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Home My WebLink AboutBLD2010-00266 oB BLD10-00266UILDING PERMIT APPLIC ON Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00266 Received Date: 7/28/2010 SITE ADDRESS: 60 HUCKLEBERRY PL PORT TOWNSEND, 98368 OWNER: JOHN D ROSS PHONE: 360-821-1802 BETH A ROSS 340 SUNSET BLVD JTWROS PORT TOWNSEND WA 98368-9443 CAPE GEORGE VILLAGE DIV 6 SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 941400001 Section: 13 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP ENCLOSE EXISTING 1ST FLOOR COVERED PORCH TO HTD OFFICE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 68 VALUATION 6,729.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 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: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 _Total:—2 Routing Date: / Type Amount Paid By: Date: Receipt: Approved/Date Permit $139.25 LYK 07/28/10 119852 APPROVED Plan Check $90.51 LYK 07/28/10 119852 State Building Code $4.50 LYK 07/28/10 119852 Total: $234.26 AUG 201U Jefferson County Planninc & Building Department 1110 Jefferson County Building Division Permit Nu•: BLD10-00266 Applicant: ROSS BUILDING PERMIT INSPECTION APPROVALS Npplicable Code: 2009 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 Foundation Footing mono slab Framing Airseal Insulation:Walls '-7 (6 Insulation: Floors Insulation: Ceiling FINAL INSPECTION (O CZb I/PIU FINAL INSPECTION MUST APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 1004-- Z°N JEFFERSOPOUNTYS � j DEPARTMENT OF COMMUNITY DEVELOPMENT f 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax �' � www.co.jefferson.wa.us/commdevelopment �`S�Y7Np� Master Permit Application MLA: \ ( Project Description(include separate sheets as necessary): I --sc� ✓QJ orch 14r Tax Parcel Number: { ` Property Size: (acres/square feet) Site Address and/or Directions to Property: (/O f/&jck/c /c — Stree f bet e c - �� C e o r 5 er o (49(rt c7 d- I/l /fit ; f Property Owner(s)of Re6ord: Jo S /2(9 t/ I177e1 Zo5 Telephone: ) 2fZ-! 15 (Dos'ytsc4-!/ .ear CD $ 1 I 6ir 1301,IS ce//) email: 190414n^ foss@ trAlt oo•«�'-� Mailing Address: .;,,I r Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation )0Building iX(cam Apt,'t, 11r-13 r ❑Critical Areas Stewardship Plan / ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family ❑ Garage Attached/Detached ❑Conditional Use[C(a), C(d),or C]** O Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑ Road Approach_ 0 Short Plat** ❑ Home Business ❑ Cottage Industry 0 Binding Site Plan** ❑ Propane 0 Long Plat** ❑ Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration*" ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑ Shoreline Management Variance ❑Wireless Telecommunication* ❑ 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 ,(1‘----• r4(�(Dow., ef_ss (� )) Date: 1 /2$ 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 accesand right elf entry will be assumed unless the applicant informs the County in writing at the time of the applicatio t he or she wants pri r notic4i'� �Signature: � �— P�v5 �Zos S� \ vI' ) A1h /2-'9 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 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 a,in compliance with the,IJeffersoyflCounty development code.The Applicant acknowledges that he,she or it holds individual and non-transfera sponsibility)for adheriy0,t nd C mplyi with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: �% J�%� j i.,_ (dd'4 /Z�) Date: 7/i G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • • BUILDER STATEMENT The signer of this staXement does hereby rtify tha they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be ass g the responsibility o h len I Contractor for the roposed project. L Signature: I v01+cos ) r (6d $S)Date: 7/19//O 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: Shor line: Type of Sewage Disposal: El New XX1 Wood Existing: /V ❑ Sewer , 'Addition ❑ Steel Proposed: Bak ❑ Community System 0 Alteration/Remodel ❑ Concrete Total: _ Height: Di' Individual System ❑ Repair ❑ Masonry SEP Permit# El 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 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 / N9' 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 ForOffiice Use Only Amount _, Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: /(0r/w Other Hea ed Base fee: Mezzanine Additional Section: Heated Basement _ Plan Check fee: Unheated Basement _ State Surcharge fee: Other Unheated Pot Water Review fee: __ - I\i .i 1"I Garage/Carport _ SUBTOTAL Decks 911/Rd Approach fee: - Other TOTAL $— Receipt Number: ( el is--, Cash/Check Number: ESTIMATED COST(REQUIRED) , Date: 7 /L f /o *Fair market value of aH labor and materials foundation to finish l 41) q 6—0 rt Initials: / G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc 0 r- ZN p o a t w o z o Z. "2 1 t �. 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