HomeMy WebLinkAboutBLD2009-00102 09
UILDING PERMIT APPLICASDN ML Review Ty 111
ype: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00102 Received Date: 4/6/2009
SITE ADDRESS: 222 DENA LN
CHIMACUM, 98325
OWNER: JOSHUA E FOUNTAIN PHONE: (360) 732-0979
222 DENA LN
CHIMACUM WA 98325-7701
BISHOP HEIGHTS DIV II
SUBDIVISION: Block: Lot: 14+
PARCEL NUMBER: 933500014 Section: 35 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION NEW DETACHED GARAGE
UNHEATED AND NO PLUMBING
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 23,181.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 864 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
4 LAO [ OCk (t<-4
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $377.25 KAS 04/06/09 105635 APPRDVE
P
Plan Check $245.21 KAS 04/06/09 105635
State Building Code $4.50 KAS 04/06/09 105635 APR 23 200g
Total: $626.96 Jefferson County Planning
&Building Department
Jefferson County Building lision Permit N er: To Schedule inspections, :u11
Applicant: (360)379-4455 by 3:00 PM prior
BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: day.
To schedule inspections, call (360)379-4455 NOTE: Monday inspections by
3:00 PM prior Thursday.
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
Erosion Control
Post Holes
Foundation Footing
Footing Drains
a
Foundation Stem Wall
Underground Plumbing
Straps(hold downs) „�y
Ext. Shear Wall Nailing
Rough-in Plumbing
Framing r
C/f) eiz-Or&I io-feJ 1.04- 114-w-1,1-or
Blocking
Wallboard Nailing II__
Drywell/Alt Drainage
Address Posted
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
S
CONDITIONS for Building Permit# :BLD09-00102
1.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
2.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington to control stormwater, erosion and sediment during
construction. BMPs shall address permanent measures to stabilize soil exposed during
construction, and in the design and operation of stormwater and drainage control systems.
3.) The building height is not to exceed 35 feet.
4.) Minimum setback from Dena Ln right-of-way is 20 ft. Minimu side yards is 5 ft. Approved
site plan meets minimum set back requirements of UDC.
ON� 0 •
w, .�i ik6
JEFFERSON COUNTY
' DEPARTMENT OF COMMUNITY DEVELOPMENT
` `4 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
gyp$ www.co.jefferson.wa.us/commdevelopment
81N
Master Permit Application Epp _ • MLA: O a— 11 J
Project Description(include separate sheets as necessary):
Ga c-aa G arrrrneNi f•nIIJI•
Tax Parcel Number: U2� Ic1. "'�"-J). ►,r�Li Property Z, yrU�
l ,J )0v— O l Size: (acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record: TO - Lt al f, FoLt,n urk,
Telephone: (V./0) 1'Z - 09 79 Fax:
email:
Mailing Address: 22-Z V-er Lh_ C-hiwi,,,a vv., t.A.:k_ Q, ZS
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies 0 Lot or Road Segregation
ilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit � 0 Variance(Minor,Major or Reasonable Economic Use)
❑ Single Family "Garage Attached etache) 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 0 Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan**
❑Propane 0 Long Plat**
❑Sign - 0 Planned Rural Residential Development(PRRD)/Amendments**
0 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 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:
GNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE (' Date: L1 3 4-1
By signing this applicatiQ, orm,the 'ner/. attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowle• Any mat- -I false`'.►•. 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 Jeffer on County and its employees,representatives or agents for the sole purpose of application
review and any required later inspections. Staff .-ss and 'ght of entry will be assumed unless the applicant informs the County in writing at the
time of the app .:tion that he or --wants prior'once. !�
Signature: ;� - Date: (� -O /
The action or ions Applican wil •undertake-s a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered pecies and coul. ad to a pote ial'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. An ndividual,group or agency car file a lawsuit on behalf of an endangered species regarding your
action(s)even if ou are in compliance with the..,I: ers deve ment code.The Applicant acknowledges that he,she or it holds individual
and non-tran era I rQsponsi..rLW 1herin. d compl in a ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: ANNUL. Date: y- 5 -0
0 •
BUILDER STATEMENT
The signer of this statement does h by ce that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be as1Dming the r sponsibi y of th eneral Contractor for the proposed project.
Signature: ih'7. Date: 4-2/s0/
GENERAL Q6 R'
NTRACT�SOR MA FACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Fr9me Type: Bathrooms: Shoreline: Type of Sewage Disposal:
''New v. Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: 7_ Height: ❑ Individual System
❑ Repair ❑ Masonry /7 SEP Permit# Oi -3�5
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: + ❑ Public
N U YI k Total: v 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 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. n 4 s d sF; ,�
Square Footage Current Proposed F Ui �0...g . 3_ , . .: , � � ' ' .
Main Floor Heated x `'i•':a: EH Bid App Review: vo
fY,
2m Floor Heated ' Consistency Review:
13-OD
Other Heated APR - 6 ,, Base fee: 1
a5
`''' Additional Section:
Mezzanine I .,
IZ
Heated Basement \. Plan Check fee: 45 al
Unheated Basement State Surcharge fee: �' 5 o
Other Unheated - Pot Water Review fee: _
/05
I SUBTOTAL
Garage arport '
0b,9 • 05I 311 I Ci l a.i
Decks 911/Rd Approach fee: EKtsf(r10
Other TOTAL $ Cl
l a ctto
t----
Receipt Number: I be535
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: ��
•Fair market value of all labor and materials foundation to finish
/ q ODot Initials:
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