HomeMy WebLinkAboutBLD2009-00020 BLD09-00020
UILDING PERMIT APPLIC . ON Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00020 Received Date: 1/29/2009
SITE ADDRESS: 80 E MAPLE ST
PORT LUDLOW, 98365
OWNER: PATRICK J RAYMOND PHONE: 360-437-8048
ANN E HEALY-RAYMOND
80 E MAPLE ST
PORT LUDLOW WA 98365-9743 PARADISE BAY ESTATES
SUBDIVISION: Block: 10 Lot: 9+
PARCEL NUMBER: 983401010 Section: 23 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: ALAN WOODBURY PHONE: 360-385- 245
252 PROTECTION RIDGE RD
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOI UNHTD ENTRY ROOM TO EXISTING SFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN:
VALUATION 4,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: 5N GARAGE: 67 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 0 Prop: 0
Total: Total.
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $97.25 LYK 01/29/09 105330 AOPROVED
Plan Check $63.21 LYK 01/29/09 105330
State Building Code $4.50 LYK 01/29/09 105330 FEB "f
Total: $164.96
Department Jefferson County Planning
& Building 2009
Jefferson County Building•ision Permit Niker: BLD09-00020
Applicant: RAYMOND
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
Setbacks -1"//i�/ k_
Framing sb a� 191,'
Airseal qtriktit
Insulation: Walls i'2.7 10/
Insulation: Floors ✓
Insulation: Ceiling
FINAL INSPECTION /0_2_4—0
(l9
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
4.,i,. oN
coo,
JEFFERSO•OUNTY I
l'' DEPARTMENT OF COMMUNITY DEVELOPMENT
`' `4 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
�,qsp� www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: NO (Yli`.& eeo' ft
Project Description(include separate sheets as necessary):
7 o,1i be b::,l4l ti /o'-Y'x 6J 64
On A t A,1 Eq_tp1 R O cm
Tax Parcel Number: 783 yV 1 01 , Property Size: f 7, OU c,-- (acres/square feet)
Site Address and/or Directions to Property:
e O /=q ,' nvie rF4 Pc c4/J.i/ CJA,
D
Property Owner(s)of Record: / Gfr,t K. II nth't R':,i m o 16i
Telephone: 360 - 4/37 -8 Oy e Fax: email:
Mailing Address: 8 O Echi} fcpi 1 R c+rs c)i 1 c, Li 6.
Applicant/Agent(if different from
PP 9owner): it;n Li cD c cl b ki
Telephone: 3 60 3 8 J -7',f S Fax: n email:
Mailing Address: AS2 Pro t F�.f;�yt R;c'ry &. i . / Pork J J t-,n ! Vn ci r Li c,r, 1 P3C $'
What kind of Permit?(Check each box that applies
Wuilding ❑ Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
;il Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
O Change of Use 0 Boundary Line Adjustment
O Address 0 Road Approach 0 Short Plat**
❑ Home Business ❑ Cottage Industry 0 Binding Site Plan**
❑ Propane ❑ 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)* ❑ Shoreline Management Substantial Development**
0 Temporary Use ❑ Shoreline Management Variance
❑Wireless Telecommunication* ❑ 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 ❑Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
/i an Wll �v DESIGNATION OF AGENT
I hereby designate CI b Of/ to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE � " uZ "M :2-0, Date: 2 5 i' 7
By signing this application form,the owner/agen atte�t 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 required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicatio tha�he oorr, he nts prior notice. /
Signature: "' 11�e`�+ /`� Date: / /2�/Lr 7
The action or actions Applicant will undertake 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-transfers ress nsib for ring to and com ying with the ESA. The Applicant has read this disclaim r and signs and dates it below.
Signature: 7 '? — /<� .�-T Date: /,� 5/ C
G:\PermitCenter\###NORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
40 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 assumtrr§tljie responsibility of the General Contractor for the proposed project.
Signature: , \ > Date: �S Z `? 1 5
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;'
❑ New I( Wood Existing: C. i i Sewer
14 Addition ❑ Steel Proposed: Bank i Community System
Li Alteration/Remodel LJ Concrete Total: Height:i I i Individual System
i Repair ❑ Masonry SEP Permit#
Li Demolition Li Other: Bedrooms: Water Supply:
Existing: C� Setback: l i Private well ,1 Two Party
Type of Heat: Proposed: C) J Public
0�,0 N , Total: Name of System:
If this is a Commercial Proiect 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.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated G\cl3 s EH Bld App Review:
.
2"a Floor Heated Consistency Review:
Other Heated Base fee: C1 1 °5
Mezzanine Additional Section:
Heated Basement CILOS Plan Check fee: �Q/ _
Unheated Basement State Surcharge fee:
Other Unheated j�(�ib Pot Water Review fee:
,ij-rr y Atom
��S. SUBTOTAL
Garage/Carport q(C)
Decks 911/Rd Approach fee:
Other TOTAL: $ I(al-, `I
Receipt Number: 10. b
Cash/Check Number: 1-1 I
ESTIMATED COST(REQUIRED) Date: n
•Fair market value of all labor and material ndation to fin ish\ _-q
1 006 Initials: —'7
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
ir ,
Q. _
1 f A
. _
N
�h
I cp
I \
b / •� .� ,'
yam' f'-
i VI0 '� te { ` �� �
� �` ht►
/ /� I` -4
•
Th i N I I
w I
'1. v
tom a -%, - I
,... ,
a Cot*re O i� /��� / / �/ ��
.a7mn // /r.r / /.,. / // ' _,_ _y
�i
r'
— = ., 7/ / / ,4 , lt ,., ,/ ,,,„/ 7 . ...._
,,, loop.al ,.5 ./
.t%
mA co a r / ////''
/ /C / / %
aoao A t ��/ j /
•c . o
,
°�`
474,1
s
i cr,
? s e i
K col
o IP
W 7 c
o ci 's—Po
m
N o (o ; -
o I f
0
< E.73
o_a^ ,-.
J , '
W 3
a
m �'
cn II
, ``' 0 ! •
�Z � - I ; 0
$c s 3 A_
r •` c -C M 'O ,,,�
171 r`n `( 4, A -. n ;,
c N g -�� I.
p
61
mlb em • ~
` e =
0 w ► W i a
�� ��
J
3 0 �
to „iir.........______V-Ir'r 4'. ."' i: cL. te. fstz , .. .tcs. oct.
Y l d , ,`o� Q''
),11- N 4.k„ cf) ),,c1, 4_ 0 ti,st .&
1 /'
\ /
1 \ / 1
1 \
-4 o ems. \ /
I \ /
I \ /
`
I /
I \ �,
'opI
1 \ //
` /
i al \ /
I
4 "---44--et—›-
1 n 411
I I
N.
\
'4 ,,c, ,..) 41
\ d �•-p 1 I
. .. 0 _____:- . \ NcA
? ' y..• :9 I I
"of) n Q J i
4. V � � // X4 1 I
:4;
. I /4 / \
@s1 it/ / /
\
IE / \
• ` I
e, I / \
4s. , , p // \
A1 /� I
/ \
("j4 ,
is to -6 :-41-:
&:-.> v ci)
iu
. b. o
° � g0 ' Io
_-9
11.41
i