HomeMy WebLinkAboutBLD2010-00192 •UILDING PERMIT APPLIC BLD10-00192
N Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00192 Received Date: 6/3/2010
SITE ADDRESS: 470 SNAGSTEAD WAY
PORT TOWNSEND, 98368
OWNER: WILLIAM V GAMBLE PHONE: 360-344-4220
KATHERINE R GAMBLE
470 SNAGSTEAD WAY
PORT TOWNSEND WA 983689258
SUBDIVISION: Block: Lot: TX 49
PARCEL NUMBER: 001293017 Section: 29 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP REPLACE 2ND STORY DECK WITHIN FOOTPRINT
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 11,827.00 ADD'L: HEAT TYPE:
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: 424 BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total: -
Routing Date:
Ir
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $209.25 LYK 06/03/10 117796
Plan Check $136.01 LYK 06/03/10 117796 APPROVED
State Building Code $4.50 LYK 06/03/10 117796 IPJiU
Total: $349.76 JUN 3
Jefferson County Planninc
& Building Department
Jefferson County Building Pision Permit Willer: BLD10-00192
Applicant: GAMBLE
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
Foundation Footing
Framing
`iylU
Blocking �
FINAL INSPECTION A 3 -IC
' FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
�4J \OLD JEFFERSO OUNTY
W 1‘, DEPARTMENT OF COMMUNITY DEVELOPMENT
F' 'N 0 621 Sheridan Street• Port Townsend •Washington 98368
4• � 360/379-4450 • 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
is
Master Permit Application �h� 3L-i-- MLA: ! t il y A e.-c(--) 1 k
Project Description(include separ to sheets as neces ary): 1'J
:�mac. �e,,�lw�Mt.. '- - 5�9:.i Y t 7t u - ne' (t Y i i . t i-(lV� s
Tax Parcel Number: 6 01 �Cl 1 011 Property Size: i,:.!• ' r,
(; (acre square feet)-
Site Address and/or Directions to Propert : 5.,(i �",4.,
het. -II 0 S,n c.),ke.3 C :A-t ��i s c_..., '� 1Cwzv 1 C.L.c i s 5:I l l:,n r(t J 1
Property Owner(s)of Record: W xt-t-APri 4 KA1 L L7 AIA d`L,
Telephone: 3`I`1- y Z a
P Fax: email: Ac�;;,nljlz. � IhSn.c.o•�
Mailing Address: 141 0 S•'N�53�ej '�1Gl
W`7 ';j
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
0Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family ❑ Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home .0 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 31i.cce.,r.c�.�- 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**
❑ Slyn .. 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).
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. Staffs access and right of entry will be.assumed unless the applicant informs the County in writing at the
time of the appli tion th ta, he or she wants prior ice. -
Signature: 4-- V /`�J! - --how_II, t. .. (A /Z./ ..d I J
Date:
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 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-trartsferable'r sponsibility fofidheri�g to and co}npiying with the E A.,The Applicant has read this disclaimer and signs and dates it below.
Signature: �. ��1� ,.;t L f�t 1 111�J Date: ii,
G:\PermitCenter\###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 t esponsibiillity of the Gen r I Contractor for heproposed project.
Signature: (l Date: t//•-0
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PFIONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: 1/L%2-V % ,okt_ NUMBER
ARCHITECT/ENGINEER: ►`% % O\LA. PHONE (3 Lo) 3 SS 5 (.t y 5FAx:( ) 1
MAILING ADDRESS: -09 ,sf Ant.;7� �;
5 -k- i T EMAIL ,.r.�.}Q.C\ @ S4AI-teal..A-e l
Project Type: Frame Type: Bathrooms: 1
Shoreline: Type of Sewage Disposal:
❑ New xt Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: — Bank ❑ ommunity System
Alteration/Remodel ❑ Concrete Total: '1 _ Height: Ef Individual System3 3
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: —�j Setback: ❑ Private well ❑ Two Party
Typeof Heat: Proposed: --.�L� *;Public
Total: ) Name of System: V"D
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 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 Fctr Office Use-Only Amount _Revision
Main Floor Heated t EH Bld App Review:
2"°Floor Heated Consistency Review: ___
Other Heated Base fee: CYc i t 3
Mezzanine Additional Section:
Heated Basement kL1, Plan Check fee:
- a .
i34).c)
Unheated Basement State Surcharge fee: 1 SO
Other Unheated Pot Water Review fee:
Garage/Carport, r' SUBTOTAL ��/
:LA x <•3 SS2- `� y t .
Decks 45y y 54 I IS ne 911/Rd Approach fee:
Other TOTAL $ 5i_ICj 7(c-
srC_e\C` "' e ,sk'"t Receipt Number: I ITIgCp
&tit- C .*z.400••••, .
Cash/Check Number am,., f
ESTIMATED COST(REQUIRED) Date: /
•Fair market value of all labor and materials foundation to finish e.7 - -E v
5D J•o a Initials:
r
_
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