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Home My WebLink AboutBLD2010-00150 1113UILDING PERMIT APPLICASDN MLLA1Review 0 00p180 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00150 Received Date: 5/11/2010 SITE ADDRESS: 80 BURNS RD PORT HADLOCK, 98339 OWNER: DAVID W HEID PHONE: 360-437-0429 BARBARA L HEID 80 BURNS RD PORT LUDLOW WA 983659425 SUBDIVISION: Block: Lot: TX 3 PARCEL NUMBER: 921194011 Section: 19 Township: 29 N Range: 01 E CONTRACTOR: BROCKMAN BUILDERS PHONE: (360)638-1125 33165 HOFFMAN RD NE KINGSTON WA 98346 Contractor's License BROCKB1961ON Expires 9/15/2010 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP STAIRS TO THE BEACH TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 10,000.00 ADD'L: HEAT TYPE: CODE EDITION 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 . Total: 0 Routing Date: • Type Amount Paid By: Date: Receipt: Approved/Date Permit $181.25 LYK 05/11/10 117668 APPFcVEED Plan Check $117.81 LYK 05/11/10 117668 State Building Code $4.50 LYK 05/11/10 117668 JULd?t 2010 Total: $303.56 Jefferson County Planninc &Building Department Jefferson County Building Asion Permit NuSr: BLD10-00150 Applicant: HEID BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Code 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 ?21'`(b Erosion Control Post Holes _7 to Framing /l"[ (1,CM rf PA_ —12/(Cst...0 FINAL INSPECTION 10 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD10-00150 1.) See SDP10-00035 for conditions on Shoreline Approval granted June 14, 2010 2.) The applicant shall comply with the conditions of CSP10-00002 as required under JCC 18.22. 3.) 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. 4.) 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. 5.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat management plan. 6.) In addition to Jefferson County permit conditions, the project proponent shall comply with all conditions set forth by the Washington Department of Fish and Wildlife through Hydraulic Project Approval. 7.) PRIOR TO BUILDING FINAL, THE APPLICANT SHALL SUBMIT AN AS-BUILT, AS REQUIRED BY THE CASP, FOR COUNTY REVIEW AND APPROVAL. A BUILDING FINAL SHALL NOT BE ISSUED UNTIL JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT HAS APPROVED THE AS-BUILT. • • O'kr--- 134y P.P.0Pc,.a6 8sEer o4�,w TOG oG A7ar FrisruCv ?a P o P QA� 0A-.864 Qv 61.0;e05 2.0 (a--c ci S3 6S PAitrEa gzas' ot> STPtc fS -To (Li Dew t=i Srg, r r / APPROVED PLAN 1 � JUL 6 2010 r 4. ' 'UNTY _ SIGNair.i7' Le/ 743 1 Page I off _ I Q vG n 2 4 c010 fox c w o� JEFFERSON COUNTY ' \ a DEPARTMENT OF COMMUNITY DEVELOPMENT '' 'N o: 621 Sheridan Street• Port Townsend • Washington 98368 `�� 360/379-4450 • 360/379-4451 Fax .4'4BINS www.co.jefferson.wa.us/commdevelopment 4111 MAY 1 1 2-31 Master Permit Application MLA: IG 1 M Project Description(include separate sheets as necessary): 6C'u, f Str4IR< Tax Parcel Number: 9111 95( p/l Property Size: 12,4 -'' - (acres/square feet) Site Address and/or Directions to Property: fc• r.f,>LI i`Z L R Dj. ' i. ,) f b wJ L A . 9 ' t Property Owner(s)of Record: >:1 u,.6 /-f tz_iD Telephone: y,i 7- 1 t1.2 `/' Fax: email: 4 A e%d 6 cf-dkr)sta.C Mailing Address: SA.yc 4s- -a6.v-.,e., 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 ❑Conditional Use[C(a),C(d),or CI** ❑ Manufactured Home .❑ Modular . - ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** ❑ Propane ❑Long Plat** ❑Sign . CIPlanned Rural Residential Development(PRRD)/Amendments** ' ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions""' ❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑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,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 required later inspections St s access and right of entry will be assumed unless the applicant informs the County in writing at the time of the app' f that or s w is p r notice. / 1 Signature: Date: //AO ' The action or actions Applicant will undertake s 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 he Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trans ,mot J respo s bility f rin t and complying with the ESA. The Applicant has read this disclaimer an signs and dates it below. Signature: ram+' Date: t d(//G) 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 Contractor for the proposed project. Signature: Date: A,,,,.. L CONTRACTOR O NUFACTUR/ED HOME INSTALLER: PHONE: FAX: 7 H ( ) • 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 ❑ Wood Existing: ❑ Sewer O Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel o Concrete Total: Height: 0 Individual System ❑ Repair ❑ Masonry SEP Permit# O Demolition ❑ Other. Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ 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 ornipants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have F.00d'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 1 Cook Stove ► Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 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. „ r>,jrtj Square Footage Current Proposed , r ce tr F r; _. -i � ,.,., ...,: w ,,t.,1. -v�' -S.._n=�;"�1s�-°l . Main Floor Heated -'�� EH Bid App Review. 2"1 Floor Heated Consistency Review: i dr Base fee: I Other Heated ? I g Ij Mezzanine Y '`'' Additional Section: - ' Plan Check fee: Heated Basement Unheated Basement • State Surcharge fee: l j(C) ._ Pot Water Review fee: Other Unheated Garage/Carport M SUBTOTAL JIw . Decks ; 911/Rd Approach fee: j-- . sx Other . . TOTAL: $ -)1(v Receipt Number: ` ) 10 3 ,'' .;, ` Cash/Check Number: f) ESTIMATED COST(REQUIRED) Date: _y 1 •Fair m rket value of all labor and materials foundation to finish �-•1'M-'+0--_----; Initials: �..:`--