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HomeMy WebLinkAboutBLD2013-00196 Ilk UILDING PERMIT APPLICAN BRD1e OOp96 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00196 Received Date: 6/25/2013 SITE ADDRESS: 7462 COYLE RD QUILCENE, 98376 OWNER: MICHAEL SAIA PHONE: 503-643-1039 4222 47TH ST SE AUBURN WA 980928443 SUBDIVISION: Block: Lot: 1 PARCEL NUMBER: 701341001 Section: 34 Township: 27 N Range: 01 W CONTRACTOR: SENTINAL CONSTRUCTION PHONE: 360-297-0080 26119 CALVARY LANE KINGSTON WA 98346 Contractor's License SENTICC961RT Expires 12/30/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION DEMOLISHING AN EXISTING 1300 SF CABIN TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: 1,300 VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2012 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 $76.00 MEB 06/25/13 142202 APPROVED State Building Code $4.50 MEB 06/25/13 142202 Total: $80.50 AUG 0 9 2013 Jefferson County DCD \\fi'Icmor4\rlofo\fnrmc\F PI(l Ann P1,1 rn4 R/9F/9f11Z '11111.111111.1.11111111111111111117 ■ ■ - MI M - MINIM • III NNW __________-------...o.............o-s;....... ......_.__-------•'''''.---- _ozza\,----.1...___ r....,,,, ,,,, ,,...,..... ..................r47.....,4., VINIall.,_ _,.----i,„.' i ■ °' V- - s N l✓ X 3` • 11 • 8 ,o Ti; rV Ul te sb t 11 ow \uli■ • ■ ■ ■ jj ' '' 1i ili m ❑ iI XiIi 1 i I m0 j,I I D(I 0) I!1 M M I II Ili Z I I; 0 ll Ii X I I 1 'N li • CO W HI!' 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N _ - _ �z 7462 Coyle Road U O ti Ouilcene, 98376 lerVi JEFFERSON COUNTY 4tor` DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax -744-41.1;04:7" www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessary): 4.1,i4Locq cox 1 t son`# ,t j,i/ Tax Parcel Number: 71Di 34 I COI Property Size: 22)4s 41— (acres/square feet) Site Address and/or Directions to Property: 7440.1. Coyle �ci�k4ei e, MA. 933XP Property Owner(s)of Record: �A• Telephone:/263) $23- 7(PI S Fax: e' email: i l ilat Mailing Address: "4 ' VI • 1 _ ,: - 4.• .r Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan X Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C)** ❑ Manufactured Home ❑ Modular ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat" ❑Home Business ❑Cottage Industry ❑Binding Site Plan" ❑Propane ❑Long Plat" ❑Sign ❑Planned Rural Residential Development(PRRD)Amendments" ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions" ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development" ❑Temporary Use ❑Shoreline Management Variance ❑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: DESIGNATION OF AGENT I hereby designate ►' ' U`/i ' / to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE �i. ..i�/ __% Date: Z i 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 attorneys 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 info s the County in writing at the time of the aprali ati n that he r she wants r no Signature: A� _ Date: f% 2 SA/ 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 res sibility fo dhering and complying with the ESA. The Applicant has read this di cl and s and dates it below. Signature: Date: in G:\Pem itCenter\ #FORMS###\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. Skjnature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Derr- al C�lnt;}'�UC.-�iar� C 2117-c V) 247-CO I MAILING ADDRESS: '.T..00l19' 1�6ClUecs14 Lane/� /� EMAIL:4 l dC � tCOIrS rl,c J .1.136" CONTRACTOR'S LICENSE WAINS NUMBER: � ' �41 NUMBER ARCHITECT/ENGINEER: ��,�11 ._ ` PHONE /, ,o ; r V FAX:( MAILING ADDRESS: 2 W ,� y�!7,7[e.�11�✓ l ' f1.��II • e`.i/ Al • ��J Project Type: s , Frame Type: Bathroom Shoreline: Type of Sewage Disposal: ❑ New Wood Existing: ❑ Sewer ❑ Addition ❑ Proposed: Bank ❑ Community System ❑ Alteration/Remodel Total: Height: ❑ Individual System , ❑ Repair Masonry SEP Permit# • ' Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ol ❑ Public Name of System: If this is a Commercial Protect you must answer the following: Number of Parking Spaces: Current Proposed: Number of ADA Parking Spaces: Number of occupants(indudes 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: 1 Underground Tank I Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank I Pellet Stove 1 Other Is this appliance beinsl installed in a Manufactured/Mobile Home? Yes / No When applying for a penult 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 al/property lines,buildings and septic system components, includin. the reserve area. ��, � s� �,,,�� --sue- � �,� "r �"` � s.� �x`� � .. � Square Footage Current Proposed �"a � Main Floor Heated r r EH Bid App Review: ...7i-e, CC) 2 Floor Heated � ���. Consiste Review: Y Other Heated ''' Base fee: Mezzanine Additional Section: Heated Basement '5 ,', I Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated _ Pot Water Review fee: Garage/Carport '; SUBTOTAL Decks i! 911/Rd Approach fee: � `. Other cf — TOTAL: $ /5-t.e 31)- , {* �_ ;� Receipt Number: ,r1Z ` - pt 1 . Cash/Check Number: ESTIMATED COST(REQUIRED) Date: 62,77211'15 .Fair market value of all labor and materials foundation to finish Initials: d \` G:\PemutCenter\###FORMS###\DRD FORMS\Master Petmit Application 5-29-08.doc . • - - 4,11P 44, '1i�a.,a�o,,• Notification of Demolition Permit It is unlawful for any person to cause or allow the demolition(or major renovation)of any structure unless all asbestos- containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project or demolition unless the owner or operator has obtained written approval from ORCAA. A written application for a demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the structure. Project Site Address: 7402... GOLtie, 94:1. County: lefet in City: W"%tC 41 State: IAA Zi %b"t2s Starting Date: 05,0//2.01'f 1.O1' Completion Date: 07by -1- "(There is a 10 working day advance notification period from receipt of permit application) Property Owner:__ Telephone: (1 Vj MS 7( Fax: Mailing Address: 1222 -17 City: At inn Ch State: WA. Zip: ` 2. Demolition Contractor:6a+1 net Geoff State License#:6Eisti lGG9ge i 42.1' Mailing Address:` ��� .0 nQ city: 1ti�� State: . ,Zip: Contact Person: -�'.t.lfP✓ C� �L16�' Telephone: X00 2er eirAO Fax:Ye) f7 0*1 YES NO Demolition by Wrecking or Dismantling? ($25.00 fee)check# )( Training Fire Demolition? (If yes,attach fire department request for training fire) y Renovation,Alteration,Remodeling,Maintenance,or other Construction? /' Asbestos found or suspected* *An ORCAA"Notice of Intent to Remove or Encapsulate Asbestos"form and appropriate fee must be submitted prior to any asbestos removal work. Asbestos removal gojects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation t Article 14 for additional requirements that may apply. rr Asbestos Survey Completed by AI ERA Certified Inspector V ec4$16e.Tet,t.`fro' Certification#- 2.561 . l 3.01 .4}3 This approved permit must Enclose$25 Certification of the Asbestos Survey must be available at the job site Processing Fee accompany this form 2940 B Limited Lane NW,Olympia,Washington 98502 360-586-1044 * 800422-5623 * fax 360491-6308 homepage:www.orraa.org * email:info@orcaa.org Rev.07111102 \\... j ,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,, _, „„,...---_,,, .. \ � ■ g %1 I ! i i ■ �� of ' '� ■ �' *�'' ` I ■ 1 .,1/ / Gl ys/�l .' 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W , • n I 1 X m '`��// I D \ I tl / / // - /// T `\ III \\ / �� ii �\ I / ` p 4i sl 1 I - / 1 /� iA �� 1 Y-----, I FEE, / ® dS 3 /I/, _ m N mi l& AV z A _ x � p pp y ` g I / 1p @ N ti29_ 3 \,\` III © $/ t / / A�\ YS n j 60 Pi n \ M k \,>\\ I I \\ \A A /�`,,\ ; i / 1 I 1 ri- --/-y / i b_ al \ . 1 \/ / / 3 Z CL V1 E 1 / /V j / / J- \ i / V , / / \ 0 ry� ,• I / \ / • D VO ,u I \ X ifP N to Z 51 Lii r lisi .„..1 Z I O m il_i7i • A s ' ■ âaia IZesklence T_ ^J a pp lL1 >i w p� oy g i A • f{` _ m r 7462-Coyle Road 6- CO U Oti LIR n C T1 - p c g 7" Ouilcene, 98376 • • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00196 Received Date 6/25/2013 SITE ADDRESS: 7462 COYLE RD Issue Date 8/9/2013 QUILCENE, 98376 APPLICANT: MICHAEL SAIA PHONE: 503-643-1039 4222 47TH ST SE AUBURN WA 980928443 1 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701341001 Section: 34 Township: 27N Range: 01W CONTRACTOR: SENTINAL CONSTRUCTION PHONE: 360-297-0080 26119 CALVARY LANE KINGSTON WA 98346 Contractor's License SENTICC961RT Expires 12/30/2014 OWNER, MICHAEL SAIA PHONE: 503-643-1039 if different: 4222 47TH ST SE AUBURN WA 980928443 PROJECT DESCRIPTION: DEMOLISHING AN EXISTING 1300 SF CABIN 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 8/9/2014. REQUIRED INSPECTION: FinalApproval: q-I Lt-(t BUILDING INSPECTION HOT-LINE 379-4455. REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED. Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday SPECIAL CONDITIONS APPLY- SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CASE#BLD13-00196: 1.) The building permit for the replacement home will not be approved until the"Bedroom Restrictive Covenant" has been recorded. \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 8/9/2013