HomeMy WebLinkAboutBLD2011-00018 00
�UILDING PERMIT APPLICAtN B RD1e Type1:8
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD11-00018 Received Date: 1/27/2011
SITE ADDRESS: 71 MARINER PL
PORT LUDLOW, 98365
OWNER: ROBERT N BURNS TRUSTEE PHONE: 360-437-0451
MARTHA A BURNS TRUSTEE
71 MARINER PL
PORT LUDLOW WA 98365-9765 BAYVIEW VILLAGE DIV 2
SUBDIVISION: Block: Lot: 13
PARCEL NUMBER: 931900013 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: G M A CONSTRUCTION INC PHONE: 503-635-5286
PO BOX 926
LAKE OSWEGO OR 97034
Contractor's License GMACOI*9740Z Expires 9/9/2011
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr REMODEL 2 BATHROOMS
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 20,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: R 3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: SEW
WATER SYSTEM: 68700
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $321.25 LYK 01/27/11 120406
Plan Check $208.81 LYK 01/27/11 120406
State Building Code $4.50 LYK 01/27/11 120406
Total: $534.56
Jefferson County Building Desion Permit Null, r: BLD11-00018
Applicant: BURNS TRUSTEE
BU .ANG PERMIT INSPECTION APPROVALS applicable 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 2 -/, / 1
Shower Pan
Wallboard Nailing -� � r PrP
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
gsoN c
�,�4� oe., JEFFERSON COUNTY
kilo. DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
� G,sc3 www.co.jefferson.wa.us/commdevelopment
<yS,�N
Master Permit Application MLA: IvcD MLA-- e,fziA
P t Description(include separate sheets as necessary):
[v IOC , ( E )i�)t -
-ax Parcel Number: 13 1ccoo 13 Property Size: (acres/square feet)
Site Address and/or Directions to Property:
i M Af V ciPvQ t 1 'J I W A- '1 � 7 c
(,
Property Owner(s)of Record: is i- t,t�R 1(t. _ (,L MS 7rL(S-}rO
Telephone: " .0 • Fax: email: li A')Gq v15 I2 PO 71,CC l
Mailing Address: ) L .L.L jo,
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
76uilding 0 Critical Areas Stewardship Plan
O Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
0 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
O Commercial* 0 Special Use(Essential Public Facilities)**
O Change of Use 0 Boundary Line Adjustment
❑ Address 0 Road Approach 0 Short Plat**
0 Home Business 0 Cottage Industry 0 Binding Site Plan**
❑Propane 0 Long Plat**
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
0 Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions**
0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
0 Temporary Use ❑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:
ESIGNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURF / / �1/c��� ` Date: /� �?i ��l L
By signing this ication 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 attomey'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 req _�.er:er inspections s access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appl`it e e prio otice. /
Signature/ � °'� � Date: f . 9,-/f
The actio or actions Applica will undertake as a result of the issuance of this permit may negatively impact upon one or mor 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" ."Jefferson Cow ty makes no assurances to the applicant that the actions that will be undertaken because this
permit has been iss wi violate the ES' y individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if u li w Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-tran r ,.nng to�nd�m ying with the ESA. The Applicant has read this discr�sigrLe and dates it below
Signature / /��''%4 Dater O� m
G:\PermitCenter\###FORMS##v#\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:
( ) ( )
MAILING ADDRESS: M A C F I ST' 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 f1 Wood Existing: LI Sewer
n Addition f i Steel Proposed: Bank ❑Cammunity System
,Alteration/Remodel I1 Concrete Total: Height: ❑ Individual System
❑ Repair C Masonry SEP Permit#
r Demolition C Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: Public
Total: a of System;
11,Nit:AL 'S
If this is a Commercial Proiect you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of Air 9paoe�:n R y 1f;;I(
Number of occupants(includes owners,tenants,employees,etc) Current Propo 1' a l • 1 IL l
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: \N 2 7 2011
1
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 p# buildings,ap4 l{it}r
lines,tank location and size,distances from the propane tank to all property lines,buildings an ep►c system components,
including the reserve area.
Square Footage Current Proposed For OfficiUse Only Amount 4rh evasion h ','
Main Floor Heated EH Bld App Review:
211°Floor Heated Consistency Review:
Other Heated Base fee: 32 I
Mezzanine Additional Section:
Heated Basement Plan Check fee: 2d 8 f
Unheated Basement State Surcharge fee: 4 sc,
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL ��'r
Decks 911/Rd Approach fee: `�
Other TOTAL: $3y, _
Receipt Number:
-
' Cash/Check Number:
1
ESTIMATED COST(REQUIRED)! Date:
•-market value of all labor and ma(/als foundation to finish
`-4-z 00 fl Initials: '
GAPcrmitCcntcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
b u•-pb-E--112--
PI-A 0
,
,
, .
. , . .
. .. ,
. . ...
. .
. ,
. . , .
, 33 ill s la
6 i
,-".• ,,
€ a a
€
s s
a
s s
s . s
t a
- €•, .,—-- ..-- - '_,*
Ns
17-----...
r
t
t
t
t 1 '
1
1
t
; .
. ..,.
t t
AN Il
t . ,
4--. ,
fr,m
1
' r t
P.." .4 " .......--
s t
Cs1 ie _
lerigAv— . I
-,..•......071 ,
,,,,,1 C.; „....:, %.5,•,...„...7. Z ..:.....,-,„ s . I
.
. ( , -40r.iik ,..;,..,
...,..
...,er,66-' ,0,-.. V) 11:.;
.... t.
to t t
#
.# 1
\ ' a ..i':.., .•.'...•:. CL 4 :' -e- i : JAN 01
2 7 2 1
2 J
I 6
t
.• ..e e
Li. - 4111410461111h• INN.. t'? . e
e ,•
• ;€'..• 6,00011
• .. CL! ''''' 1111116116116,00,-• 0644 ....' . . sl j .FERsok.cllillotiia........... -10...
0:i,,,...1-r ....
i
e
,
NI"' .it 1 I ml N ... ,„
„
. Hci
, .
, .
1 ,
„ .:
€ .
/ t €
, 1
il I
,...
. ,. . ,. ,I
I I
, lieSSFIlairipp‘ .
...,
:
••
, /
ma, il... . i e I,-11110 1
II .. , , ,
e 1
i -4
CI, r f
1 1 /# 1
€
... .
/"..- I
"***--
•-•.
N.
N
N...., 1 111..C.••
\
-- •..-' ----- nit# „t€ N.
\t
tt., !
a t ,. ,
lc_ '......"----71L—_...._._._..„ „ ......„.. ......:1,_, ill
I
• •
A
/ 42 e„ / 84i" /
/ 127;" // 35;"
ff G1" f 15"�/-17;"11-161"/ 21{" 39t"
•
„AFF
N \ ��. \ Date-10/04
PLUMBING PL 1 MI31'G
,.,IM '� A Customer name/PO#-BU
et'" qW Overview of job-MASTER :P
cNv ���; ROGER ATTENDED
•'„F, s m_ : Exterior wall covering-WO•C
-`t� I • T-1 �T• Roofing material-COMP
�y""" la Interior wall construction-D"`
,oW Interior wall covering-PAIN
Y Z Room above-UPSTAIRS
w --IC 0 Room/area below-CRAWL.I
O 0 r Existing flooring-TILE
W \ CO m I w Anticipated flooring-?
I- ,, Existing base cabinet dept -:
2 ro Toe kick depth-3"
Access limitations-NONE
R/H SHOWER -= Ceiling height-100"
Soffits-NONE
co
\ Gas location-NONE
Plumbing location-ON 20-2.
Venting-ON 20-20
J Appliances-NONE
,, Please review all supplied .h
N N _ 1 _ "_ l \ before beginning design.
Call Madera Woodworking .
/L•21•*" 1 38*" 1 733" ,I' 33:" 74 with any questions. Thank,c
/ 167;" /
•
All dimensions.size designations * This is an original design and must Designed:10/4/2010
given are subject to verification on i► not be released or copied unless Printed: 10/6/2010
job site and adjustment to fit job A`. � applicable fee has been paid or job
conditions. �� order placed.
PPS EueA s ► ..,
FK000279.kit i MI I TIrawina t• 1