HomeMy WebLinkAboutBLD2011-00158 •LDING PERMIT APPLICAT f MLA11-00130
Jefferson County Department of Community � ReviewType:l
Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD11-00158 Received Date: 6/20/2011
SITE ADDRESS: 294983 HWY 101
QUILCENE, 98376
OWNER: CHARLES H THRASHER PHONE: 360-765-4717
7450 COYLE RD
QUILCENE WA 98376-9677
SUBDIVISION: CAMPBELL'S JOSEPHINE ADDITION
PARCEL NUMBER: 937500602 Section: 24 Township: 27B10 N Range: 02 Wt
CONTRACTOR: OWNER/BUILDER
PHONE:
REPRESENTATIVE:
PHONE
PROJECT DESCRIPTIOP NEW RAMP, DECK & STAIRS
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP NEW INDUSTRIAL:
VALUATION 12,000.00 MAIN:
CODE EDITION: 2009 ADD'L: HEAT TYPE: UH
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER:
CONST TYPE: GARAGE: SHORELINE:
DECK: 90 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
NUMBER OF EMPLOYEES:
WATER SYSTEM:
BATHROOMS:
Exist: 0
Prop: 0
Total_-- 0-
Routing Date:
Type i By: Date: Receipt:
Approved/Date
Permit $209.25 LYK 06/20/11 123608 APPROVEDPlan Check $136.01 LYK 06/20/11 123608
State Building Code $4.50 LYK 06/20/11 123608
Total: $349.76 JUL 2011
iefferson County Planning
&Building Department
Jefferson County Building Dion Permit NumIW- BLD11-00158
Applicant: THRASHER
BUILDING 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
Setbacks
Erosion Control
Foundation Footing
Footing Drains
Foundation Stem Wall
Underground Plumbing
Straps(hold downs)
Ext. Shear Wall Nailing
Rough in Plumbing ` f+)
Framing 9.- ii ) r rid IVW / t(:),13 ,
Blocking
Wallboard Nailing /ZiP
Drywell/Alt Drainage
Address Posted
FINAL INSPECTION /G-/r, 1/
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD11-00158
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.
3.) The building height is not to exceed 35 feet.
4.) Building setback from Highway 101 is no less than 50 feet. Side setbacks are no less
than 5 feet. Rear setback is no less than 20 feet from Quilcene Ave.
(- -04i)jfir‘l
6, 0
44 JEFFERSON OUNTY
ti 44— DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
'Y ��4 www.co.jefferson.wa.us/commdevelopment
Master Permit Application ff
MLA: � 1 - ( �Project Description(include separate sheets as necessary):
Gb N 5 -)Gr & - )`t p s/
Tax Parcel Number: � 7 . O 0 66 •'Z_
Property Size: 7---./* yr Site Address and/or Directions to Property: 1 (acres/square feet)
Property Owner(s) .of Record: a �� �����— � O
ZONI.7 -eh
Telephone:?�
Fax: /
Mailing Address: O email:�� ey ,Z J
Applicant/Agent(if different from owner): e 3 Q C
Telephone:
Fax:
Mailing Address: email:
What kind of Permit?(Check each box that applies
lkailding ❑Lot or Road Segregation
❑ Demolition Permit Critical Areas Stewardship Plan
0 Variance
❑Single Family ❑Garage Attached/Detached ❑Conddo al Use[C(a),rCor(d),or Cj able Economic Use)❑ Manufactured Home . .0 Modular _
=commercial* ❑Discretionary"D"or Unnamed Use Classification
❑ Change of Use 0 Special Use(Essential Public Facilities)**
0 Boundary Line Adjustment
❑ Address ❑Road
❑ Home BusinessApproach 0 Short Plat
❑ Propane
0 Cottage Industryi_ 0 Binding Sitee
Plan**
❑Sign 0 Long Plat**
0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis
❑Stormwater Management 0 Plat Vacation/Alteration**
SPAAD 0 Shoreline Master Program Exemption/permit Revisions**
0 Site Plan Approval Advance Determination
❑Temporary Use ( ) 0 Shoreline Management Substantial Development**
❑Wireless Telecommunication* ❑Shoreline Management Variance
❑ Forest Practices I- " „i 0 Comprehensive Plan/UDC/Land Use District Map Amendment
*May require a • • • F:'" .:;,. fke� • 0 JeffersTree en County ShorelinequestMaster Program Amendment
❑Tree Vegetation Request
Please identify an r local s at or feder **R_•wires a Pre-A.•iication Conference
�U� 2��� its required for this proposal, if known:
ii
I��i�
I
' e�� ATION OF AGENT
hereby designate
to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE DEPT OF COMMUNITY DEVELOPMENT
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 required later inspections. Staffs access and right of entry will be assumed unless the applicant info s e County in writingat the
time of the ap heat' n that a or sh PP
r noti
Signature: //,,
The action or actions Applicant will undertake as a result of the issuance of this a Date: CL% i
.:�
prmit may negatively impact upon "ne or more threatened or
endangered species and could lead to a Potential"take"of an endangered species as those terms are detined in the federal 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 regardingyour
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-transferable r ponsi ility fora ing to and mplying with the ESA. The Applicant has read this disclaim r a signs and
ignature:
9 dates t below.
Date: `�
BUILDER STATEMENT
The signer of this statement does hereby certify that they
C are the
erOwners
for the proposed parcel
pro referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the Genera
Date:
Signature:
0GENERAL
CON -•CTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
ww
•
EMAIL:
MAILING ADD" " • WAINS
CONTRACTOR'S LICENSE NUMBER
NUMBER: PHONE ( ) FAX:( )
ARCHITECT/ENGINEER: EMAIL
MAILING ADDRESS: Bathrooms: Shoreline: Type of Sewage Disposal:
Project Type: F • e Type: ❑ Sewer `'
1 ood Existing:
❑ New ❑ Steel Proposed: Bank 0 Community System
❑ Addition Total: Height: ❑ Individual System
Alteration/Remodel ❑ Concrete SEP Permit#
❑ Repair ❑ Masonry 0 Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Proposed: ❑ Public
Type of Heat: Total: - Name of System:
•
If this is a Commercial Project You must answer the following: Number of ADA Parking Spaces:
Number of Parking Spaces: Current: Proposed:
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 Pro ane Tank and/or A liance Installation rmit mark all items below that a
1 Underground Tank I Above ground Tank
Size of Propane Tank:
1 Heat Stove I Cook Stove I Woodstove I Fireplace Insert 1 Hot Water Tank 1 Pellet Stove I Other
Is this appliance bein installed in a Manufactured 1 Mobile Home? Yes / No
erty
When applying for a permit size, installtac a propane tank
you must tank to all property lines submit a site ,build buildings and septic systeman showing all of the gcomponents,
lines,tank location and size,distances from the propane
+ .v r i / '? -a
includin• the reserve area. �, : 1 ;fir, 4 x' f;1-
. ,fib C- t ... S ? l ,"� f �, '1
#� ,��:.s, a 1�, : ,i- tl i••,•�:,tRy�� 4r, •;''.....'%..
.! 'i`-� `"Y
S•uare Foota•e Current Pro•osed `. •�mice u ... = `::`
n5e, EH Bid App Review:
Main Floor Heated -�. :_
x f Consistency Review:
2 ' Floor Heated
Other Heatedli,,,..-er-r ,, , Base fee: MEI
Iiiii # ;t Additional Section: MEM
J f 1
Plan Check fee: ,
Heated Basement ;f
Unheated Basement , : State Surcharge fee:
- Pot Water Review fee:
' Other Unheated '
SUBTOTAL r-�7�'�
Garage/Carport .1 -: 08 - Q`'
Y
Decks --< . 911/Rd Approach fee: . _ —__
Other TOTAL:
rr, Receipt Number: �IMlinill
Cash/Check Number: 1- ((02
ESTIMATED D IIIIIIMIIMCOST(REQUIRE Date:
I 1�� 1
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.Fair_ arket value of all labor and maten:Is foundation to finishInitials: Lill
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