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HomeMy WebLinkAboutBLD2012-00071 BLD12-00071 WILDING PERMIT APPLICAAN Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00071 Received Date: 3/6/2012 SITE ADDRESS: 702 SUGAR HILL RD CHIMACUM, 98325 OWNER: HENRY L LUND PHONE: 360-732-0682 RITA L LUND 384 SUGAR HILL RD CHIMACUM WA 98325-7705 SUGAR HILL ESTATES SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 901135001 Section: 13 Township: 29 N Range: 01 W CONTRACTOR: RON MELHEIM CONSTRUCTION PHONE: 360-301-4586 3112 DISCOVERY RD PORT TOWNSEND WA 98368 REPRESENTATIVE: RON MELHEIM CONSTRUCTION PHONE: 360-301-4686 3112 DISCOVERY RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTION ADD 2ND FLOOR BDRM & BATH, REMODEL & CONVERT ATTACHED GARAGE TO HTD LIVING SPACE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 896 VALUATION 116,413.00 ADD'L: 640 HEAT TYPE: EEE 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: ALT WATER SYSTEM: 2PARTYWELL BEDROOMS: BATHROOMS: Exist: 1 Exist: 1 Prop: 1 Prop: 1 Total: 2 ; Total: 2 Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $1,088.95 LYK 03/06/12 131526 APpR Plan Check $707.82 LYK 03/06/12 131526 CA/F State Building Code $4.50 LYK 03/06/12 131526 „ ,. APR to � �� Total: $1,801.27 Jefferson County Department Planning & Building .'sfferson County Building Dion Permit Nun,: BLD12-00071 Applicant: LUND 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 kt,c/'ct-jn) 23) 12 Footing Drains Straps(hold downs) Ext. Shear Wall Nailing Rough-in Plumbing '�,��_!� 4rD Framing T‘Z--t lL Airseal ,�� Airseal Insulation: Walls I_lc! i l d `� Insulation: Floors Y� Insulation: Ceiling p to-Ig-LZ Wallboard Nailing lZ( I L )tv Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance Smoke&CO2 Drywell/Alt Drainage Address Posted FINAL INSPECTION FINAL INSPECTION MUST BE AP VED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR 4frilikarsi c � JEFFERSOFUNTY • ,a DEPARTMENT�r COMMUNITY DEVELOPMENT ` '4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax � p� www.co.jefferson.wa.us/commdevelopment kIN _ Master Permit Application MLA: CO intA eb-0J Project Description(include separate sheets as necessary): � s1 t; l gem&Ve L. Or5 's# .39 (-)cr'i c A'T)S.> Melsf-e. - 13c-'7 tizacm R 4 1-1 Tax Parcel Number: y 0 / /_3 5 D n I Property Size: v c (acres/square feet) Site Address and/or Directions to Property: C )).:�6 sti 5 At2 j Li- R') h . rvt . c 4 A- L✓A Property Owner(s)of Record: If e„/E rz 1 L- `,"Jr, Telephone:3 - '7 3 L-O 08 7._ Fax: email: Mailing Address: -3?q s-c4 ,, K j-)L - gdA-;7 42A eviAC L.4rr-i wA 9fl3;:S Applicant/Agent(if different from owner): -go eJ n1 /he_% rr, Cars Iv,-i it^ c •i, a rJ Telephone: 360- 3£'1- -J t 8 h Chi-1-Fax: email: //3i t/h e.,—, 0 M,Lr 4 %L Mailing Address: '31 / Z 'i 5 c o u ryr.._v -'v r.--Pe 4-1-T W t c°..../-- c _„/-4- 9 S - 4:.g What kind of Permit?(Check each box that applies 0 Lot or Road Segregation "uilding 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ')3[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 ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 BoundarJLine Adjus n ❑ Address 0 Road Approach_ 0 Short Plat** •\ I c', I ❑ Home Business 0 Cottage Industry 0 Binding Site Plan ❑ Propane 0 Long Plat** ❑ Sign 0 Planned kurai Residential Development IP 1' )Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** 1 ❑ Stormwater Management 0 Shoreline Master Program Exemption/Perk visions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Man opme t** ❑Temporary Use 0 Shoreline Mar)ageT VaiFiah&n ❑Wireless Telecommunication* 0 Comprehensive Ptan%UDC1L'iiil ' ' M p 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 kequest **Requires a Pre-Application Conference Please dentify arty erat-permila required forthis pioposal, if ktrutron: DESIGNATION OF AGENT I hereby des nate .. to act as my agent in matters relating to this application for permit(s). JWNER SIGNATURE ✓! ' Date: r` r 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 an later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of th pplication at he or she wants nor notice. Signatur • `7 Z-rt.„ Vh 0.___ -v Date: _5"- - () 1 Z. The action or actions Applicant will undertake as a result 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 ou are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non- erab responsibility for adheri g to and complying with the ESA. The Applicant has read this disclaimer and si ns and dates it below. Signatu • W�Q �/J� ^ Date:, S _ L� ) T2 _ G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc w iii • 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 bmin the responsibility of the General Contractor for the proposed project. �1 Signatude• ). ��✓ —�- Date: 3 —5 "-€!0 1 '_ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: C•' L-L FAX: 1`�0 I'►')c=J L, e.., .34 C'_.. ti -4 Q t4,.4_ 1 b ej (3 4 e 3�0/ -c,16 8 6 ( ) MAILING ADDRESS: 3/I. . 7)1.5 CV U F.G y n'-7 74 9Bx vAIL: /t p-i 6 1 h may et r•-1 l /4a4/v'1 Ai L.L.Cv� CONTRACTOR'S LICENSE WAINS NUMBER: O hf MeC 9 / lf 64) /-- NUMBER • ARCHITECT/ENGINEER: MA rA K ✓a wJ ph 1 LL-c ie., PHONE (?3.46 32 c.._.Sy fif}�Y.( ) MAILING ADDRESS:1v 3 e,K i g 3 y,-pe,ref-11c.ir,35 c Iv7, 9 6E. tAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: • New 1g;Wood Existing: __ ❑ Sewer L Addition ❑ Steel Proposed: 1 _ Bank ❑ Community System k Alteration/Remodel 0 Concrete Total: �_ Height: X Individual Syste ❑ Repair ❑ Masonry — SEP Permit# 3 I_ C. Demolition ❑ Other: Bedrooms: Water Supply: Existing: _i _ Setback: ❑ Private well X Two Party Type of Heat: Proposed: ❑ Public L I e r -4 iZ ) Total: Z c. Name of System: L.✓'2 L .5h.,c1rt-1=.7 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: 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 [ urrent Proposed For Office Use Only Amount Revision Main Floor Heated / / © _—S r) (0_11 p t EH Bld App Review: .D Floor Heated p 0 4,q 0 u f� , Consistency Review: takilA lSl elt Other Pleated Base tee: r\n� (;S. Mezzanine Additional Section: V�j �l Heated Basement Plan Check fee: r107_S2 Unheated Basement State Surcharge fee: I 0 t d. Other Unheated Pot Water Review fee: /� Garage/Carport �� SUBTOTAL l Frn 07 Decks 911/Rd Approach fee: Other TOTAL: $ I grn.69-1 Receipt Number: ` 3 n2lp iJ� i 3,�t i Cash/Check Number: ESTIMATED CO (REQUIRED) J Date: •Fair market value of all labor and materials foundation to finish 3 Initials: �---) G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc BL1,5-586-09€. 'vM `CJNgSNM al'....bod /00 se/ /O6 'ON 7.g3e/v& .03 /V0Sb'3... 3r. I 6�ar" o _od Z SAS./. dbj1N-.3.-.---r-��LN.:�O b/li1 1Nn0bW/HO '0 A,,, 77//- bLVVSg Q h S�20 Js/`v • t�3777W /v7./4b?yW. 1b • ("/vC/C/b' M3N)N177d &007d ONO3.0 • J / O LV307 A1&_gd0 7/S I� SNO/1d3/d/C70GN ONV N177d 8007S Lsb/d-• Cl3bf17"d.3N 0/11l77 A. /V3H tlO.d /VV7d 73O0141.3W 0 L1LJ � w • .z Er V = w o L yy0 U F W Z z I O L.!Cc c \ �6907d 161:1I. 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