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Home My WebLink AboutBLD2010-00098 BODING PERMIT APPLICATIc BL 098 Revv iewiew T Tyype: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00098 Received Date: 4/1/2010 SITE ADDRESS: 472 MONTGOMERY LN PORT LUDLOW, 98365 OWNER: MADELYN CURLL PHONE: 360-437-1328 472 MONTGOMERY LN PORT LUDLOW WA 98365-9648 PORT LUDLOW NO 1 AREA 2 SUBDIVISION: Block: Lot: PARCEL NUMBER: 990400202 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: JOE GUTHRIE CONSTRUCTION PHONE: 360-301-6199 PO BOX 744 PORT HADLOCK WA 98339 Contractor's License JOEGUGC963RO Expires 12/20/2010 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION REPAIR EXISTING DECK & STAIRS TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP DEK MAIN: VALUATION 4,742.00 ADD'L: HEAT TYPE: CODE EDITION: 2006 OCCUPANCY: HEAT BASE: HEAT TYPE: 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: �(— icy Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $111.25 LYK 04/01/10 113871 APPROVED Plan Check $72.31 LYK 04/01/10 113871 State Building Code $4.50 LYK 04/01/10 113871 APR 5 2010 Total: $188.06 Jefferson County Planning & Building Department Jefferson County Building Divii Permit Numbe•LD10-00098 Applicant: CURLL BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Post Holes Foundation Footing Framing FINAL INSPECTION • - FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR (4;9°N-cG JEFFERSON C • IOkh61 DEPARTMENT OF C MUNrrY DEVELOPMENT 21 Sheridan Street• Port Townsend•Washington 98368 ` �$ 360/379-4450 • 3wa.us/ om Fax www.co.jefferson.wa.us/commdevelopment us/commdevelopment Or Master Permit Application MLA: No in`L Pc Project Description(include separate sheets as necessary): 101— 9--, AQept °n Poet- j-udiaNJ,„iE I 2ef',4i 2 Decic + ST `2 Tax Parcel Number: (I g() - Lion , 0 Property Size: ,396 (acres/square feet) Site Address and/or Directions to Property: Li l a Al o h) 6 tyke2 LAI)f' A2� Iud C Oed Property Owner(s)of Record:��A'ne c C.1 t c..Cc C.1 t2(.L_ Telephone;>t 0 417 / 5 2/ Fax ernal: Mailing Address: `F�� fCt o i O tvt P P 4 L/!�' Pea* Lu�Q L ext.) Applicant/Agent(if different from Telephone: i 0 4 3'7 13 2L Fax email: Mailing Address: D ,r ri What kind of Permit?(Check each box that applies I Building ❑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 Cl** ❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use iZ� L P}c e r�e't'� OF !� P mot=r 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 Mowed'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 Are-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 for permit(s). OWNER SIGNATURE'k�� Date: ! 20/0 By signing this application form,the owne gent 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 applica" n that or.str¢,wants prior not :' / Signature: � _ Lt \: Date: L C The action or actions Applicant will undertke 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 Ad"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 responsibility for ad to and complying with the ESA. The Applicant has read this dis7f/ " er a signs and dates it below. Signature` Date: 32 n/C G\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-084oc • BUILDER STATEMENT 411 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 eral Contractor for the proposed p Signature: / Y \ . ( 2 f Date: 3 1/''o r° GENERAL CONTRACTOR OR MANIHFACTUREO HOME INSTALLER: PHONE: FAX: 53 G cf-f-A f2- e. C'p iu_S-1(1_061-�0_0 `� c 0) fo r 6 r s, ( ) MAILINGC�5LICENSE SS: P t� 60K 7% Lf pool- tiptf L.r cti 1:(),4 9 93J`, WARS NUMBER: 0 lG UG G r o 3 2•D NUMBER ARCHITECT/ENGINEER: llr PHONE ( ) FAX:( ) MAILING ADDRESS: ' EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Ty pe of Sewage Disposal: J New Wood Existing: ❑ Sewer ❑ Addition ;1 Steel Proposed: Bank Q Community System ❑ Alteration/Remodel a Concrete Total: Height 0 Individual System ;.' Repair • ,c C Masonry SEP Permit# ❑ Demolition C Other. Bedrooms: Water Supply: Existing: Setback: ;I Private well D Two Party Type of Heat: Proposed: LI Public Total: Name of System: If this is a Commercial Protect 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, r>, z; `, Amount 4 ._.. 1f '` `'°' Main Floor Heated EH BId App Review: 2na Floor Heated Consistency Review: Other Heated - �, Base fee: � � - 5 Mezzanine Additional Section: Heated Basement Plan Check fee: I ^ 3 Unheated Basement State Surcharge fee: a) Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 88 .06 Decks f. ! , 911/Rd Approach fee: c Other TOTAL: $ 1 i SE d,� �_ Receipt Number: /1 2 g- \ ICash/Check Number: 9 400 ESTIMATED COST(REQUIRED) Date: Ig .Fair market value of all labor and materials foundation to finish I1 7l. j‘, Initials: • G:\PemtitCentcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc