)C 13 Property Size: 2.0°0O' I dr square feet)
Site Address and/or Directions to Property:
TSB 7 ku5[;!1 S ,6L
Property Owner(s)of Record: s S�<, Oh/50 r1 !� g I1 vY-/( �/ .1
Telephone: (30 ) 7741 — Cam/70 Fax: email:
Mailing Address: 2 -s z 7 /L. s i-iA S ,
Applicant/Agf nt(if different from owner): -.T ki2_ v (L_..
Telephone: `. 360 6//(-(�"" �5 3O Fax: email: �0�L2 1 �' l w+a i .-co.�
Mailing Address: (�G 0 -(:) 0, Sf f--rr j<<,.,'y1,r1 LC/4 36�
What kind of Permit?(Check each box that applies
jXlBuilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
_ 'Single Family L:kNoccLEI Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* ❑ Special Use(Essential Public Facilities)**
❑ Change of Use ❑ Boundary Line Adjustment
❑ Address ❑ Road Approach ❑ Short Plat**
❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan**
❑ Propane 0 Long Plat**
❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 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 ❑ Shoreline Management Variance
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
G. _ .c-q. I
/ /D� ESIGNATION OF AGENT
I hereby designate e/! �Z9t/(ce _ - to act as my agent in matters relating to thi applicati n fo permit(s).
OWNER SIGNATURE z_P Ck- (,tr-t— _(JZA.4) l
Date: l ZZa
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 Couly and its employees, representatives or agents for the sole purpose of application
review and any required later inspections. Staff access and rig of entry will be assumed unless the applicant informs the County in writing at the
time of the application that he or she wants prior
ice. ? �1
Signature: Date: ( -Z/JO ,e
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 aryl.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 complia ith the Jeffer dCounty development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable responsi ' f ..adfiering to complying with the ESA. The Applicant has read this disclaimer and sig s an dates it below.
Signature: Date:
G:\PermitCenterf#'#.t?#FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
0 BUILDER STATEMENT 0
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 IuIANUFAC URED HOME INSTALLER: PHONE: FAx:
6� C� 4 ( fry ( ) b 3 35A�/�7 ( )
MAILING ADDRESS: I—1 U b 3o" f—I ro,.✓.' J- 4// EMAIL: j 5.60�j,�L r _,4% — ial / . -' -
CONTRACTOR'S LICENSE ,,// _ WAINS J
NUMBER: 2 X—t� tt W(;q:5 S--- NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAx:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
I 1 New ;fi! Wood Existing: CI Sewer
I Addition LI Steel Proposed: Bank L: Community System
Alteration/Remodel L 1 Concrete Total: Height: I I Individual System
❑ Repair _I Masonry SEP Permit#
❑ Demolition LI Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well Li Two Party
Type of Heat: Proposed: f 1 Public
131^cpcix Total: Name of System:
If this isf 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 1 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:
2"a Floor Heated Consistency Review:
Other Heated Base fee: .
Mezzanine Additional Section: O
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee:
4.50
Other Unheated Pot Water Review fee:
�'�d Li vD e' L J l68
Garage/Carport - SUBTOTAL
Decks fiv 4 b( 0 911/Rd Approach fee:
I VtP•4ll
Other TOTAL: $ l sic ill ,a,'7
Receipt Number: I D5&a
Cash/Check Number: I a `a
V
ESTIM 6t IRED)"_ Date: h
•Fa' arket value of all labor and materials ndation to finish V�
f , (,6 6 C)6) Initials: O
G:\PermitCenter\###FORMS###\DRI FORMS\Master Permit Application 5-29-08.doc