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Home My WebLink AboutBLD2011-00138 • • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD11-00138 Received Date 6/7/2011 SITE ADDRESS: 391 BEACH DR Issue Date 6/15/2011 QUILCENE, 98376 APPLICANT: RICHARD S LINZER PHONE: 360-765-3136 ANNA 0 LINZER 391 BEACH DR QUILCENE WA 983769646 T 16+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 701344022 Section: 34 Township: 27N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, RICHARD S LINZER PHONE: 360-765-3136 if different: ANNA 0 LINZER 391 BEACH DR QUILCENE WA 983769646 PROJECT DESCRIPTION: DEMO ATTACHED GARAGE Directions To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 6/15/2012. REQUIRED INSPECTION: FinalApproval: \ . &- b // BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY • • SPECIAL CONDITIONS FOR CASE#BLD11-00138: 1.) Approval of this permit does not provide any assurance of future approvals for onsite sewage disposal on the property or use of any existing septic systems. Actions taken to date and proposed as part of this project may limit or prevent future development of an onsite sewage system. Future proposals must meet current code at the time of application. 2.) Future permitting will require a septic system designer to designate a reserve drainfield area. I:\F_BLD_Permit_Propane.rpt 10/29/19 �ILDING PERMIT APPLICATIlk B RD1e 00138 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00138 Received Date: 6/7/2011 SITE ADDRESS: 391 BEACH DR QUILCENE, 98376 OWNER: RICHARD S LINZER PHONE: 360-1 -313L ANNA 0 LINZER 391 BEACH DR QUILCENE WA 983769646 SUBDIVISION: Block: Lot: T 16+ PARCEL NUMBER: 701344022 Section: 34 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr DEMO ATTACHED GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP DEM VALUATION MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Pr • Total: Total: Routing Date: '0 M I ( Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $71.00 LYK 06/07/11 123562 State Building Code $4.50 LYK 06/07/11 123562 APPROVED Total: $75.50 jUrJ b 2011 ,efferson County Planning FA Building Department • _`• GION CLE,j�I, Olympic Region Clean Air Agency 4 2940-B Limited Lane NW i 6v 9� c , Olympia, WA 98502 2 q) (360) 539-7610 • FAX (360) 491-6308 Oa Port Angeles office (360) 417-1466 Demolition Permit '../ r'' .,:'. o R.CA A .�,-4,. Raymond Office (360) 942-2137 \47r4.14,E •�ffffY;aH•w5�"_:e-'t/ www.ORCAA.org [ [ Commercial Structure—Permit fee: $60.00— 10 working day wait period [' Owner occupied residential dwelling—Permit fee: $35.00—Prior Notice PROPERTY OWNER Name: Phone: BbO) 7.66-• 3I36 Email:--1i,1)0(ivtetyseghutl`• �... 1'( 4,4 Av1.v\A L\4\ZQJI/- FAX: ( ) Mobile: ( ) Mailing Address: City: C�1r,SL. State: Zip: 3 91 3 each. �r iv wA- T R 76 Site Address: City: Stab Zip: DEMOLITION CONTRACTORICheck if same as property owner information Business Name: Phone: ( ) Email: FAX: ( ) Onsite Contact: Phone: ( ) Mobile: ( ) FAX: ( ) Mailing Address: City: State: Zip: DEMOLITION INFORMATION # of Structures beine demolished: Start Date: Completion Date: k {6k / 2,) y -c ' 3, z[J Asbestos present _Yes ,X No Survey attached Yes No Has all identified asbestos been removed Yes No DEMOLITION PROJECT CATEGORY [ ] Complete Demolition [ ] Training Fire—Fire Agency: [I Renovation,Alteration, Remodeling, Maintenance, or other Construction [ ] Emergency—Additional Fee of$50.00 (must be accompanied by Government Ordered Declaration-Commercial only) I have read and will abide by the conditions set forth in this permit and any addendum thereto. I do hereby certify that all identified asbestos has been removed and the information in this application and supplemental data described herein is, to the best of my knowledge, accurate and complete. /9/C// el /14/2662. 6 y c-9‘,/l Applicant Name ignature D e .4.k-a- 4e -4 fP r z J ea .A-ssu"ed f } jot v z . Crn nle s rve Ae,irk au: ,. . iQiy ved Payment Info. X] Approved .ke Asbestos Permit �!// [ ] Cash [ ] Disapproved Permit# ASBOO Al Check: # "4�4 [ Demolition Permit JUN 07 2011 [ J Credit Card Review date: 6// /1/ Permit# I I DEM00 O CA Receive date: /'7/ I I Reviewed by: Agency Use Only Agency Use Only Agency Use Only 10/21/08 OVER fie coo. JEFFERSON CONTY • W ' 111\,,, A DEPARTMENT OF COMMUNITY DEVELOPMENT '' A, 621 Sheridan Street• Port Townsend • Washington 98368 Il ° 360/379-4450 • 360/379-4451 Fax k' c$ www.co.jefferson.wa.us/commdevelopment 'CSWING(' Master Permit Application MLA: ICY MCA en 1J Project Description(include separate sheets as necessary): ,?fYI) -A- �. Tax Parcel Number: 10 I — 3 [[ ._ 2 2._. Property Size: I• c'OtCYCS' (acres/square feet) Site Address /or Directions to Pro K 1 ,• _ I yell�r Cc�>z (.. - qg 3-4- Property Owner(s)of Record: Q. a L—t Telephone: 36 O- %5— - ?i 6 Fax: email: o I) zey PW1!)•(•Ceill Mailing Address: 391 13 zoe-V •,c rlJ.e.. Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: l What kind of Permit?(Check each box that applies ❑Lot or Road Segr 0 E il V IE 1 (Building ❑Critical Areas Ste r Demolition Permit 0 Variance(Minor, ' ' )or Reasonable Economic 6 ❑ Single Family 0 Garage Attached/Detached 0 Conditional Use[ `lid),or C]** 7❑ Manufactured Home .0 Modular - 0 Discretionary"D" i lamed Use Clas �Qsifica1tion ❑ Commercial* ❑Special Use(Ess ntial, iblic Facilities)** ❑ Change of Use 0 Boundary Line Adjust e ❑ Address 0 Road Approach 0 Short Plat** 1 JEFFERSON COUNTY ❑ Home Business ❑ Cottage Industry 0 Binding Site Plan 4' DEPT.OF COMMUNITY DEVELOPMENT ❑ Propane ❑Long Plat** ❑ Sign ❑ 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)* ❑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 0 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 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 requi later inspections. Staffs access and right of= try will be assumed unless the applicant informs the County in writing at the time of the applica. hat he or she w pri notice. , Signature: 'Opp '"' -' Dat 7r .u,J/ The action or actions Applicant will undertake as a resu of th suan o is permit may negatively impact upon one or more threatened or endangered species and could lead to a potential lake"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 are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer e responsi i ity r adhering t nd cocnplying with the ESA. The Applicant has read this discla' er and signs and dates it below. )cignature: Date: « 2, -)._(:),// G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc BUILDER STATEMENT• The signer of this atement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that :i:: 1rthe il be assu ng responsibility of the General Co actor for the proposed project. e: Date: 1/ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTAL PHONE: Fax: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) rAx:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New 0 Wood Existing: ❑ Sewer ❑ Addition 0 Steel Proposed: Bank l] Community System ❑ Alteration/Remodel 0 Concrete Total: _ Height: ❑ Individual System Li Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ 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: 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 For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: r 2nd Floor Heated Consistency Review: Other Heated Base fee: vr--' Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: 53 Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ 1 "-k g .3c Receipt Number: \'-:(F 2 Cash/Check Number: , �14 0 ESTIMATED COST(REQUIRED) Date: ��r_[�_1 •Fair market value of all labor and materials foundation to finish Initials: c - am— --- G:\PemutCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc / / ri 2�-0 ,, 1 ,,,,,,,, ii, . ., /6\ lcs=17 /7) i• )11() \ ,14/'---- ' \ 7 � r r -- d r . 3 g V ... ,=:----------- \\ ' r 1 �op� T \ \<) :-\ o -.›. .r. �� _ m -h�, n is► 7,5 i ' -- 6�\ --- ---.._ , �, - \ 1 t - :-, - . _.. '\ \ \ 1� L�\�\ / / Z o 6Cr K.. D,F / Rl / O 2 1. \. �'e/ ti ... .. 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