HomeMy WebLinkAboutBLD2010-00418 BUILDING PERMIT APPLICAIN BLD10-00418
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00418 Received Date: 12/23/2010
SITE ADDRESS: 82 MARILYN CT
PORT TOWNSEND, 98368
OWNER: PAUL H ANIOTZBEHERE PHONE: 360-531-3731
PATRICIA ANIOTZBEHERE
82 MARILYN CT
PORT TOWNSEND WA 98368-9568 WOODLAND HILLS NO 1
SUBDIVISION: Block: Lot: 33
PARCEL NUMBER: 001275025 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: WALLYWORKS ENTERPRISES LTD PHONE: 360-385-2771
1037 LAWRENCE ST
PORT TOWNSEND WA 98368
Contractor's License WALLEYL979C8 Expires 2/28/2011
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP REPAIR WATER DAMAGE FROM FROZEN PIPES
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP REP MAIN:
VALUATION 79,948.00
CODE EDITION: 2009 ADD'L: HEAT TYPE:
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:
(2-ZS IC
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $853.75 LYK 12/23/10 120360
Plan Check $554.94 LYK 12/23/10 120360 APPROVEP
State Building Code $4.50 LYK 12/23/10 120360
Total: $1,413.19 DEC 27K 2010
Jefferson County Planninc
& Building Department
Jefferson County Building Dion Permit Nurr: BLD10-00418
Applicant: ANIOTZBEHERE
BUILDING PERMIT INSPECTION APPROVALS \pplicable 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
Rough-in Plumbing
Framing .� I
Airseal /
Insulation: Walls 4L I L
I
Insulation: Floors 2. L Fa--
Insulation: Ceiling
Wallboard Nailing 117 II
Fireplace Insert _1
vt
11 • - / (7-1,
FINAL INSPECTION S''-0, f ,, OT5
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
� N C
,6"" b JEFFERSON OUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
414, 1 DEC 2 3 2010
621 Sheridan Street• Port Townsend •Washington 98368 II
360/379-4450 • 360/379-4451 Fax
qs N��o www.co.jefferson.wa.us/commdevelopment
aster Per pplication MLA: iN 6 t L4
.-Firoje:1 Description(in d separate sheets as nec sary): C')(
r-Nill; t (- U.)c Q r c\ 1tic
vL G C l l't!•: t u Z e. Y\ ' . Cc,S
Tax Parcel ber: 0 0 1 `7.5'0,Zs Property Size: (acres/square feet)
Site Address and/or Directions to Property: / ( l 1 �/
A /ICc.v. 1i 0 l0c1 ^ / D'4 ( JJ.00JCziltC) pi;. Lz11Cf ii C A.o
Property Owner(s)of Recdrd: f��t'f a i t c. Pct 0 I A i-•+e; i i he. he✓`e..
Telephone: J3 i 57 Fax: / email:
Mailing Address: .2 . cum- /14 Cf O /_c-0/,,- �t. e I•[ G" 1Ju, ?a: 6 s"
Applicant/Agent(if different from caner): lcjcff y e,c/o f�.S it)N s•Iv`v� `0vi
Telephone: 3_� -77 I Fax: ! errs B"'7 7/ email: t// ^,,k_s t9, _
Mailing Address:_0.37 L-cz0,v.e+nGe._ .1..rire et.- 0�Ow,,fSe-�t0 •i• A Y'1: 6
w t kind of P rmit?(Check each box that applies 0 Lot or Road Segregation
uilding , C.c�, cw-1L. 0 Critical Areas Stewardship Plan
Demolition Perl'nit 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family 0 Garage Attached/Detached ❑Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home .0 Modular - 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use ❑ Boundary Line Adjustment
❑ Address 0 Road Approach_ 0 Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan**
❑ Propane ❑Long Plat**
❑ Sign - 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
❑Stormwater Management ❑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:
DESIGFATION OF AGENT
I hereby desi natell C t to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE . ^. Date: 1a•as 1 0
By signing this application form,the o er/agent a ests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowledge. Any material falsehooc r 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 agr a to pro ide ss and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review anny requited la in pections. St- s access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicatio that h o he wants pr'.
Signature: . IOW- .�-- Date: to •3 ,0
The action or actions Applicant I undertak• - a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and could le d to a pot,nt=I"take"of an endangered species as those terms are defined in the tederal law known as the
"Endangered Species Act"or"ESA."Jefferso i ounty 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-transfergble onsibility f p- dhejin. ,� d co plying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Cl aua1J G���ZZ�C� 1k Date: / ',,?—/v
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 the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( X(/ &/I^�"( -7/./c4� v✓�` a V J)ice -,) 77 1 p) )� - '77
MAILING ADDS: fa j/ `„• j G✓ L:P IA L.e S free? EMAIL: . ,,C-f// • ac",v"k5( /0/7/(`y 1U5 ,tie,
CONTRACTORS LICENSE WAINS /L / 11p
NUMBER: AM L "67- Cf 79&(? NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New 0 Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ f Iteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
l Repair ❑ Masonry SEP Permit#
Ill emolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: 0 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:
1 Heat Stove i Cook Stove i Woodstove l Fireplace Insert 1 Hot Water Tank 1 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 fair Off ice U -OOnl Amount Revision
Main Floor Heated EH Bld App Review:
2nd Floor Heated Consistency Review:
Other Heated Base fee: '5----
Mezzanine Additional Section:
Heated Basement Plan Check fee: , �',
Unheated Basement State Surcharge fee: it 5 C.)
Other Unheated Pot Water Reviewfee:
Garage/Carport SUBTOTAL
Decks 911/Rd Approach fee:
Other TOTAL $ ////3, /9
Receipt Number: /�Q 3 %/�
Cash/Check Number: ! 6.2 7
ESTIMATED COST(REQUIRED) \ Date: /2 Z 3 _( r✓
•Fair market value of all labor and materials foundation to fin h
7r? q 7, 6
5- Initials: C--
G:\PernutCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
kn 0 A f °
lz
r
o i D -� o o �'
W V1
ty S• � ( � � m m p CJt • ky' \ '� -} `�
h ; F
i- Ha
J Cl
L a
a'
°o
• ,
a tP"i /...r „„„.---i-- .. --- \, •
_. ____ _______„.___ ._ .____
, .
. .
5-0 . ,... ,...•
. , ,, 1 „ ,..,_______,)' '' • • :'
z --P ci ' "
. 1
?.,c,4,E \r, , il
(t ........,,, i, , , .
(4
. s- 1- , 1 ...___)....,___ 1:.__y. ,
I �x�o
' I^
D
p � s w
a
c
(Ili 5
y
-�
13
S
c� c +,
Vvg i i
o
S ;Q\
(do �-
. v1. o
,. -4- 5:) --f' ? \ .
rO � _
/ I •
i
{,.
I
1
I
J___ _
3Z '- 75 '
\,