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Home My WebLink AboutBLD2012-00077 • • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD12-00077 Received Date 3/12/2012 SITE ADDRESS: 151 FOUR CORNERS RD Issue Date 5/17/2012 PORT TOWNSEND, 98368 APPLICANT: EDWARD M NEET PHONE: 360-732-5024 SANDRA NEET PO BOX 907 CHIMACUM WA 98325-0907 T 10+ SUBDIVISION: Block: Lot: PARCEL NUMBER: 001333015 Section: 33 Township: 30N Range: 01W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, EDWARD M NEET PHONE: 360-732-5024 if different: SANDRA NEET PO BOX 907 CHIMACUM WA 98325-0907 PROJECT DESCRIPTION: DEMO EXIST SFR 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 5/17/2013. REQUIRED INSPECTION: FinalApproval: 5— 'l 7 � jZ /3 pp � BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. - 4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY I:\F_BLD_Perm it_Propane.rpt 10/29/19 BOLDING PERMIT APPLICATICO Review00077 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00077 Received Date: 3/12/2012 SITE ADDRESS: 151 FOUR CORNERS RD PORT TOWNSEND, 98368 OWNER: EDWARD M NEET PHONE: 360-732-5024 SANDRA NEET PO BOX 907 CHIMACUM WA 98325-0907 SUBDIVISION: Block: Lot: T 10+ PARCEL NUMBER: 001333015 Section: 33 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr DEMO EXIST SFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: , Total: Total: Routing Date: 3'(?�t2 Type Amount Paid By: Date: Receipt: Approved/Date Permit $74.00 LYK 03/12/12 131536 APPROVE- State Building Code $4.50 LYK 03/12/12 131536 Total: $78.50 MAC. 11 ., 3 Jefferson County Planninc & Building Department ff4i " � ocr, JES COJTY • W DEPARTMENT FFERON OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment BINa Master Permit Application MLA: 0 ✓ 'k CASV{� P yject Description(include separate sheets as necessary): Tax Parcel Number:Oa 3Property Size: L 5 4 crc 6°7.s�(�cTeYsfsq are feet) Site Address and/or Directions to Property: Property Owner(s)of Record: Ed t..."4/() E sg rid(Li fkiE r Telephone: l_3ho ) 30 i ` D.11 Fax: email: pert rcc_yCl (I) yeitho Co.11 Mailing Address: P.O. 80A/ 901 chirrtq yrt ite/jsr7,. cf e US" Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation! n C ❑Building 0 Critical Areas Stewardship,Pla Demolition Permit 0 Variance(Minor, Major dr'Reasonable Economic Use) ❑ 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 El Boundary Line Adjust ent ❑ Address 0 Road Approach 0 Short Plat** JEFFERSON COUNTY ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** i7EPi OF COP�MUNITY DFVfLOPMFNT ❑ Propane 0 Long Plat** ❑ Sign -- 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑Stomiwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 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: 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 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 tior that he r e ant nor notice. Signature: it Date: 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 you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfera le respo ' ility for herig to an complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: C —y:! : 1,2 Date: G:\PemutCenter\###FORMS###\DRD FORMS\Current 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 NUFACTURED HOME INSTALLER: PHONE: FAX: 61J '.E� V--, - TE'U ( ) -301 t2 . ( ) MAILING ADDRESS: (30 �I�- .. c3r;,,1 Act. MAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: I-- ❑ Sewer ❑ Addition ❑ Steel Proposed: O Bank '"1 ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 7_,., Height: -Individual System ❑ Repair ❑ Masonry SEP Permit# Ia.--oc c 4 Af iiBedrooms: Water Supply: -Demolition ❑ Other: pp Y: intviNuF4,40 Existing: 3 Setback: ❑ Private well ❑ Two Party T of Heat: Proposed: Q ) Public Type of C Total: "b _ Name of System:_ ' If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: 7 - Proposed: 9 Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current 'L Proposed 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: 1 Underground Tank i Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove i Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 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 yFor Office Use�Q.ti>bf. ,Almo nt Revision _ Main Floor Heated EH Bld App Review: r 2fd Floor Heated Consistency Review: ------ Other Heated Base fee: 41 Mezzanine Additional Section: 1 Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated. Pot Water Review fee: _ Garage/Carport - SUBTOTAL SC) Decks 911/Rd Approach fee: Other TOTAL: "' 4-513 Receipt Number: 13 I 3r Cash/Check Number: �� `F' ESTIMATED COST(REQUIRED) Date: Z *Fair market value of all labor and materials foundation to finish Initials: �� TI - G:\PermitCenter\###FORMS###\D FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc c a c o 0 Z - rr --� m o o o o I '---- 1 O c -e T I-- o °•o p M = —_ Z onco o O Ldn v)ro -o m 10 c Cn al E— c r � � m -- o W o M c LL C r _� v r}- N M CO 3 IA l CD 1l_ o _z o 7 E1- M a� O c 0 3m oocp co o) -' co v U o ¢ O If _ 3 j� c W 17 x f9 - in +I �=/ �L �� -I p c0 2 iri A— d C tl ~ v CO ' Lo CO o W d LL1'L J O ____-._. __ a, d J I CO _ 0 / +I N °' ,L£b+ 32ZNT c +I j 0 a> c T-- I 0 0 0 o c •v . x 3 I 0 tali •c m S c a)El' o CC > I �- j -o -0 c a o c of X E a) co t,, CI) b 0 2) o : o a co \-'�-4 C N CD ii) fn 4.9 C j v fn 'No r+w�wtr� •��••• ��,�•W•�•� •'4 l am ��. �• ��.•� • •�• �� 0) o _ w.♦♦•♦♦•♦♦♦fir♦ r CO i s C.) ,y(l ►♦♦• � �`^ ��"'tf''4f-a:.. w.♦♦♦♦♦♦♦♦♦♦ a _ (mom' •w�♦�i`.•-`- .. , : ti' ,.•t^!.�ti..E./.-J r y nr:ti�•��♦•+�. 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