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HomeMy WebLinkAboutBLD2009-00119 (0002) ilkl UILDING PERMIT APPLICA ON BL Review vy119 iew T Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00119 Received Date: 4/16/2009 SITE ADDRESS: 53 HUNT RD PORT HADLOCK, 98339 OWNER: LEONARD E ENDERS JR PHONE: 360-385-4747 PO BOX 307 PORT HADLOCK WA 98339-0307 CHALMER'S 2ND ADDITION SUBDIVISION: Block: 31 Lot: 24-25 PARCEL NUMBER: 942903107 Section: 3 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP 2ND STORY (UNPERMITTED) 2nd FLOOR ADDITION TO EXISTING SFR (SEE BLD 96-381) TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: VALUATION 71,115.00 ADD'L: 702 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 255 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 1 Exist: 1 Prop: 1 Prop: 1 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $818.75 LYK 04/15/09 108273 APPROVED Plan Check $532.19 LYK 04/15/09 108273 State Building Code $4.50 LYK 04/15/09 108273 2009 JI �1 Total: $1,355.44 Jefferson County Planning &Building Department Jefferson County Building *ion Permit Nu•: Applicant: BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 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 // j l t k. 't/R ; � 4, L!(tf,,,^- r t I l( l � 2- (>._t (4 t k- PS-4 I) 5-°ol77%, cc l'" ie 1 e.k /DIV I �CEN `;'t 4-,4—rl�� ,,,6,,1� 0-- 4 of 1 l ( 4/1"Q-1S R``_ 2 54'etraG!( /��� �/"'r j? ; /J,' /J,,. 3. 2 !,. o,lc a- e-e-ds' Zti 44 ,,i 2,//f/ o ,i`/'' 51...-//,,,5 /a.vt 3-Z 1/a,,,,- SVIR o°4 l V1.4 R. I ti 4"4 0C- L,,,,t 3 r Live .4% "row .6 r -T0,,41-2 _rt.(/'7 :S''h ,,,,,,to pS j u /6,,,,..,,z b —, /z /z x- p FINAL INSPECTION a AI 6(6l FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 4 �\ JEFFERSOSOUNTY 0 _ DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 A r* 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: NO (YA 2 .i. Project Description(include separate sheets as necessary): AM,/ i7 C ) c'14- GA-U�"L 77 r/o 8•• leOz' 4 C'ec7 i -I /a/NM-1g Tax Parcel Number: r,42 4C.3 ie 77?5/L y0.S//6 / T / Property Size: /7 De) 0 (acres/square feet) Site Address and/or Directions to Property:53 >1 Lc fi! -I- *Ph ) ,,e— Jib GO�j� � 14` , Property Owner(s)of Record: jLi�j'- 6 E. _,t,r�Le.2 s s Telephone: 6,0 3 5 47 4 `7 Fax: email: Mailing Address: 0 i3Q)k' 730'7 P€,. i "//tbLec1k, WIT-. 9fi=339- 0 307 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 uilding 0 Critical Areas Stewardship Plan ❑ pemolition 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 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑Binding Site Plan*'" APR 15 0 Propane 0 Long Plat** 2009 ❑ 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 0 Jefferson County Shoreline Master Program Amendment *May require a Pm—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: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE __. Date: 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. l further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application revir:w and any required later inspections. Staffs access ' ht of entry will be assumed unless the applicant informs the County in writing at the lime of the application that he ors piidnoti . Signature: Date: -o 9 1 The z;ction 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 lei 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 ,)emit 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 a'cthn(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual arid non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: G:\Per.nitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.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 they will be assuming the respo i of the Ge ontractor for the proposed project. Signature: ' Date: •/ '—e, ' GENERAL CONTRACTOR OR UFACTURED 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: O New R'Wood Existing: I ❑ Sewer VAddition tySteel Proposed: I Bank ❑ Community System ❑ Alteration/Remodel V Concrete Total: "'- Height: Eilndividual System ❑ Repair 0 Masonry SEP Permit#.;CP y0'o6)/9 O Demolition 0 Other: Bedrooms: Water Supply: Existing: I Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: _____L__ _e'Public Total: L. Name of System:p,a,� — Ts- -F&e.,r.1 C'OL.WrY 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: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: i Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 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 UseOnl�r Amount �Revisioi Main Floor Heated _IA EH BId App Review: 13. DO z"" Floor Hem Consistency Review: 70A. 1ffl5.(oa Other Heated Base fee: S 1 b• J• C Mezzanine Additional Section: Heated Basement Plan Check fee: 5a, Unheated Basement 1,^p� State Surcharge fee: 4.50 Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL I a$ "1-4 . Decks 911/Rd Approach fee: _ - Other 0✓ D A 55 i e c14 9.0 TOTAL: $ 1 LI a? 1'4 Receipt Number: \c 1'3 Cash/Check Number: I D15^ ESTIMATED COST(REQUIRED) 1i 14,(Q ate: /' ")' •Fair market value of all labor and materials foundati to Ish 'II—(5 / 7 , O© �_ Initials: IC - D 1 4 G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc /. \ So \r) q, , ,,,, _, , E ,(-,_.,.. v 1 U xi J ____,------- �� � ,, ,i ,......_, __________ i \J ,,,..___ .) ____ ___. _ ; !) c -its \ -� „ tL \ .�_. ,q ''. 1 e_g_i I \ to G-- (31 �911,< \.. -- Z-ht/ir .,' ] l..il (1:f i '' .,,___ --,..VI, I X L V) I: I � °° _, , -4_,4 z V rS) J v _1----) ---T G:_-75,-7;y3 ..ri-c X—G----iv9 1 l �`£�Y I - i I ! 1 x + f 14.1 oli t j 7.r--`) ..---- 1 0 — - :41 / \ ,c 4\71---- >< kliQ) \,±/J- 1—1—i 0 i .----ifK, Y\ , ' . (1)c L (Lici I Xr-c2)2,. ... fo 1 c-,i�i (\) • , _,.. •--y \'' / I p-,S1X,g Oc Y-C/19 ,..,.„...r,....1.,_____.„...._,.... . 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