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HomeMy WebLinkAboutBLD2009-00244 •UILDING PERMIT APPLICAAN BLD09-002244 view Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00244 Received Date: 7/29/2009 SITE ADDRESS: 2828 HASTINGS AVE W PORT TOWNSEND, 98368 OWNER: BRYAN HAYES PHONE: 360-379-8755 2828 HASTINGS AVE W PORT TOWNSEND WA 98368-9640 HASTINGS MILL SHORT PLAT SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 001053033 Section: 5 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REMODEL -ADD INTERIOR FLOOR TO EXIST 2ND STORY, 2ND STORY DECK & STAIRS & NEW SHED ROOF TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 45,181.00 ADD'L: 280 HEAT TYPE: CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 620 BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 1 Exist: 2 Prop: 0 Prop:_ 0 Total: 1Total: 2 J Routing Date: 9-oq` Type Amount Paid By: Date: Receipt: Approved/Date Permit $603.35 LYK 07/29/09 108850 APPROVED Plan Check $392.18 LYK 07/29/09 108850 State Building Code $4.50 LYK 07/29/09 108850 AUG 5 2009 Total: $1,000.03 Jefferson County Planning &Building Department Jefferson County Building •ision Permit Nu er: BLD09-00244 Applicant: HAYES BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Erosion Control Foundation Footing /(,'Act.try fI` Footing Drains Foundation Stem Wall Underground Plumbing Under Floor Framing Straps(hold downs) Ext. Shear Wall Nailing Rough-in Plumbing Framing Blocking Airseal Insulation: Walls Insulation: Floors Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage Address Posted FINAL INSPECTION . )'1_f(. 70 ) FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR � •g©N:).co JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax p"� www.co.jefferson.wa.us/commdevelopment �`Y$ING�' Master Permit Application MLA: 1O t--(L& Qe(311 Pr ect Description(include separate sheets as necessary): oc -Mei 1V1i1.GY S ioor tD Elctsr Of C Ck f-S" ►(S't- Tax Parcel Number: (-CC/ (;, / C T_ �j FJ,j � Property Size: 2 , `/� � (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: Telephone:'-3 t tT)3`j? 60 f S3 Fax: email: Mailing Address: 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 ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family ❑ Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** O Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address ❑ Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑ Binding Site Plan** ❑ Propane ❑ Long Plat** 0 Sign - • 0 Planned kurai Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** O Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** 0 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 ❑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,stale 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. 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 application that he or she wants prior notice. Signature: Date: 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 specie:,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 viol to 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 compli ce with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer ble responsibil't for adheringJ to and complying with the ESA. The Applicant has read this discla. er and s'gns and dates it below. Signature: Date: C G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 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: 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 0 Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank I I Community System ❑ Alteration/Remodel 0 Concrete Total: _ Height: U Individual System ❑ Repair ❑ Masonry SEP Permit# Water Supply: ❑ Demolition ❑ Other: Bedrooms: Pp Y: Existing: Setback: 0 Private well U Two Party Type of Heat: Proposed: [l Public Total: 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: Underground Tank i Above ground Tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace Insert Hot Water Tank Pellet Stove 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 EH Bld App Review: 2nd Floor Heated - 23Sr4(o C• onsistency Review: Other Heated B• ase fee: I 403 •55 Mezzanine Additional Section: Heated Basement Plan Check fee: Sq.& 18 Unheated Basement State Surcharge fee: `"'II Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 504 i o00.03 Decks 911/Rd Approach fee: Other - �1�L0� (pG'31(6L) TOTAL: -$ `c .03 Receipt Number: 10g41 45 , ' Cash/Check Number: 3COCi ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc . , iv) .-) 0 Tiv) an 0 f--- • -1. .'.I .. ---- --„,...R *-N. & I • • 1 '1 • , T.2* , 41 .f -..z...,,.) , N.., I._ 1 7,.-I r•5 c‘o cN1.4 c\............ 0 1 • = I -,1 . .......,0 ‘,14.... , L. I . I ,. L. . . J 1 ; 7 , l' 1 i 1...... / L et 1 , 1 1 ; 1\1 i i ..... 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