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Home My WebLink AboutBLD2011-00206 AILDING PERMIT APPLICATION BLD Jefferson County Department of Community Development Review Type: 06 yp 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD11-00206 Received Date: 7/27/2011 SITE ADDRESS: 40 MARINER PL PORT LUDLOW, 98365 OWNER: JUDITH M MC CAY TRUSTEE PHONE 360-437-2156 THE JUDITH MC CAY TRUST 40 MARINER PL PORT LUDLOW WA 98365-9765 SUBDIVISION: BAYVIEW VILLAGE DIV 2 Block: Lot: 1 PARCEL NUMBER: 931900001 Section: 16 Township: 28 N Range: 01 E CONTRACTOR: DO IT RIGHT ROOFING & CONST 251A WAWA POINT RD PHONE 360-774-6348 BRINNON WA 98320 Contractor's License DOITRIR943QL Expires 11/24/2012 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOl RE ROOF TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 12,985.00 MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: CONST TYPE: GARAGE: SHORELINE: DECK SETBACK: SEWAGE DISPOSAL: BANK HEIGHT: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $223.25 LYK 07/27/11 127953 Plan Check $145.11 LYK 07/27/11 127953 State Building Code $4.50 LYK 07/27/11 127953 Total: $372.86 Jefferson County Building Divion Permit Numb." 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 FINAL INSPECTION G' 2/ � FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • �gSON Cow JEFFERSON COUNTY kilof.} DEPARTMENT OF COMMUNITY DEVELOPMENT "C 621 Sheridan Street• Port Townsend •Washington 98368 y 360/379-4450 . 3.60/379-445 Fax <yS, N��O www.co.jefferson.wa.us/commdevelopment c• Master Permit Application MLA: �� 1 TL fl P E Project Description(include separate sheets as necessary): 1<FRooF (rk ( le .-.Pl.i4CE CED/11aS(.1AVE. u.)l'r/J C0M1'061rrCN) Tax Parcel Number: 13 1 `-k;0 -Oe I Property Size: J pi COL' 5 F (LA0 9) (acres/square feet) Site Address and/or Directions to Property: LI-G M)1 R 1 NJ k 1'LA CC l'Jj,r t_tl i) L c u), co 4 a J 3 L s' Property Owner(s)of Record: .J c I 7 j-/ M, ,Njc C ity Telephone: (3 f,L) i-f 17 2-/S-E. Fax: email:J M r1't CL'c 1 cz .el It sCs4 Mailing Address: 46 vlAf'/n)L12- Pi 4-cc Pc AT 1.v ;14i41 . oi4 c 03ts- Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies (Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) II Single Family 0 Garage Attached/Detached 0 Conditional Use[C( , ** El Manufactured Home 0 Modular 0 Discretionary"D"orn �1 cltti6n/] El Commercial* 0 Special Use(Essent I F `► 11 V ❑ Change of Use 0 Boundary Line Adju 'e ❑ Address ❑Road Approach ❑Short Plat** ❑Home Business ❑Cottage Industry ❑Binding Site Plan** I, E J U L 2 r 2011 ❑Propane 0 Long Plat** . � i CI Sign ❑Planned Rural Resi entire evelopment(PRRD)/Amen s ❑Allowed"Yes'Use Consistency Analysis ❑Plat Vacation/Altera on""' ❑Stormwater Management 0 Shoreline Master Pr ram Exem ki Phtii@ isions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Manage Iht11PMENT ❑Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑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: LOCAL '6.4y \JICtn) VILL /16E ,IRcrl ITl;4-rU12..4t, iEV%Et& (//AC (IEPj ED) DESIGNATION OF AGENT I hereby designate)thy/Act f i= Vic 6-A,, to act as my agent in matters relating to this application for permit(s). ✓ OWNER SIGNATURE (� / 1� (/Z l ( Gt.� Date: 7 (�5 if i By signing this applica o 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 informs the County in writing at the time of the appli tion that he or she wantsn prior notice. Signature: i.r (AT,( al �'A <Cc.u,. Date: 1 ( � /j The action or a ons Applicant will undertake as a r sult of the issuance of this permit may negatively impact upon one or more 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"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 le responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer a d signs and dates it below. , Signature: ` L ice LT(` c 1.i 1 L i (rct, Date: Li , , l G.\PermitCcnter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc Ammisommonsom 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: 1--1.(6—k1 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: _ FAX: 7A i-r +2(CfIi RooFirJ6 1- lr olNI( ST RUC%/ Ci 01,c) 774- '(,3`4 ( ) MAILING ADDRESS: 2 0 z 64(zr IJ RD Pok r LAID 1_o tAi EMAIL: , f CONTRACTOR'S LICENSE 61,0 �,"�roe f t✓g a MSN i'yt NUMBER: WAINS v 1)01-I RIQ aLt3 DL NUMBER ARCHITECT/ENGINEER: e J PHONE �S AA VC. 31: ) 7 ILI,.L 34 FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: ❑ New Shoreline: Type of Sewage Disposal: ❑ Wood Existing: ❑ Sewer Fl Addition ❑ Steel Proposed: Bank V Alteration/Remodel ❑ Community em ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry ❑ Demolition Bedrooms: SEP Permit# ❑ Other: Water Su I Existing: Setback: --�y Type of Heat: Proposed: I v-py-----w t DTotal: I me o If this is a Commercial Project you must answer the following: I., Number of Parking Spaces: Current: I J if` 2 7 2011 Number of occupants(includes owners,tenants,employees, t)eCurrent Number of A P Ring Spaces: IBC Occu anc Pr poselaL : P y IBC Type of construction: Will you have Fo Service? ltriiiERMCOUNTY If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply. DEPT OF COMMUNITY DEVELOPMENT 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 I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No lines,When o install a propne tank you must also submit a site pan showing all of e builds,all property applying tank location and size,distances froma athe propane tank to all property I nes,lbuildings and septic syste components, including the reserve area. Square Footage I Current Proposed `" " � Am o P F449frp EisetOPI ' „;,,, Amount _'�v7sion � i ' Main Floor Heated ,'r EH Bld App Review: _____� VOJA:t2"Floor Heated y4f2 .- Consistency Review: Other Heated Base fee: ' 33 3 5 Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement �� I I State Surcharge fee: e Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL c� L� �l Decks �(1 1 • t 911/Rd Approach fee: Other - TOTAL: $ 9-. 1911 7 Receipt Number: I a- (6 ' Cash/Check Number: J ESTIMATED COST(REQUIRED) Date: .Fair mrket value of all labor and materials foundation to finish �--)—( I 1-2_ I �( � S, j Initials: G:\PcrmitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc Map Output Page 1 of 1 41 • ArcIMS HTML Viewer Map 9319000'7 — --..--- 93.1 0•4 93.9000" 93'9 00.6 93 2 93'90fq" - f 93'WY�O'S } 93'900048 93'900_kr' 821163028 93'9000'9 111td'^er P1 93'90000S Legend Selected Features 93'900004 Towns OCwmyses • 93,90x0's * Pura Camas 93?900002 JC_Roads \\ 93 Parcels +) 7 Par0fta Bl y Rd------___ _ ' OU 82.'63006 a m \i:rr..�u:hd x.d'c-w�_ui n'^..•r..y^x..r c.:,u FOR INFORMATIONAL PURPOSES ONLY- 2n Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity.Data contained in this map is limited by the method and accuracy of its collection.Wed Jul 27 12:09:17 2011 http://gisserver/servlet/com.esri.esrimap.Esrimap?S erviceName=ovmap&ClientVersion=4.... 7/27/2011