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Home My WebLink AboutBLD2012-00213 ItILDING PERMIT APPLICAT!N BLD12-00213 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00213 Received Date: 7/10/2012 SITE ADDRESS: 30 SADDLETREE DR PORT TOWNSEND, 98368 OWNER: DANIEL C GRACZYK PHONE: 360-301-5909 CATHY A GRACZYK 73 W VANCOUVER DR PORT TOWNSEND WA 98368-9447 KALA POINT#1 SUBDIVISION: Block: Lot: 36 PARCEL NUMBER: 964700036 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: EUGENE MATT PHONE: 360 385 1205 30 SADDLETREE DR PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOP DECK REPAIR & REPLACE DECK BOARDS & RAILINGS - NO LAND DISTURBING TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP DEK MAIN: VALUATION 5,580.00 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: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $125.25 LYK 07/10/12 134977 Plan Check $81.41 LYK 07/10/12 134977 APPROVED State Building Code $4.50 LYK 07/10/12 134977 JUL 10 2012 Total: $211.16 Jefferson County Planning fit Building Department \\fir.rnnrk\rinfn\fnrmc\C RI n Ann Ri,a rr,f 7NN9n99 Jefferson County Building Divion Permit Numb BLD12-00213 Applicant: GRACZYK 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 Framing 7_��1)— /�/2 FINAL INSPECTION 2 1� / /7- 19 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • (iS9-1---1 coa. JEFFERSON COUNTY ", . y� rA DEPARTMENT OF COMMUNITY DEVELOPMENT in .\lp 1.4 621 Sheridan Street • Port Townsend •Washington 98368 \,,,I360/379-4450 • 360/379-4451 Fax ,q p� www.co.jefferson.wa.us/commdevelopment HIN I Master Permit Application MLA: `�� f� Project Description (include separate sheets as necessary): Tax Parcel Number: (per} 7 00 03(Q Property Size: 17►5-is (acresEuare feet Site Address and/or Directions to Property: 3 0 S Pt DDLETP E I� et`ye Property Owner(s)of Record: (!4 1 k•1_�-Z 2�GZ`/IL_ Telephone: 3caOJ"3dI - 9(2 Fax: email: Mailing Address: -7 3 W• v 141•1cvvv�R- 'P2IUe- 1 PnfLT t0(..... 1.3S-e(tal to i- €73[P S Applicant/Agent(if different from owner): _V L-LtJiJ C • MAC Telephone: 3(QO/3$6"- l2OS Fax: Sa Me. email:ecane.ssoe [aJ CpEq,(Votil Mailing Address: ;3 0 SA-DOLE T-12.8.a. oat y£ (IT i Ou.)/_)s --rsriJ/ WA- ct 3CoB What kind of Permit?(Check each box that applies 0 Lot or Road Segregation ❑Building ❑ Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, a - _-9r .;a •,..i — ' • '- --- ❑ Single Family 0 Garage Attached/Detached 0 Conditional Use[C( ....„,i, *1 v E ❑ Manufactured Home .0 Modular 0 Discretionary"EX 0,u n • -• • - - - '=-:.. ❑ Commercial* 0 Special Use(Ess ntial Public Facilities)** • Change of Use ❑ Boundary Line AdjUStmer9tj L 1❑ Address 0 Road Approach_ 0 Short Plat** r 2012 i ❑ Home Business 0 Cottage Industry ❑ Binding Site Pldn 4"; I I ❑ Propane 0 Plat** : .IFS �*(PRRD)/Am-ndments** ❑ Ciyr� Planned❑ kurial Re '•- I ❑Allowed"Yes" Use Consistency Analysis ❑ Plat Vacatioli/" - f • O"�"MUNI DEVELOPMENT ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* El 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 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DES,�G�TION OF AGENT I hereby designate u6s-uE C- • (Ylf�t l/to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: a/a c//a 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 application that he or she wants prior notice. . Signature: 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-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Date: i ! 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, c s,• •ibil. , • e General Contractor for the proposed project. nature: (- , , /�'1'• / Date: 7 10/2 f- [ GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Fame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Li New Wood Existing: 1 Sewer • Addition 1 Steel Proposed: Bank i Community System VNAlteration/Remodel 1 Concrete Total: _ Height: Individual System • Repair C Masonry — SEP Permit# _ • Demolition Other: Bedrooms: Water Supply: Existing: _ Setback: 1 Private well Two Party Type of Heat: Proposed: 1 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 apply: i Underground Tank j 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: Other Heated Base fee: 25.2s Mezzanine Additional Section: Heated Basement Plan Check fee: I • it I Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 024' ll - I (P Decks 911/Rd Approach fee: ----- Other TOTAL: $c 1 I • I (O Receipt Number: 13gq-77 Cash/Check Number: ( r , ?STIMATED COST(REQUIRED) Date: --7 •Fair market value of all labor and materials foundation to finish r--l--(2— Initials: 7 5J i )� ( A.-.,-