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HomeMy WebLinkAboutBLD2009-00152 4103 Review UILDING PERMIT APPLICA&N ML y 171 T Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00152 Received Date: 5/26/2009 SITE ADDRESS: 294 OSPREY LN BRINNON, 98320 OWNER: KENT J ROSEMA PHONE: (425) 576-1305 JANICE WAIBEL ROSEMA 6039 111TH PL NE KIRKLAND WA 98033-7201 PULALI POINT PARTNERS LARGE LO SUBDIVISION: Block: Lot: 5+ PARCEL NUMBER: 601195005 Section: 19 Township: 26 N Range: 01 W CONTRACTOR: TO BE DETERMINED PHONE REPRESENTATIVE: ARCHITECTURE INTEGRATED RESIDEN PHONE: (425) 307-3507 CINDY BIENZ (425) 307-6636 PO BOX 848 PROJECT DESCRIPTION NEW SFR W/GARAGE AND PARTIAL DAYLIGHT BASEMENT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,251 VALUATION 365,250.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: 1,079 HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: 280 SHORELINE: CONST TYPE: DECK: 680 SETBACK: 30 BANK HEIGHT: 25 SEWAGE DISPOSAL: ALT WATER SYSTEM: PUBLIC BEDROOMS: BATHROOMS: Exist: Exist: Prop: 3 Prop: 35 Total: 3 Total: 35 Routing Date: 4lcala� Type Amount Paid By: Date: Receipt: Approved/Date Permit $2,410.55 KAS 05/26/09 108444 Plan Check $1,566.86 KAS 05/26/09 108444 State Building Code $4.50 KAS 05/26/09 108444 Potable Water Application $62.00 KAS 05/26/09 108444 Permit $72.80 KAS 05/26/09 1C8445 Plan Check $47.32 KAS 05/26/09 108445 • Jk e_)(G --D‹)S_V.Vc_r___. — CR, - D2:n- ov (-K., I(..3) tfr - c E `LLT J<> (�•ti c�D�F��`L�� ( c�o�t,� ►k� To row /fin i4AA ?LT__ ) t,,Cs F6Z.TS 1. �c, P2g._ F-ck'_ i Et )c'tAI..< • • I C r % z lir,' W66r1I 1:1; Cl x o,gr0iX ® w�;3 ° . tit M <o \ dL� b ,.. /\ m u. ,uA J e O II 1 \ D :«d ® ;1 I OOiI ® r - // (A;/ N WSLI O ,_,Irn ( I _, , y° I°AM I y W no - ��L ' p rnIN A co _,71 I.' 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D _a m f N ogc, ° Al C) (0 ( N ' O. 0 n O 0 J • 0 ___f lb i pP IN ! -A abo A I1 m 4. -----)----1 D Jm 40 J §°n'3 / L dog / 41 m r ..I A b, co 7 _ i GPM O (D0 r 3 N 0 3 � 0 ti i°› tot, IA rD 3 q 'I 3 a I 1 A) (D D PI 3'� � 0 T LO3a) rD ra ,, 1 81 f° 3 0" 'I- _ c_ m Cri D K i (Dchg lJ� N n n ��' 2mc ='.c0 0 W N - D0 ° CO - � I- � 0 Q N 0 0 °;d j'�j�l� CO y 0 . .,.L/.E it \�V 1L..9;(_J) ,N• O6 JEFFERSON COUNTY W � DEPARTMENT OF COMMUNITY DEVELOPMENT MAY 2 2t7E;9 A' 621 Sheridan Street • Port Townsend • Washington 98368 . , '~ 360/379-4450 • 360/379-4451 Fax Is NG,e, q www.co.jefferson.wa.us/commdevelopmenl: JC[CCG �j COUNTY ['`; Master Permit Application MLA: 0q-1 i Project Description(include separate sheets as necessary): New one story plus partial daylight basement home on waterfront Hood Canal property Tax Parcel 601195005 Property Number: Size: 2.50 acres (acres/square feet) Site Address and/or Directions to Property: 294 Osprey Lane, Brinnon/Pulali Point Partners Lot#5 Property Owner(s)of Record: Janice&Kent Rosema Telephone:(425)576-1305 Fax: email: jrosema@verizon.net Mailing Address: 6039 111th Place NE,Kirkland,WA 98033-7201 Applicant/Agent(if different from owner): Cindy Bienz/Architecture Integrated Residential, Inc. Telephone:425-307-3507 Fax: 425-307-6636 email: cindy@ArchitectureIntegrated.com Mailing Address: P.O. Box 848, Kikrland,WA 98083 What kind of Permit?(Check each box that applies fdBuilding ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use[C(a),C(d),or C]** J7 Single Family ❑ Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)** 0 Commercial* ❑ Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach ❑Binding Site Plan** ❑ Home Business ❑Cottagelndustry 0 Long Plat** ❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ,j Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑ Shoreline Management Substantial Development** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance ❑Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: Cindy Bienz DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). 1- *OWNER SIGNATURE Date: May 8,2009 By signing this applicati n form, e owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's 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 la -r inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap' atio 4 t'�; -.,;,'— art � Gr4 ' $p'or notice. Signature: (_ .�� `% Date:P - . CkdrA Q_b May 8,2009 The action or ac Applicant wil 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 violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if are in compl' nce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf a e es ili d erigg to and complying witht he E A. The Applicant has read this discla'�7err an signs and dates it below. Signature: v Z_ ti�.T i- ( Date: r (_N C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc • r ' a- 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 responsibility of the General Contractor for the proposed project. Signature: Date: F D GENERAL CONTRACTOR OR}�MANUFACTUREDy._ � � HOME INSTALLER: PHONE: FAX:L to be determined �,�%'_ 1 /�/a,��l d/y/�.� 1�!ed0 ( ) ( ) MAILING ADDRESS: ✓46 �7 a� "{`" EMAIL: MAY Z 6 20U9 CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAiY(E„[) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: VI New Wood Existing: 0 ❑ Sewer ❑ Addition ❑ Steel Proposed: 3.5 Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 3.5 He2eight: y1 Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: 1I Private well UI Two Party Type of Heat: Proposed: 3 30I I Public Electric Total: 3 Name of System: qel ners Community WW 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: ❑Underground Tank r]Above round Tank Size of Propane Tank: CI Heat Stove 0 Cook Stove Woodstove ❑ Fireplace Insert 0 Hot Water Tank 0 Pellet Stove 0 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 Main Floor Heated Bld App Review: 0 2,251 a, 15.OD 20a Floor Heated Consistency Review: 0 0 a 15-CID Other Heated 0 0 Base fee: a il,'D•55 7 a• 8D Mezzanine Additional Section: Heated Basement 0 1079 !+b,OC�`-.O5Plan Check fee: l 56 (F)` _ 41• a Unheated Basement 0 State Surcharge fee: Other Unheated Pot Water Review fee: /� LQD •O�D Garag Carport SUBTOTAL ' ° 751D.�ID 4,3 og.91 Iao •la Decks 0 1 7 q lq . /R P cMee: 411.00 Other I.r st%� 'PoC '.� / ' r !, TOTAL: $ C3 VJ`I q ' MO: a Receipt Number: IDg L1 q4 t Q u(AL\5 2,251 Cash/Check Number: A aq '1 3,33 ESTIMATED COST(REQUIRED) a e: 5 �� 09 3 1 lrG •Fair arket value of all labor and materials dation o finis " J �/ .�' 305 a5clr n itial (\_-_-_,) C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc N MM ^1 ^W W V' LM �Oc= Oro 0 E_�� 0 CU _� Q� H �co Z m, LM W IdNIVNCI Ln A 4) L 1 0! ►V O Ll'1 mi 0*1 O ry u LM om O ow O N kh 00 fm w QOO O V— UA H L Ln cGWMO of (UOM i vC +L Q n 0 �.+ Ln u = v+jLn N a, 0 u�-X M i ._ L Eon ry Ml uW—MO m �o0 o w j°'+''7C0 0 C U OM vO)Ln 0) �`�vt� CN > U _ �Q� >ti cu N L LMv \ 7^ +.� \ LU A Lu leJ•>> \ O N \ w \ tio�/ \ \ w Q o � IV \J YJ6' ,� �� � 6`l \ \`•. /dab\ \ u L Q Q) M qcu t N N C.— HMO CtA�om W 'ALMNM Q . 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