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Home My WebLink AboutBLD2012-0176 BLD12-00176 ILDING PERMIT APPLICATON Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00176 Received Date: 6/12/2012 SITE ADDRESS: 1451 OLD GARDINER RD SEQUIM, 98382 OWNER: RICHARD D HANEL TRSTEE PHONE: 360-797-0050 LINDA L HANEL TRUSTEE 1451 OLD GARDINER RD SEQUIM WA 98382-8775 SUBDIVISION: Block: Lot: TX 33 PARCEL NUMBER: 002342013 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: C H S INC PHONE: 385-5797 PO BOX 518 AUBURN WA 98071-0518 Contractor's License SUNSHP*077QP Expires 11/17/2012 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP ADD BATHROOM IN EXISITNG SFR &A/G 500 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 7,500.00 ADD'L: HEAT TYPE: 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: BEDROOMS: BATHROOMS: Exist: 1 Exist: 1 Prop: 0 Prop: 1 Total: 1 _--Total:-2------ _ . ........ Routing Dat c ---.- _,._ Type Amount Paid By: e: Receipt: Approved/Date Permit $30125—t-Th 06/12/12 131796 APPROVE' Plan Check $99.61 LYK 06/12/12 131796 State Building Code $4.50 LYK 06/12/12 131796 JUN 3 L,2 Total: $405.36 Jefferson County Plannint & Building Department Jefferson County Building Division Permit Null,. BLD12-00176 Applicant: HANEL TRSTEE 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 Rough-in Plumbing Gas Line: Interior Gas Line: Exterior - S 6 j'-zi Propane Tank lZ - S" rlZr7 FINAL INSPECTION 7 -/ /4y FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR ` -- z - • _ 2 7± N! I , • I 1 1 i . OLD FENCE LINE X X • X X X X X X I 1 k 1 1 i I'll I ‘ei.kwizi . LUOIX:1 14NFOIN't As' 0 lis Gc‘etuce.A go I fort...I, to Pi .813 f 2. , ! 1 I t• 1 -I , I i I i I I i . i 1 A 1\ 1 _____,A , TOP OF SLOPE 0-BOX lc RISER I - 37.5 . 1 U.V. DISINFECTION UN -1 .:. I I I . •. . 1 .. MONITORING PORT S (TYP. FOR 4) (o -1, ° I 1 1 .• I 4%. '--------\ :.. 1‘ t f 0 WHITEWATER AEROBIC \ 1 TREATMENT UNIT TWGRAVELLESS CHAMBER DR INFIELD TRENCHES 0 -3' 750 3AL -TRASH: TANK x 7.5 x 20- DEEP .N..." ,I, /t• 4-X, 577 n/6- 1 101 PATIO 2,311 21 I \l/ I I 20.6- i 4.• I 2 BEDROOM SINGLE -4-)- FAMILY RESIDENCE I EY I51,c74 ! , 5:Geri. --6-4.i. - , - . _:- ,-(..i.) : -.----11 ---d I I ---r-A,L3V--• 1 I " I i. , I >_. 1 .4C .'. 1 . i 1 Lj i ..f(0 ---- 31P 1 Cr I Q i 1 1 4 1, L _ , , ,, ,________ • I L:311-1 I JP,'VERSON COurTry , . ,w ' ONir cod,, JEFFERSOIIOUNTY '� ' DEPARTMENT OF COMMUNITY DEVELOPMENT _ '' ` '4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 4Al'i NIWf.ov www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: rt) na'.1- pef-D't Pr.'ect Des ription(include separate sheets as necessary): AA _ _ H . N, (Lr�s& C-xisTi t..xi T(�t'L i? pyr e c,6 prop r n Tax Parcel Number: ; 'J42.Q I j Property Size: (acres/square feet) Site Address and/or Directions to Property: I DID Ca.e01rObC KOR Property Owner(s)of Record: a _ a ► Q _ . a e Telephone:360- ocil— SO Fax:_Q trF�- l email: ® ,� ••,_ m 1, !orl„ Mailing Address: I4�i (�►1 0.(20 iYUE.2 I�oA t� 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 1IBuilding 0 Critical Areas Stewardship Plan ' 0 Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) O Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]** O Manufactured Home .0 Modular . 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** L Change of Use 0 Boundary Line Adjustment O Address 0 Road Approach_ 0 Short Plat* � --' 1 �fl ❑ Home Business 0 Cottage Industry 0 Binding Site PI r $-' , \9 I U \J 1 , Ir Propane ❑ Long Plat**, 7J I ❑ 3iyn 0 Planned kdral Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration*'' ❑ Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Manag ment Substantial Development** 0 Temporary Use 0 Shoreline NianagementOriiame,r,rray ❑Wireless Telecommunication* 0 Comprehensive l lasu/klDC/Lanci-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 I 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 b assume unless the applicant informs the County in writing at the time of the application that\heprishe wants prior notice. • Signature: • `_ • i .('-.)' Date: S — !D - I 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 you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adhering,to and co pl ingwith e ES . e A licant s read this disclaimer and signs and dates it below. Signature: '__3-,. .._`- l ,� - Date: 6, —/0 — f 2-__ G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • BUILDER S • TATEMENT 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: GEN L CONTRACTOR 9R MANUFACTURED HOME INSTALLER: PHONE: FAX: ) MAILING ADDRESS: EMAIL.: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: E New El Wood Existing: I1 Sewer 0 Addition ❑ Steel Proposed: Bank Community System 1E�Alteration/Remodel 0 Concrete Total: c; _ Height: C Individual System ❑ Repair ❑ Masonry — SEP Permit# _ Bedrooms: Water Supply: El Demolition ❑ Other: PP Y: Existing: i _ Setback: C Private well E Two Party Type of Heat: Proposed: Li 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 i Underground Tank t..Above ground Tank Size of Propane Tank: 'OV ai i Heat Stove kCook *Fireplace Stove i Woodstove €ireplace Insert i Hot Water Tank i Pellet Stovd 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: i ((c2`d Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: 99. / I Unheated Basement State Surcharge fee: 1 E(J Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: ..---__-- Other TOTAL: $ 48I Receipt Number: 1317q(C) Cash/Check Number: 1? r(c' TIMATED COST(REQUIRED) Date: _ rket value of all labor a terials f ndation to finish ' /�O� Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc - - 1 2) r c__ , — ,---, ..... , f?, i 2 9 — T1. ._.. „ IN-) N..3 ! - I 1 TT 1 ey 1110 ,<:, .........._ co 0 ... ....1\ I I _ 0 1 0 fil 0 ...? & 67 I P lign r rus 1 1T:) 4- mow .. m ,..-•% . -C. v — • .1 i 13 -_, I I -.., -,.., ..._ _ P , - 3 e .. 1 C . " i 4-• 0 0 "0 -4 1 3 , 0 ! pi , r.. 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