HomeMy WebLinkAboutBLD2009-00183 MLA09-00203
UILDING PERMIT APPLICAN Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00183 Received Date: 6/22/2009
SITE ADDRESS: 2064 BLACK POINT RD
BRINNON, 98320
OWNER: QUATSAP POINT LLC PHONE: (253) 906-5806
C/O LORI UDDENBERG
PO BOX 99988
LAKEWOOD WA 98496-0988
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 502232000 Section: 23 Township: 25 N Range: 02 W
CONTRACTOR: MARINE FLOATS PHONE: (253) 383-2740
1208 EAST D STREET
TACOMA WA 98401
Contractor's License MARINF*085QP Expires 3/11/2011
REPRESENTATIVE: MARINE FLOATS PHONE: (253) 383-2740
1208 EAST D STREET (253) 383-1102
TACOMA WA 98421
PROJECT DESCRIPTIOr REPLACE (4) CREOSOTE PILINGS W/(4) CHEMONITE PILINGS
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 18,400,00 ADD'L: HEAT TYPE:
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
CoIaaloaC1;)
Type Amount Paid By: Date: Receipt: Ap lr t
Permit $307.25 KAS 06/22/09 108656
Plan Check $199.71 KAS 06/22/09 108656 AUG ��,� z
State Building Code $4.50 KAS 06/22/09 108656 Jefferson Caunt
Total: $511.46 & Building Department 9
Jefferson County Building Desion Permit Null:
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
SQ � (C34LJ ( c } 4kc9
FINAL INSPECTION 1,
1
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD09-00183
1.) Flood hazard reduction measures are to be used as required by the Jefferson County
Flood Damage Prevention Ordinance 07-0515-06 (Jefferson County Code Chapter
15.15).
2.) Construction Materials and Methods of Construction to Reduce Flood Hazard:
(i)All new construction and substantial improvements shall be constructed with materials
and utility equipment resistant to flood damage; and
(ii)All new construction and substantial improvements shall be constructed using methods
and practices that minimize flood damage.
3.) 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.
4.) Prior to commencing development activity, proponent is responsible for informing the
Washington Department of Fish and Wildlife (WDFW) in order for WDFW to determine
whether this action is subject to the Washington State Hydraulic Code (Chapter 220-10
WAC). Hydraulic Project Approval (HPA) is required for all hydraulic projects, which are
defined as construction or performance of other work that will use, divert, obstruct, or
change the natural flow or bed of any of the salt or fresh waters of the state.
5.) In addition to Jefferson County permit conditions, the project proponent shall comply with
all conditions set forth by the Washington Department of Fish and Wildlife through
Hydraulic Project Approval.
6.) Prior to commencing development activity, the proponent is responsible for informing the
US Army Corps of Engineers (COE) in order for COE to determine whether a Department
of the Army permit or review is required. Generally, review is required for construction
and dredging in or around navigable waters of the US and for work or fill in hydrologically
connected wetlands. Contact the US Army Corps of Engineers, Seattle District
Regulatory Branch, PO Box 3755, Seattle WA 98124, (206) 764-3495, for more
information.
7.) Work within the jurisdiction of the Shoreline Master Program other than as described
above shall receive separate review from this Department.
8.) No fill or other material may be placed in the waters or intertidal areas of Jefferson
County.
9.) The design, location, and construction of the pilings as well as their subsequent use, shall
avoid adverse effects on fish, shellfish, wildlife, marine vegetation, water quality, and
geohydraulic processes. Construction methods shall minimize the use of materials
hazardous to the environment.
10.) The development shall be essentially the same as the original in location, size,
configuration, and external appearance.
11.) The applicant and/or representative shall contact the Development Review Division of the
Permit Center (360-379-4450) regarding a final inspection for compliance of zoning permit
conditions prior to scheduling a final building inspection.
• •CEIIVED
ogON c,
�gi ! pt. JEFFERSON COUNTY
r' DEPARTMENT OF COMMUNITY DEVELOPMENT JU,JN 2 2 2009
° 621 Sheridan Street• Port Townsend •Washington 98368
$ 360/379-4450 • 360/379-4451 Fax
4,�S p, p www.co.jefferson.wa.us/commdevelopment JEFFERSON CQUNTY BCD
Master Permit Application MLA: 0a -aC3
Project Description(include separate sheets as necessary):/ l )
14f !ewe '4) crto50-it r i 1 I0 3 �r pat, Ly)�.lutupo i /? Pi)1,1
Tax Parcel Number: 5-43 a 3,2 p p 0 Property Size: (acres/square feet)
Site Address and/or Directions to Property:
90Itil MO< A in*7d. i grrlMtw) I,,) 98a? 0
Property Owner(s)of Record: r 0 — S• rD l A 7 LLC, )ro
Telephone: 3' 1) — _ Fax: email: '±�' L ,_J�:'
Mailing Address: 1.) • ,
Applicant/Agent(if different from owner): 6 r pia i Oil
Telephone:253-5S 3 //() Fax:-353-3g.3-I& L email:/D r ��n4avv/ba/Uads.i_p/'f1
Mailing Address: Jab)?' FE S+ 17 $;' . fa CDni 2. 1)4 9 g-y,i)
What kind of Permit?(Check each box that applies
XJBuilding ❑Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use)
0 Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 p,- ��hg 0 Special Use(Essential Public Facilities)**
❑ Change of Use 5°1 ❑Boundary Line Adjustment
❑ Address ❑Road Approach 0 Short Plat"*
0 Home Business ❑Cottage Industry 0 Binding Site Plan**
❑Propane ❑Long Plat**
❑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)* ❑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 ❑Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
/*Al C)(Q51).r bn3;racer W T nio NPd-
f DESIGNATION OF AGENT
A4,,
I hereby designate PIJJP F/o0445 O I'P. to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE c/geA J�/ C/a 2-C 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 attomey'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 an requ' d later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap li n that h r she wa prior notice. �`
Signature: tr. C E /�Date: 7?kw L' /
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 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 yo are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trans r e respo lbility for a ering to and complying with the ESA. The Applicant has read this disclaimer and sign/i nd dates it below.
Signature: Q-( Date: / /7/.1/ls'
G:\PemmitCcnter\###FORMS###\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 responsibility of the General Contractor for the proposed project.
Date:
Signature:
PHONE: Fes'
GENERAL CONTRACTOR
�ORMAN FACTUREDHO E INSTALLER: �� �g�_�7i1v FAX: _'/`(J
M U r t►'1 ri vat s Corey 1 M�t i J✓'-1� ' ,/ EMAIL: )v 7 /S, ( rvi
MAILING ADDRESS: /r2 jl 8 50- )4ii•/ /Ol'f)int ju 4 q 7t'�L'2) r ti r,JU I D D
CONTRACTOR'S LICENSE WAINS NUMBER N J A
NUMBER: Mm ,_rg F,�E CQ P PHONE ( ) FAX: )
ARCHITECT/ENGINEER: A)1 EMAIL
MAILING ADDRESS: Shoreline: Type of Sewage Disposal:
Project Type: Frame Type: Bathrooms: Li Sewer
❑ New O Wood Existing:
❑ Steel Proposed: Bank ❑ Community System
Li Addition Total: Height: ❑ Individual System
❑ Alteration/Remodel ❑ Concrete SEP Permit#
0 Repairmo ❑ Masonryther: Bedrooms: Water Supply:
❑ Demolition ❑ Other: Existing: Setback: ❑ Private well ❑ Two Party
—
Proposed: ❑ Public
Type of Heat: Total: Name of System:
If this is a Commercial Protect you must answer the following: ADA Parking Spaces:
Number of Parking Spaces: Current: Proposed: Number of �
Proposed ��
Number of occupants(includes owners,tenants,employees,etc) Current Will you have Food osrvice? Yes / No
IBC Occupancy: IBC Type of construction: —
If this is a Propane Tank andlor Appliance Installation permit,mark all items below that apply:
1 Underground Tank 1 Above ground Tank Size of Propane Tank:
1 Heat Stove 1 Cook Stove i Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 Other
Is this appliance being installed in a Manufactured I Mobile Home? Yes I No
When applying for a permit to install a propane tank you must also submit a ite�pl n sdinwi and septic system all of the wildig,all propertylines,tank location and size,distances from the propane tank to all property
onents,
including the reserve area. f` _��+{ tir I rcr j�,
��,� �� n ? a.:xsiQn ,. 3
n"l :�w
Square Footage Current Proposed '��' EH Bld App Review:
Main Floor Heated IRIF;f ,Eq k\ e�
2°Floor Heated i f lqi £ Consistency Review: 3• v
yet 14 V
Other Heated c) cZ ' Base fee: �\'1 a5
Jury 30 I
Mezzanine g-i r°
Additional Section:
41 °; -� Plan Check fee:
Heated Basement ..) i-R � „ �„�: l q q i
Unheated Basement f ' State Surcharge fee: `'t C, /
Lo
Other Unheated r;i� Pot Water Review fee: ----_,
Garage/Carport
a H SUBTOTAL 1(X14 4(
Decks e , �„ 911/Rd Approach fee:141
r__
'� b" r "f •` TOTAL: $ '�J �p
Other { � 5, t, i
;�'" ; , :, Receipt Number:
4 �1 CashlCheck Number: Stk( Q
ESTIMATED CO 4REQUIFtED) Date: 1 P I a�" f
j
.F ' arket all-limbo L
end materials foundation to finish Initials:
c______>,,P) 0.,i)
G:\PermitCcnter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
Y
A
Q
0
U � � z C3
!f W H O W Q
J (3oZCO A a zli
• F-- La 0 CO O •
z f
y a z d
ZfaC., , . CO 3 N s
d = U 3 p a, Z O o , o
/� ^, � PI �t yy8 E>„' a f cI
LL_ ce J Z I'. r.1 V LlJ
Q 0ala �/ Off. �4 l7Z ::..] N
00
O �� \ 'cC 0 n- N• C'JUNW U
W
p w LaI- '.f ¢
Y C.) * Q1
ULa
Z .-. ^
LL
I • G aoZ
y
_9 cq -- ,
I__ LaU a_ E� o i Cy i.
,a A ce > ,r. J , > ! L_7 ....
1 O a .-
dN� Q' W N • o Q
1\ O Z �' CO14)
o p T_
I- (L.I Q.. 1-. . I! m J
CY d CO Q� .•', er Q'W co
NZ Y Q titi� vti
WU N p �n
y r a ,-<
J Z
W O = N
1�y � oZ \\
6' Jcum ,11
S Q I
ii
11
OF.
�
1: �001
_.
i li
lirg ;-40.21g
ilP 1
4o
1
1 Qi1
ss
1
\NN
N\ e
f ,.
--..
1 4
li
N
rd
a
W
W f
•
U
9 V.f
i
-,,.. :2' ,,':::.: /
\N----.. 0.
ro
u�
,
QW
Q
u
1
22
g
2 R.
exx,g
J2e,
W
ug