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Home My WebLink AboutBLD2010-00046 • BLD10-00046 BOLDING PERMIT APPLICATION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 BLD10-00046 Received Date: 2/18/2010 PERMIT #:SITE ADDRESS: 40 DUNGENESS PL PORT TOWNSEND, 98368 JOHN L GARRETT PHONE: 360-385-4332 OWNER: LELA J GARRETT 40 DUNGENESS PL PORT TOWNSEND WA 98368-9413 CAPE GEORGE COLONY DIV 7 Block: Lot SUBDIVISION: PARCEL NUMBER: 939601407 Section: 13 Township: 30 N Range: 02 CONTRACTOR: LE1 STO ESTRUCTION PHONE: 253-332-0287 20205 7 BONNEY LAKE WA 98391 Contractor's License CASTLC*994J4 Expires 12/20/2011 PHONE: EPRESENTATIVE: 2OJECT DESCRIPTION REPLACE WINDOWS IN EXIST SFR PE OF WORK NON SQUARE FOOTAGE: °E OF IMP ALT MAIN: '_UATION 4,512.00 ADD'L: HEAT TYPE: DE EDITION: 2006 HEAT BASE: HEAT TYPE: ;UPANCY: UNHEATED: #OF STORIES: ;UPANCY: OTHER: SHORELINE: 1ST TYPE: GARAGE: SETBACK: ST TYPE: DECK: BANK HEIGHT: AGE DISPOSAL: ER SYSTEM: OOMS: BATHROOMS: Exist: Prop: Total: Date: Amount Paid By: Date: Receipt: APPROVED $111.25 LYK 02/18/10 113841 'ck $72.31 LYK 02/18/10 113841 FEB 18 in 'ding Code $4.50 LYK 02/18/10 113841 Jefferson County Planninc Total: $188.06 & Building Department Jefferson County Building Divan Permit Numbs Applicant: BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes FINAL INSPECTION 1; ,�.� J� FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR coJEFFERSON COUNTY (41eisoist 1j' DEPARTMENT OF COMMUNITY DEVELOPMENT y '4 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ' gyp'$ www.co.jefferson.wa.us/commdevelopment $INCs Master Permit Application . k`.' ; , k;<<� ._. MLA: Op MA -D ' e, Description(include pr sr e C6vo y$ ,,,rv,A- i. Acl.0-d 4-M A ynecev� µ Sv Tr"T.er S a F oyes-iry • Tax Parcel Number: tk Property Size: (acres/square feet) Site Address and/or Directions to Property: 304 N c ^-"a 77- '40 Ptfiv tN.ss fI ,of T p rc-A.,r 1 4,4 f-6 j. g Property Owner(s)of Record: Telephone:_ 30-30- y31L Fax: email: Mailing Address: -M t Ito 4B/✓1 - Applicant/Agent(jf different from owner): Telephone: 3 6tP -30--' 3 3 Z Fax: email: Mailing Address: 5AM G a'S A 60" 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 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home .0 Modular - 0 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 ❑Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 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 0 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). Date: -10 �� , OWNER SIGNATURE//t By signing this application form, a 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 sh wants prior notice. �//l�� zSignature: Date: b � 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 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-transferable r ibili for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Date: f• Signature: G:\PernutCenter\###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 NUFACTURED HOME INSTALLER: PHONE: Fax: C &c - e- __.0--itS;1z. cX ha.-,_ (_zo6)p4-001‘ (206) zyd -deg MAILING ADDRESS: AIL. S jOh sa SCA/'S/j/it C c#0/^O•CQm, CONTRACTOR'S LICENSE _ AINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) . MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer 0 Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel 0 Concrete Total: Height: Li Individual System ❑ Repair ❑ MasonrySEP Permit# El Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Type of Heat: Proposed: Party Total: ❑ Public 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: i Underground Tank I Above ground Tank Size of Propane Tank: I Heat Stove i Cook Stove I Woodstove i Fireplace Insert I Hot Water Tank I Pellet Stove I 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 EH BId App Review: 2`d Floor Heated Consistency Review: Other Heated Base fee: I I Mezzanine ` I ( `25 Additional Section: Heated Basement Plan Check fee: — ` 12.3 Unheated Basement State Surcharge fee: - Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: — Other TOTAL: $ 1 $ $ -Dco Receipt Number: ( 1384 I Cash/Check Number: �,�;- ,UW ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish 4 0. " Initials: j G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc _ ___\ _ . g 40 IN t 0 II r-> • a w co b X w a u. I -/ L" O W m E m z w z O = a ks m co �, ce 0 a° ---- -----. Ni ..., a z .1\NI\ ., ( I 1 f a: O p 1 1 i L\ CO f ( c ' ' W H H <---�o W --- 0 Z ' r co co W �• ce ,f W d- 1-- • Lli cc .......5s aQ w E z I- rS u� 0 a