The URL can be used to link to this page

Home My WebLink AboutBLD2010-00003 tILDING PERMIT APPLICASN B RD10 00003 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00003 Received Date: 1/4/2010 SITE ADDRESS: 142 GOLIAH LN PORT LUDLOW, 98365 OWNER: JASON MAC DONALD PHONE: 360-437-7830 BLAIR CRITTENDEN 142 GOLIAH LN PORT LUDLOW WA 98365-9641 PORT LUDLOW NO 2 AREA 2 SUBDIVISION: Block: Lot: 103 PARCEL NUMBER: 990602103 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI UNHEATED BASEMENT TO HEATED TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 50,801.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: 704 HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: 3 Exist: 2 Prop: 0 Prop: 1 Total: 3 Total: _.3 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $650.75 LYK 01/04/10 113793 APPROVED- State Plan Check $442.49 LYK 01/04/10 113793 Building Code $4.50 LYK 01/04/10 113793 Total: $1,097.74 JAN 5 audlJ Jefferson County Planning &Building Department Jefferson County Building Lsion Permit Null: BLD10-00003 Applicant: MAC DONALD BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 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 Rough-in Plumbing z c)fo Framing `/c? (A),7-k ACirov Airseal 1 ; Insulation: Walls Wallboard Nailing I 0 Mechanical Systems Fire Alarm Init. Device FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • ON cp • (4%; L JEFFERSON COUNTY • ' � 11 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment IN Master Permit Application MLA: 111«l Project Description(include separate sheets as necessary): UASE..v €41 1ZEmo (se t_/FiNisH Tax Parcel Number: q ck O Co 0 21 0 3 Property Size: d ,3 (t square feet) Site Address and/or Directions to Property: Iy2. (z oL.tAl4 Lt'4 �oa-t 1-,u1i1414.4 (A)Pt ci 8365 Property Owner(s)of Record: JALoa ENAL:OotOick $,. - ia-. C41-r-re c Telephone: 14 - 7 83 Fax: email: shAt4t 4. MAe•ta a 4Ai+co,coin Mailing Address: 1142 U ct AN LAI Pot"' 9C136 Applicant/Agent(if different from owner): ,!`)A A Telephone: Ji4 Fax: email: 'S/4 4 Mailing Address: 5-4A What kind of Permit?(Check each box that applies 0 Lot or Road Segregation ►.�:uilding ❑Critical Areas Stewardship Plan II Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home . 0 Modular ❑ 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 0 Binding Site Plan** ❑ Propane 0 Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** 0 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 ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—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. 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 requir r inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the app' ion that or she ri e. Signature: •� Date: /2/5 /09 The action ions 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 tederal 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-trans e respo sibility fo and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: _ Date: /Z/5/40y G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • • BUILDER STATEMENT The signer of this stat does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be a ing the re onsibilit ontractor for the proposed project. Signature: -Oil> Date: I IS /09 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 Ibe Wood Existing: 2 *Sewer ❑ Addition ❑ Steel Proposed: 6.5 Bank ❑ Community System Alteration/Remodel ❑ Concrete Total: 2,5_ Height: 0 Individual System O Repair ❑ Masonry N/A SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: 3 Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: O .� Public Total: ,3 KiA Name of System: OcYAiPtc_. 0A-ree. 4 Seraee 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: 1 Heat Stove i Cook Stove l Woodstove i Fireplace Insert i Hot Water Tank 1 Pellet Stove l 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 S b$ EH Bld App Review: 10 2"tl Floor Heated Consistency Review: t._4q Other Heated Base fee: Mezzanine Additional Section: Heated Basement 13,5 - 7Oy g c Plan Check fee: l 2 iq Unheated Basement State Surcharge fee: , rn Other Unheated Pot Water Review fee: �•J. '4 ' / I Garage/Carport (030 SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: Receipt Number: 1 f (`., rJ- � Cash/Check Number: i ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish ' 1 .r7D� O d-p Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc NEMMi a. 1. f ,/' `'9y cc, <ti • / . rP`' .5 e o 1- /‘ • sls -d1 ii g 7. C' o r Z R' i ,oS r 0 c. 0, g L- --'' ('‘ 4 cn_—� 't CoTP G► ) tr'l 35 Z N \ gl O. C O rn (0al u W m o o fi v'_ �''' ,as 3> -' 6 r 7. cam- , N s d o N o 0 cZ D r in tSl I' _ U mZ 0 Z F s co i o N g z• { 10 m U w r o (,I,� s P f W -1 r 0 I Z 0 o Q i v \ ,a8