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Home My WebLink AboutBLD2009-00276 MLA09-00270 EIOLDING PERMIT APPLICATI. Review Type:V\VO Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00276 Received Date: 8/18/2009 SITE ADDRESS: 1253 GRIFFITHS POINT RD NORDLAND, 98358 OWNER: ANDREA ROSE TRUSTEE PHONE: 619-417-881 1 4346 HILL STREET SAN DIEGO CA 92107 SUBDIVISION: Block: Lot: TX 52 PARCEL NUMBER: 021321028 Section: 32 Township: 30 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: HENRY M SOUZA PHONE: (360) 379-8338 DESIGNS BY SOUZA INC (360) 379-9136 164 SWANSON PROJECT DESCRIPTIOP PERMIT FOR UNPERMITTED HTD OFFICE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 315 VALUATION 29,750.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: 40 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop�1 Total: 0 ;' Total: 1—�� Routing D te: Type Amount Paid By: Date: Receipt: Approved/Date Permit $441.75 LYK 08/18/09 110749 Plan Check $287.14 LYK 08/18/09 110749 State Building Code $4.50 LYK 08/18/09 110749 APPROVE-) Permit $71.00 LYK 03/29/10 117473 Plan Check $71.00 LYK 03/29/10 117473 JUL 1 2010 Potable Water Application $98.00 LYK 03/29/10 117473 Jefferson County Planning • &Building Depe,filienr • • CONDITIONS for Building Permit# :BLD09-00276 1.) This structure is approved ONLY as an office based on the capacity of the onsite sewage sytem. It is not approved as an ADU or satelite bedroom. The built-in bed and all kitchen facilities shall be removed prior to final approval. Verification shall be by inspection of the Building or Health department. 2.) All water lines shall be 10' from all septic system components unless prior approval is obtained from the Health Department. 3.) See BLD09-00542 for conditions that apply to this property and may apply to this case. 4.) 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. 5.) 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. 6.) See SDP09-00063 for Shoreline Exemption conditions. Jefferson County Building Gifsion Permit NA, BLD09-00276 Applicant: ROSE TRUSTEE BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:03 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 Setbacks Setbacks Erosion Control Foundation Footing Foundation Footing Footing Drains Footing Drains — Foundation Stem Wall C'MU Foundation Stem Wall — Under Floor Framing Under Floor Framing — Rough-in Plumbing Framing Airseal Insulation: Walls Insulation: Floors Insulation: Ceiling Wallboard Nailing Miscellaneous Miscellaneous Anchor Bolts • FINAL INSPECTION ;'. - ver FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING 0 CUPIED THIS PERMIT IS VALID FOR ONE YEAR • 4 „ oN co6, JEFFERSGCOUNTY '`,. 3 DEPARTMENT OF COMMUNITY DEVELOPMENT '' • ` ''l 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 F jj 0 1 1prftet 2009 -limo�p www.co.efferson.wa.us/commd Master Permit Application MLA: ine-a-10 Project Descripon(include separate sheets a necessary): earetei l'-(e 0 p-e-r int.A- sc--- n Sheci. -on h-t-ct, io nate) Tax Number: rcel D2 _ l 3 2 ` 0 2 Property Size: (acres/square feet) Site Address and/or Directions to Property: 12--6 6--er KLA-\141.5 CO 1/4 00L.A. I•L ordt. cuAA , _,„\,(IL ci.S3 6-5 Property Owner(s)of Record: C J\AX-��.,� r 6 -" Telephone: (OYYl -� tz-W- j ssFS Fax: email: Mailing Address: 14 S (U l-Ir i(l '", , 50.AA. --):6A6 , C'_..A 61 7_t 01 - 1-k( l'j Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑Conditional Use[C(a),C(d), or C]** ❑Single Family ❑Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address 0 Road Approach 0 Binding Site Plan** ❑ Home Business ❑Cottagelndustry 0 Long Plat** El Propane 0 Planned Rural Residential Development(PRRD)/Amendments'""` ❑Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑Shoreline Management Substantial Development*" gLSite 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 0 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: ✓'. _ DESIGNATION OF AGENT I hereby designate • ti,` ! `'t- L to act as my agent in matters relating to th's application for permit(s). OWNER SIGNATURE - AZ,; '. Date: /ti Q j 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 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 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 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 applicatioon,that he or she wants pry r Signature: 1. '—[,/ f-�, v i ( '',.� Date: ' /(C( U 9 The action or actions Applicant will und ertake dertake 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 you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfera4[e respon 'bility for,eKiher• to and complying with the ESA. The Applicant has read this disclai er a d signs and dates it below. / / Signature: r, t'G v Date: I 1C 1 C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.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 CogtiQor tprte iv sed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: k 0( C �A, 542� (10q) z2O- S5 I\ ( ) 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: 0-New 1.. Wood Existing: -6,- ❑ Sewer ❑ Addition ❑ Steel Proposed: '-�" Bank ❑ Community System C Alteration/Remodel ❑ Concrete Total: ' Height:/ A-Individual System ❑ Repair El Masonry �t ) SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: -E- Setback: ❑ Private well ❑ Two Party Typ o Meat: Proposed: -� �J�t ❑ Public r� fNO � Total: 0-- Name of System: ►) Pt " etB If this is a Commercial Proiect 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 °Above ground Tank Size of Propane Tank: 0 Heat Stove 0 Cook Stove Cl 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 Revision Main Floor Heated �� I�� C7 � EH Bld App Review: wrc 2na Floor Heated --) -f�c,�t.i(,' Consistency Review: IcJt��72- p Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: 4 �� Other Unheated Pot Water Review fee: 00amb lac- Garage/Carport SUBTOTAL Decks 4IO�� -7 20 911/Rd Approach fee: ,S71 Other TOTAL: $-755, 4 Receipt Number: I is 7 49 (1-4/2 0 i i-v-iv WCash/Check Number: 2- t LltC1 I?j 1 ESTIMATED COSTBEQUIRED) Date: �,I�� _ f/ •Fair m u all abor a materials foundation to finish Initials: , �' C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc • ---------..."- ------.. \ Tr\ . ' I ."' •. -. _,,, ... 0 X M CO CP \ , _____.rt _.,_,..v , � 4 - T 5 Rt. P a -I . Z. .-..--- 0 rag ,o 0) 3 rn < m j `� x�' A , . ,..t . = _, , , to 1 0 6 — (t. 1 I 7b .. 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