HomeMy WebLinkAboutBLD2010-00415 QUILDING PERMIT APPLICAN MLA10-00418
Jefferson County Department of Community Development
ReviewType:l
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00415
SITE ADDRESS: 1117 BLACKPOINT RD Received Date: 12/22/2010
BRINNON, 98320
OWNER: BENJAMIN G PORTER
CHESLEE E PORTER PHONE: 206 624 8890
6238 51ST AVE NE
SEATTLE WA 98115-7710
SUBDIVISION:
Block: Lot: TX 7+
PARCEL NUMBER: 502143006
Section: 14 Township: 25 N Range: 02 W
CONTRACTOR:
PHONE
PHONE:
REPRESENTATIVE: RONALD HOLSMAN
10141 CITATION CT PHONE: 206 842 0693
BAINBRIDGE ISLAND WA 98110
PROJECT DESCRIPTIOP CONSTRUCT NEW SOFT BULKHEAD
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW
VALUATION 40,000.00 MAIN:
CODE EDITION: 2009 ADD'L: HEAT TYPE:
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: 212
CONST TYPE: GARAGE: SHORELINE:
DECK: SETBACK:
SEWAGE DISPOSAL: BANK HEIGHT:
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 $542.75 LYK 12/22/10 120357
Plan Check $352.79 LYK 12/22/10 120357 APPROVE,State Building Code $4.50 LYK 12/22/10 120357
Total: $900.04
JUN A 'all
Jefferson County Planning
& Building Degartmere
Jefferson County Build!ng Div on Permit Num
Applicant:
BUILDING PERMIT INSPECTION APPROVALS applicable 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
d 4 ye _ I/L ei—
c . d alj 61h / s'
FINAL INSPECTION 1 44 C, e'/"� � Tar, /41 ,e.tr
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD10-00415
1.) 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.
2.) 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.
12/09/2010 09:21 36037940 DCD JEFF CO • PAGE 02/03
431A11.OIv �
JEFFERSON COUNTY
'\ ,Wfai DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Shendan Street•Port Townsend•Washington 98308
4 -egg:- , 360/379-4450• 360/379_4451 Fax
ISZtilVa° www.ca.Jefferson.wa.us/commdevelopment
Master Permit Application .
Project Description(Includeas MLA: `
Construct Soft Bulkhead Armoring along Owners waterfront at base of bluff.
Tax Parcel Number 502143006 ��
Site Address and/or Diractlons to Property Size: 50,933 SF (acres/seuare feet)
Property:
1117 Black Point Rd,, Brtnnon,Wa 98320, 3 mi.$of Bnnnon,Exit HY 101 S onto
Property Owner(e)of Record; lien"amin otter.Cheslee E. Porter
Telephone: 206 624 8890 Fax: 206 587 0579
Mailing Address: 6238 51 st St Seattle Wa. 98115
atrial):_bporter(ciprterkohli.com
AppltcalitAgent(indifferent from owner): Ronald H Hoisman
Telephone: 206 200 5688 Fox: 206 233 3920
dress: 280 Rhoden oddron l.n, Brinnon,Wa,9g320 email: rhh�pacificpoin}e.
Mailing Ad con t
What kind of Permit?(Check each box that applies
POullding
Q Demolition Permit Critical Areas Stewardship Plan
❑ Family 0 Garage Attached I Detoehed 0 Variance(Minor,Major or Reasonable Economic Use)
O Single Family Home p Modular 0 Conditional Use[C(a),C(d),or C)""
00 Commercial' orDisc etionary"D" Unnamed Use ClassificationO Change of Use 0 Special Use(Essential Public Facilities)""
a Address 0 Road Approach_ 0 ShoDJ �lat line Adjustment
0 Horne Business ❑Cottage Indus
❑Propane y 0 eindIng Site Plan"
Sign ❑Lone Plat"
0 Allowed"Yes'Use Consisten Anal 0 Planned Rural Residential Development(PRRpuAmandrner>ts•"
O Stormwater Management �� nr°iat Vacatiat/Alteration"
Q Site Plan Approval Advance Determination(SPAAD)• ICI Shoreline Master Program Exemption/Permit Revisions""
❑Temporary Use 0 Shoreline Management Substantial Development••
Wireless Telecommunication' 0 Shoreline Management Variance
0 Forest Practices Act/Release of Six-Year Moratorium 0 ComprehensivePlan/UDC/Land Use District Map Amendment
•May requhr a Pre—Application Conference Cl Tree VegetationJeffersen County Squest ,Master Program Amendment
Cl Tree Request
Please Identify any other local,state or federal "Requiem a Pre-Application Confe►wncs
permits required for this proposal,If known:
I hereby designate_Ronald H H2lsman D iC+NATION OF AGENT
act as my agent in matters relating to this appll - for perrnit(s)
OWNER SIGNATURE Date: / l / f9/O
By signing this application � — _
OWnedagent attests that the information provided herein,end In any sttachmerits,is true and correct to the best of
his,her or Its knowledge. Any aterial falsehood or say omisabn of a material fact made b the owner/ ent with
may result In this pemih being null and void. y a9 respect to this apWication packs!
I further agree to save.Indemnify and hold harmless Jefferson County against at llabifafes,Judgments,court costs.reasonable attorrwy'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 Jaffe o County and its employees,representauvei or agents fur the sale purpose of application
review and any red later inspections Staff a an
time of the moot t ha or he n nor no of entry will be assumed unteae the appGeant informs the Coo In wilting at the
Signature: ���i L�4 l! �</
—
The - Date' �
The action or actions App nt will undertake as a resul of the issuance of this
endengorod species and tilt lead to a potential'taken of an end permit astray terms are
defined
in theh one or l law knee,,as t or
e
"Endangered Species Acr-or"CSA,"Jefferson County makes no assuraanedce$toas those terms d ioned is federal undertakenw known because the
permit has ben issued Wilt not violate the ESA. Any Ind I, up or agency la that the bel that an end be regot this
action(s)oven if y ,are In comRitanottwitnthe o tin sue � q can file a lawsuit on behalf of an endangered species regarding your
and non-transeverah a a Mrin ko merit code.The Applicant acknowledges trot ,she• It holds Individual
t ESA. The App6oant has reed this diecla a ei• and dates it below.
Signature:
Date:
G,\PetmicCmtcr\###P $###\DRD I'tMINS\Muter Fermat Application 5-29-0il.doc
• BUILDER STATEMENT •
The signer of this staiernent 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 MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: Architect,Ronald H Holsman AIA NUMBER
ARCHITECT/ENGINEER: 280 Rhododendron Ln Brinnon Wa 98320 PHONE ( ) FAX:( )
MAILING ADDRESS: 206 200 5688 fax 206 238 3920 RHH @ pacificpointe.comEMAIL
NA Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
LI New U Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
u Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
n Repair C Masonry 45ft SEP Permit#
El Demolition C Other: Bedrooms: Water Supply:
Existing: Setback: n Private well C Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
NA 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 andlor Appliance Installation permit,mark all items below that apply:
I Underground Tank I Above ground Tank Size of Propane Tank:
I Heat Stove 1 Cook Stove I Woodstove I Fireplace Insert i Hot Water Tank I Pellet Stove 1 Other
Is this appliance being installed in a Manufactured I 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. .fi rwn,*�mwv�.rt nw.+urnry ra,
-loom: L'P,r'k»Yi.Ix� -4: S+d'9Y ��i7�uR�k .l' a'Pa�dl +fir i+��.�'�a`rV ,/ "FRl
Square Footage Current Proposed fh MHu¢. "' w' r�'�''�'d" '"
Main Floor Heated NA � e EH Bld App Review:
a-
Consistency Review: GA
2"0 Floor Heated NA * - . �: '
rt ,
Other Heated TNT Base fee:
NA Z .+f1aJ ,5L G `7 j
anitima� Addi' al e rl►'ln- 1�/�, l
Mezzanine NAti *�,� ` ''
nd4 ,
Heated Basement " ' ' r rl Plan Check fee: !Q N A pfrp- :" c�
Unheated Basement NA licit 4 State Surcharge fee: f
Other Unheated ' "" .. P `: {y, < ''
kz
Ck
Garage/Carport witiA�' ," SUBTOTAL 11 tt
NA iti T lJ�t
Decks i ¢ iv , 'i 911/Rd Approach fee:
NA A
Other 212 If of soft bulkhead r ,i • TOTAL: $
� 44
rf .* '. Receipt Number: I ZD
.,
Cash/Check Number:
�n..[ l ' Z j
5^` 'i,ilmt�'Avv.*'
ESTIMATED COST(REQUIRED),W. Date: ��
.Fair market value of all labor end materials foundation to finish
nn J Initials: ' —�
"'� *2:Engineer: Katherine Bailey: NTI En ing,7-1-7 S-PLabody St Port Angeles Wa 98363
(360)452-8491 Office 360)452-8498 Fax catherine@nti4u.com
G:\PernvtCcntcr\###FORMS###\DRD FORMS\Muter Permit Application 5-29-08.doc
6
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y ,,., �, �_ PROJECT: _t
Porter Shoreline Soft Armoring �' Pacific Pone Prnpert es RO\ALD I{. fiOLSMAN A l
c Aar ARCYIHTECTS
''.4 - 1117 Black Point Road e."`
c 280 Rhodeadron In Bannon Wa 98320 r W...y...w -or l,- %,%,'?�' /C,,
Brinnon, Washington, 98320 PO Box 11805 Bainbridge tsland Wa 98110 ai P ea.,-w a..