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HomeMy WebLinkAboutBLD2014-00368 Ilk UILDING PERMIT APPLICA•N MLA14-00082 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00368 Received Date: 10/13/2014 SITE ADDRESS: 3744 EAGLEMOUNT RD PORT TOWNSEND, 98368 OWNER: TIMOTHY GREEN PHONE: 303-238-6376 1805 APPLEWOOD DR LAKEWOOD CO 80215-2521 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801054002 Section: 5 Township: 28 N Range: 1V1 CONTRACTOR: EVERGREEN DESIGN AND BUILD PHONE: 360-732-0428 DAVID CERVENKA 2260 EAGLEMOUNT RD PORT TOWNSEND WA 89368 REPRESENTATIVE: DAVID CERVENRA PHONE: 360-774-0908 2260 EAGLEMOUNT RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOP CHANGE OF USE PERMIT POLE BUILDING CHANGED TO HEATED SHOP/STORAGE REMOVE ALL PLUMBING/WATER & PERMIT EXISTING HEAT WOODSTOVE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: WOD OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 1 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 IRouting Date: Type Amount Paid By: Date: Receipt: Approved/Date Change of Use or Occupar $456.00 SRE 10/13/14 151626 State Building Code $4.50 SRE 10/13/14 151626 i� Total: $460.50 , 6 12 14 Jefferson County DCD \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/13/2014 `4' ' (b DEPARTMENT OF COMMUNITY DEVELOPMENT ,., 621 Sheridan Street,Port Townsend,W A 98368 Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment 1 Cb,co E-mail:dcdnco.jefferson.wa.us 4-1 CERTIFICATE OF OCCUPANCY PERMIT#: BLD14-00368 APPLICANT: TIMOTHY GREEN PHONE: 303-238-6376 1805 APPLEWOOD DR LAKEWOOD CO 80215-2521 SITE ADDRESS: 3744 EAGLEMOUNT RD Issue Date: 11/3/2014 PORT TOWNSEND, 98368 Final Date: 11/10/2014 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801054002 Section: 5 Township: 28 N Range: 1W PROJECT DESCRIPTION: REMODEL PERMIT TO REMOVE ALL PLUMBING TO EXISTING POLE BUILDING CHANGtD TO HEATED SHOP/bTORAGE PERMIT EXISTING WOODSTOVE. THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: R-1 TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes (nom THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 11/10/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 11/14/2014 Sally Ellis From: David Cervenka <evergreendesignandbuild @yahoo.com> Sent: Saturday, November 08, 2014 6:59 AM To: Sally Ellis Subject: Tim Green update/revised site plan Attachments: 13043_Green, site plan pg 1 of 3, (11-7-14).pdf; 13043 Green, site plan pg 2 of 3, (11-7-14).pdf Sally, I wonder if you would be kind enough to print these two pages of my revised site plan, and please put them in the Tim Green file, and get them routed to Randy Marx. They are revised to say "woodshed" instead of"cabin" to meet Randy Marx's request, and as is the truth anyway. Randy asked that I update the site plans to show this. If this is too much to ask, I can also bring in a hard copy, and thank you either way. David Cervenka Evergreen Design and Build 360-774-0908 WI LI `N AIL - 52 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT REQUEST/POSTING MEMO DATE: 11/1/14 The amount of: 524.90 received from: EVERGREEN DESIGN BUILD for(case#): BLD14-00368 is to be refunded to: EVERGREEN DESIGN BUILD IT WAS DETERMINED THAT THIS CASE SHOULD HAVE BEEN ENTERED AS A REMODEL- NOT AS A CHANGE OF USE PERMIT. as a result of: Date & number of original receipt: 10/13/14 RECEIPT#151626 REVENUE FUND CODE NO. REVENUE SOURCE NAME AMOUNT 001-250-000 369.90.00.0000 BAD CHECK FEE 127-000-010 346.23.11.5200 WATER AVAILABILITY FEES-EH H2O 127-000-010 346.23.11.5400 DCD BLDG REVIEW-SEPTIC 158.00 127-000-010 346.23.11.5800 SHORT/LONG PLAT FEES 143-000-010 322.10.00.0000 BUILDING BASE & INSPECTIONS 143-000-010 322.10.10.0000 BUILDING PERMIT RENEWAL FEE 143-000-010 322.40.80.0000 ADDRESSING FEES 143-000-010 341.60.00.0000 DUPLICATING SERVICES 143-000-010 341.75.00.0000 SALE OF MAPS& PUBLICATIONS 143-000-010 345.70.00.0000 DCD TECH ASSIST FEE 143-000-010 345.81.00.0000 SUBDIVISION APPLICATIONS 143-000-010 345.81.20.0000 SHORELINE SUBSTANTIAL DEV. PERM. 143-000-010 345.81.30.0000 CURRENT USE TAX ASSESSMENT APP 143-000-010 345.81.40.0000 ZONING APPROVAL APPLICATIONS 366.90 143-000-010 345.81.60.0000 CONVERSION OPTION HARVEST PLAN 143-000-010 345.83.00.0000 PLAN CHECK FEES 143-000-010 345.83.10.0000 FIRE MARSHALL PLAN REVIEW 143-000-010 345.89.00.0000 SEPA/ENVIRONMENTAL REVIEW 143-000-010 345.89.00.0143 PERMIT SCANNING FEE 143-000-010 346.22.30.0040 DCD WATER REVIEW 143-000-010 389.40.00.0000 CASP- NON-REVENUE CUST DEPOSITS 180-000-010 322.40.40.0000 MISC APPLICATIONS& PERMITS 180-000-010 322.40.50.0000 RIGHT-OF-WAY APPLICATIONS 180-000-010 343.20.10.0000 DEVELOPMENT REVIEW FEES 650-511-000 386.00.00.0000 STATE BUILDING CODE FEES TOTAL REFUND 1524.90 itVir Authorized person signature: Treasurer's check# Date: Treasurer's signature: ClqQ-6,4exCA MaitQ-PX) \ �� 12/f Pi 111:( ;I;I_I_�. ...iirl (21 .W / SHEETNO. 1 RO1"O7G,V R-001kPlk0 OF, Gf.l.!Rt,PA i`:-S CALCULATED BY DATE CHECKED BY DATE ! 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L ,E L(J.pc(rNT S t 62 }-r Standard Conditions for Residential Development in Jefferson County • 1. LIGHTING: Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. Exterior lighting for residential uses shall not exceed twenty feet (20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 2. BUILDING HEIGHT: The building height is not to exceed 35 feet. 3. OUTDOOR STORAGE: Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4. UNLICENSED VEHICLES: Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 5. PARKING: A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 6. This permit has been reviewed consistent with JCC 18.40.130 & 140. Notice: this permit does not excuse the applicant from complying with other local, state and federal ordinances, regulations or statues, applicable to the proposed development, but consistent with RCW 90.58. Future development beyond that specified in this permit shall require further review. 7. BMPs: The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 8. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the a pp licable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that"takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine 2013-03-07_SFR_StdConditions 3/7/2013 1 • Fisheries Service can levy penalties. Portions of Jefferson County, including marine waters, are included as "critical habitat"for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters Remove minimal vegetation for site development, especially large trees Allow trees that have fallen into surface waters to remain there Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a"take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/)to learn more about how this law affects your project. Any individual, group,or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. 2013-09-06_SFR_StdConditions 9/6/2013 2 bit SILDING PERMIT APPLICAT M 0082 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00368 Received Date: 10/13/2014 SITE ADDRESS: 3744 EAGLEMOUNT RD PORT TOWNSEND, 98368 OWNER: TIMOTHY GREEN PHONE: 303-238-6376 1805 APPLEWOOD DR LAKEWOOD CO 80215-2521 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801054002 Section: 5 Township: 28 N Range: 1V1 CONTRACTOR: EVERGREEN DESIGN AND BUILD PHONE: 360-732-0428 DAVID CERVENKA 2260 EAGLEMOUNT RD PORT TOWNSEND WA 89368 REPRESENTATIVE: DAVID CERVENRA PHONE: 360-774-0908 2260 EAGLEMOUNT RD PORT TOWNSEND WA 98368 PROJECT DESCRIPTION CHANGE OF USE PERMIT POLE BUILDING CHANGED TO HEATED SHOP/STORAGE REMOVE ALL PLUMBING/WATER & PERMIT EXISTING HEAT WOODSTOVE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT VALUATION MAIN: CODE EDITION: 2012 ADD'L: HEAT TYPE: WOD OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 1 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Change of Use or Occupar $456.00 SRE 10/13/14 151626 State Building Code $4.50 SRE 10/13/14 151626 Total: $460.50 \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/13/2014 ' 10(D11 soN\ • q - .(eF_) _...... 7'?•-riz, o�\ JEFFERSON UNTY r�` MI NiTY DE - s\ DEPARTMENT OF CO!i/li•iJ:;i DEVELOPMENT t t Lt �} � •.,-.fit �� y �, �C.� t V ` "` 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax www.co.Jefferson.wa.us!commdeve;op non; 2__ -)(--- SNp`S Master Permit Application MLA: Protect Description(include separate sheets as necessary): y („r &t.c4 SUIk S �' hCA:iinc� - Use_ St.4+le C ON IL1- 7A - ku_ • mtE , - PREJUIf MO Tax Parcel Number: —�q 002- Property Size: 20 0 CAP i r (acres/square feet) S Site Address and/or Directions to Property: ?,7L VA/AZ-how-7r RU. W RT 'TU wPS`Eul W}i.: . 615`›i, Property Owner(s)of Record: TI ti & r: --.1...) Telephone: v3- Z- -637b Fax: email:-RA•NrZ eevti Coiv.0 •.riot Mailing Address: Applicant/Agent(if different from owner): >vib C> V k Telephone: `°-771i -0090$ Fax: email: �g"eerlO�tSrxv►av►r��vi�dke, Mailing Address: °1 Z/ 110ile.7T- RI>, 7:1"- 1\k/A. qQ53b8 a100.40iteN What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation ❑Building 0 Critical Areas Stewardship Plan 0 Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) 0 Single Family ❑ Garage Attached/Detached ❑ Conditional Use[C(a),C0; — ❑ Manufactured Home 0 Modular • O Discretionary."D"or Unn)atr L�e,i .tiRnW Li Commercial* ❑ Special Use(Essential utiilC�F geli ..-- LI Change of Use 0 Boundary Line Adjustmexit i ❑ Address_- 0 Road Approach_ ❑Short Plat** " 0 Nome Business O Cottage Industry O Binding Site Plan** OCT CT 1 3 2014 i 'i O Propane O Long Plat** ,I Sty; - erLt(PRRD/A> 1 {s 'H ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** i i z•. C(2%FY ❑ Stormwater Management 0 Shoreline Master Program ExenVtiefi/PlartivitiffairSityriVrt ❑ 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 O Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference 0 Tree Vegetation Request **Re•uires a Pre-A••lication Conference Please identify any other local, state or federal permits required for this proposal, if known: } /�t--p D SIGNATION OF AGENT I hereby designate cV1 I> C.--`\ 14i1( 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 • • later inspectio- r Staffs .ccess and ••• of entry will be assumed unless the applicant informs the County in writing at the time of the apil , •• -t he or sh: ants . ler/aice. Signature: all = Date: 10 (3- 141 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 ••u a • in complia• r, with the Jeffer • County development code.The Applicant acknowledges that he,she or it holds individual and non-transfaile r-' •®nsibili for adhering to d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ale- J/ Date: —(5 i I 1 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: G NERAL CONTRACTOR 0 MANUFACTURED HOME INSTALLER: PHONE: FAx J 1 U0 ' i t, > (110) 771 -Dcip, ( ) AILING ADDRESS: .y2i20N h01/17f' kD '� l �q,` EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: eVe.gdbio1 ws NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: -_ EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New C Wood Existing: C Sewer C Addition C Steel Proposed: Bank El Community System !Alteration/Remodel C Concrete Total: Height: Individual System Repair C Masonry _ SEP Permit# I H -103 Demolition C Other: Bedrooms: Water Supply: Existing: Setback: pp y Private well Type of Heat: Proposed: a Two Party WneCt SkOTC- Total: C Public 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 :BC 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 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 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 For Office Use Only Amount I Revision Main Floor Heated - EH Bld App Review: - 1cJ� v • U 0d Floor Heated Consistency Review: r - __ Other Heated Chof' SSE � � Base f : Mezzanine Aitierrat 3itSn: — Heated Basement SCp i 1 C C?(- Plan Check fee: Unheated Basement . State Surcharge fee: Other Unheated Pot Water Review fee: l Garage/Carport SUBTOTAL I Decks 911/Rd Approach Other — — TOTAL: $ U 54_ c0 Receipt Number: 151 L. 2 Co Cash/Check Number: sl ESTIMATED COST(REQUIRED) Date: 'Fair market value of all labor and materials foundation to finish I 0/131i Initials: 6CC - • �4gON coo JEFFERSON CO Y 4 '-�`-�'`� t ��`�' �` DEPARTMT L �, OF COMMUNITY DEVELOPMENT ����� �' ,q ...).,,t,,,..,./ 621 Sheridan Street 1 Port Townsend,WA 983681 Web:www.co.Jefferson.wa.us/communitydevelopment skrNC: Tel:360.379.44501 Fax:360.379.4451 1 Email:dcd@co.jefferson.wa.us Building Permits&Inspections/Development Consistency Review/Long Range Planning/Watershed Stewardship Resource Center LIFE / FIRE AND CONSISTENCY REVIEW APPLICATION Please check one: CHANGE OF USE REVIEW SITE ADDRESS: X71-1 El i,`t-tot/ R.Q, t V, i - WA.. cj S ib' ,.1 - r- I' /! t ZIP " 95365 . .—._', I 9 DIGIT PARCEL ID NUMBER O( '0 je-I - 002_ ii r,. 1 3 2014 ! l Legal Description: I !I Subdivision Name {, I( IZkj j'-�l Block LoO) ; ; Ty Section Township North, Range I 4✓ WM rlyl,r Lln'�'�!T APPLICANT /Il> c-- .v uc,t-, PHONE 77,1 - 06105 MAILINGADDRESS ZZoo -AG F'(.ov NeP, 1'0 T `T)v i•A>, \A A- . ZIP 9536 y PROPERTY OWNER ---t-i rl (;ku ,...) PHONE '0 -i3F,°-(737 b MAILING ADDRESS I Bo A T I''L v roo I> t* LAtitvA,vvoi>, co ZIP Z I b- '2. -'2 1 CURRENT USE(S) rakti 1 1T%.-t> P Q L . 'vi LP i ti L 6130=:, '- I t1 7 PROPOSED USE(S) 1��1"D VIOLA—fl QM ( Cpl - i \1� ��"6 �"k�` 'TER-Vre,tTe-Is ,�,v A??fkkvs. Egs-n N (-A�NNR'f / fib"TVRtJ 'T� 5Tt}Rlkbly VTt 1„a-f�' SEPTIC PERMIT NUMBER IBC OCCUPANCY IBC TYPE OF CONSTRUCTION Classification Classification NUMBER OF BEDROOMS NUMBER OF BATHROOMS WATER WO WA'ctR.. 'Tp "Ot/tL4>IW(., PROPOSED a PROPOSED a// ❑ Public Water CAZtEt f���rs" EXISTING � EXISTING I ETD i5E ki M / ❑ Private Well TOTAL 0 TOTAL t) ❑2-party Well EXISTING#OF PARKING SPACES IV/A #OF HANDICAP PARKING SPACES N/Ak CURRENT NUMBER OF OCCUPANTS(includes owners, PROPOSED NUMBER OF OCCUPANTS(includes owners, tenants,employees,etc) tenants,employees,etc) CURRENT TOTAL SQUARE FOOTAGE(includes decks,porches,outbuildings, shed...etc) 1-71 b tZ- PROPOSED TOTAL SQUAB TAGE(includ ecks,porche uildings,shed...etc) 1 7 (.i, .t2 APPLICANT SIGNATURE am/ i �- ' "� DATE 10 , t3 / I ocit VIEW $ FOR O FICE USE ONLY BASE FEE 1 ST-6' RECEIPT# 1 5 14®ZCo STATE SURCHARGE 4.50 CASH/CK# 1 (e)2— TOTAL DATE i 0 / I3/ IL-1 ON Co JEFFERSON IJNTY • �� �2� DEP ARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.jefferson.wa.us/communitydevelopment �`9sk Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd@co.jefferson.wa.us Building Permits&Inspections Development Consistency Review I Long Range Planning 1 Watershed Stewardship Resource Center LIFE I FIRE AND CONSISTENCY REVIEW CHECKLIST A COMPLETE APPLICATION CONSISTS OF: MASTER PERMIT APPLICATION. Must be signed by property owner of record. FLOOR PLANS. One floor plan showing existing structures and uses. One floor plan showing proposed structure and uses. THE SITE PLAN. Please include all information requested on the site plan checklist. If the size of the site plan is larger than 11" x 17" you must provide us with 7 copies at the time of application. We cannot copy documents larger than 11"x 17". LIFE I FIRE AND CONSISTENCY REVIEW APPLICATION. The application asks for number of employees, number of bathrooms, number of parking spaces, square footage, heat source, and water source. Please sign and date. LANDSCAPE PLAN. Please include location and type of signs, vegetation, parking spaces, including handicap parking and route of travel. PRE-APPLICATION CONFERENCE.The Development Review Division will determine if your project requires a zoning permit or a pre-application conference. This may be accomplished by phoning the Planner of the Day. PERMIT FEES. Payable at time of application. • • Carl Smith,Building Official, The purpose of this permit is to satisfy requirements of your department and resolve the grey-water discharge violation at 3744 Eaglemount Rd.,resulting from modifications made to the pole barn by previous owners of the property,prior to Tim Green's purchase of this property last year. This pole barn was permitted as an unheated garage in 1993 by your department,and we propose to change the use of this building to heat-able storage/utility,to include an existing chimney and hearth pad. During this change all violating freshwater(rain)supply and grey-water discharge system plumbing and fixtures will be removed or otherwise rendered unusable. The scope of work will focus on completing the removal of the illegal fixtures and utilities that were installed by prior owners. This will include the use of a licensed electrician to remove the existing (illegal and likely unsafe)electrical connection to the pole barn. The remains of the rain catchment system will also be removed or made unusable,as the connection from the gutters to the water tank will be severed and any pumps and plumbing inside the pole barn will be removed or made unusable. Any remaining sinks, showers,and drain lines will also be removed or made unusable and holes in the sheetrock and siding will be patched where utilities once went through the walls. The drain lines that once made the grey-water treatment system have already been removed,and we will ensure that all remaining components of this system will also be removed or made unusable. Also,we will add a hand(grab)rail to the existing,original stairs,and we will close in the sides of the stairs so that a 4"ball can't fit through any openings. Otherwise,we are eager and excited to lift this violation and move on with approval of permits for the proposed building that we have recently applied for. 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I , 1 : : , , ' ' . , ■i• -- -' ' - : • . gl.r.3 4iiNINT-viz z z PRODUCT MCI(age Seds1205-1 Wiled) II p Front Parcel Review Parcel 801054002 Printed: November 3, 2014 TIMOTHY GREEN Site Address(es): 1805 APPLEWOOD DR 3744 EAGLEMOUNT RD PORT TOWNSEND, WA 98368 LAKEWOOD, CO 80215-2521 • Parcel Number: 801054002 S-T-R: 5-28N-1W Total Acreage 20 Legal Description S5 T28 R1 W TAX 14(INC PTN IN S4)BND TGTH THRU Land Use: 8800 BLA#107248 Flood District: Fire District: Planning Area: 6 Flood Map(FIRM)Panel No: School District 50 Zoning: 'P--210 COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ i/( Plot plan states "property line" [ 14 Assessor's Map(Property lines o bmitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ Legal Access to Property eitr7 NO [L'] Parcel Tags or Scanned Documents YES NO [ vr ESA's: Special Reports N-. by YES NO [ ii''' Designated Ag YES NO [t/] Shoreline Designation: YES [ ,,f Shoreline Slope Stability: YES NO Stream Type:YES NO FWHCA: YES NO fx, Wetlands: YES NO Rare Plants:YES NO Seismic: YES NO Landslide: YES NO r I Flood: YES NO Erosion: YES NO j Aquifer Recharge Area:YES NO SIPZ: none At Risk High Risk Coastal CMZ: none High Risk Moderate RiskDisconnected CMZ Stormwater site plan submitted: YesNo [ VI] Forest Lands: YES 0. Adjoining Forest Lands: Commercial/ Rural/ Inholding [ 0- Mineral Lands: YES O [ tx1 ' Agricultural Lands: YES O [ t4' Archaeology: YES NO [ a No Shooting Zone: YES NO . _ sow v [ 1/1/' Stormwater: New I :.-- •, Surface Lane Disturbing Act ity ESA's Stormwater ',J s:Min R-1 : __ Min Reg#1 thru#5 Min Rey#1 thru#10 Engineering [ Vf Notice Provisions/Disc osure:Airport YES NO MRL YES NO Forest Lands YES NO [ 1/6" 4 Landscaping Required: Yes No [ v ,-Parking Spaces Required NO 2 Other I- j/i" Building Height: 35' UBC Standard 1 [ ] Impervious Surface coverage centage: ,IN.'2T Resource Lands&Public: 10% Rural Residentia.4104 , Rural Industri r UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industri ands only [ (4 Total Building (s) Size: RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified [ iAr- Setbacks: Front: Left Side: Right Side: Rear: Shoreline Setback: LSHA Setback: [t/f Road Classification: Road Approach: EXISTING QD RAP [ l/r- SEPA Required: YES XEMPT [ ( Flood Certificate: [ U' Existing Case(s)&Condition(s): Violations: Yes No [ V' Recorded Date of Subdivision: 6./.f(} AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ L4 Lots/Require Declaration of Restrictive Covenant YES 0 submitted: YES NO [ C4- UGA No Protest Agreement YES T submitted: YE NO [V]' Site Visit conducted YES 0 [ Require Final Zoning Approval ES 4 [ i4V.ADMIN: Setbacks entered in Permit Plan case 1 /A YES New Parcel Tags entered in Permit Plan 4 ES Special Reports Scannec N/ YES No parcel tags found for parcel Cases Associated with APN 801054002 Review Cases Name Type Status Planner BLD14-00368 GREEN P David Wayne Johnson Application Received: 10/13/2014 Permit Issued/Case closed: Case Finaled: REMODEL PERMIT TU REMOVE ALL PLUMBING TO EXISTING POLE BUILDING CHANGED TO HEATED SHOP/STORAGE PERMIT EXISTING WOODSTOVE. BLD14-00352 GREEN I P Anna Bausher Application Received: 10/1/2014 Permit Issued/Case closed: Case Finaled: NSFR WITH ATTACHED GARAGE, NO HEAT OR PLUMBING IN GARAGE PROPANE TANK BLD93-00197 MURRAY F Application Received: 4/6/1993 Permit Issued/Case closed: 4/12/1993 Case Finaled: 1/5/1994 pole building COM14-00037 GREEN VIO Application Received: 4/29/2014 Permit Issued/Case closed: Case Finaled: SEPTIC-discharge in brambles. HMH591. COM14-00039 GREEN P Application Received: 4/29/2014 Permit Issued/Case closed: Case Finaled: BUILDING LIVING SPACE WITHOUT PERMITS MLA05-00641 SUB05-00050 MLA05-00641 FOX I F Mo-chi Lindblad Application Received: 10/31/2005 Permit Issued/Case closed: 5/3/2006 Case Finaled: 11/9/2006 Boudary Line Adjustment SEP14-00103 GREEN I P Anna Bausher Application Received: 8/1/2014 Permit Issued/Case closed: Case Finaled: USR14-00013 GREEN A Application Received: 4/21/2014 Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 11/3/2014 Page 2 of 2 • • Page 1 of 1 801045024 •'--801045021 801052001 `\ 50104501) �: 1, ... �. 501045015 801054001 801043004 - 1 �a I .-; y 'i 801045012 U i I I i - t 1 801054002 II K i ''I W I 3 801043002 II1 i {801045011 ' 9 I I S 801054003 _ _ i A 501054004 I 1 Maps warGad by 4aikrson cans Cam*Samoa GS http://gisserver/output/Critical Areas gisserver44435961767.jpg 11/3/2014 • • Carl Smith,Building Official, The purpose of this permit is to satisfy requirements of your department and resolve the grey-water discharge violation at 3744 Eaglemount Rd.,resulting from modifications made to the pole barn by previous owners of the property,prior to Tim Green's purchase of this property last year. This pole barn was permitted as an unheated garage in 1993 by your department,and we propose to change the use of this building to heat-able storage/utility,to include an existing chimney and hearth pad. During this change all violating freshwater(rain)supply and grey-water discharge system plumbing and fixtures will be removed or otherwise rendered unusable. The scope of work will focus on completing the removal of the illegal fixtures and utilities that were installed by prior owners. This will include the use of a licensed electrician to remove the existing (illegal and likely unsafe)electrical connection to the pole barn. The remains of the rain catchment system will also be removed or made unusable,as the connection from the gutters to the water tank will be severed and any pumps and plumbing inside the pole barn will be removed or made unusable. Any remaining sinks, showers,and drain lines will also be removed or made unusable and holes in the sheetrock and siding will be patched where utilities once went through the walls. The drain lines that once made the grey-water treatment system have already been removed,and we will ensure that all remaining components of this system will also be removed or made unusable. Also,we will add a hand(grab)rail to the existing,original stairs,and we will close in the sides of the stairs so that a 4"ball can't fit through any openings. Otherwise,we are eager and excited to lift this violation and move on with approval of permits for the proposed building that we have recently applied for. Thank you, David Cervenka Evergreen Design and Build Evergreendesignandbuild(4ahoo.com (360)-774-0908 cell CONE \ - \ ocT 132014 1EESERSON COUNTY • 7 � • S Sally Ellis From: David Cervenka<evergreendesignandbuild @yahoo.com> Sent: Friday, October 31, 2014 7:49 AM To: Sally Ellis Cc: timr2green @comcast.net Subject: Tim Green permit status Sally, Thank you for your quick and informative replies. However, I am curious why the pole barn "Change of Use" permit application is waiting on the septic approval, since the pole barn was initially approved for construction over twenty years before the property even started designing a septic system, and it will not be hooked to the septic system anyway. Also, my understanding was that the violation at the pole barn (which we have tried to address through the Change of Use permit, as advised by your department) needed to be resolved BEFORE the septic could be approved, according to a letter we received from Randy Marx. This is somewhat contradictory and confusing to us. As you well know, we are hoping to resolve the violation as quickly as possible, and hoping to move forward with the proposed building and septic system. Thank you for your help, David Cervenka Evergreen Design and Build (360)-774-0908 cell MI=uir illilimra��wars'•'■, • bLiDi H - 3(.0(8 tr■Cuelc og fey n - - d€1 per r t3o i use pei i co• • S JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT REFUND REQUEST/POSTING MEMO DATE: 11/1/14 The amount of: 524.90 received from: EVERGREEN DESIGN BUILD for(case#): BLD14-00368 is to be refunded to: EVERGREEN DESIGN BUILD IT WAS DETERMINED THAT THIS CASE SHOULD HAVE BEEN ENTERED AS A REMODEL- NOT AS A CHANGE OF USE PERMIT. as a result of: Date& number of original receipt: 10/13/14 RECEIPT#151626 REVENUE FUND CODE NO. REVENUE SOURCE NAME AMOUNT 001-250-000 369.90.00.0000 BAD CHECK FEE 127-000-010 346.23.11.5200 WATER AVAILABILITY FEES-EH H2O 127-000-010 346.23.11.5400 DCD BLDG REVIEW-SEPTIC 158.00 127-000-010 346.23.11.5800 SHORT/LONG PLAT FEES 143-000-010 322.10.00.0000 BUILDING BASE& INSPECTIONS 143-000-010 322.10.10.0000 BUILDING PERMIT RENEWAL FEE 143-000-010 322.40.80.0000 ADDRESSING FEES 143-000-010 341.60.00.0000 DUPLICATING SERVICES 143-000-010 341.75.00.0000 SALE OF MAPS& PUBLICATIONS 143-000-010 345.70.00.0000 DCD TECH ASSIST FEE 143-000-010 345.81.00.0000 SUBDIVISION APPLICATIONS 143-000-010 345.81.20.0000 SHORELINE SUBSTANTIAL DEV. PERM. 143-000-010 345.81.30.0000 CURRENT USE TAX ASSESSMENT APP 143-000-010 345.81.40.0000 ZONING APPROVAL APPLICATIONS 366.90 143-000-010 345.81.60.0000 CONVERSION OPTION HARVEST PLAN 143-000-010 345.83.00.0000 PLAN CHECK FEES 143-000-010 345.83.10.0000 FIRE MARSHALL PLAN REVIEW 143-000-010 345.89.00.0000 SEPA/ENVIRONMENTAL REVIEW 143-000-010 345.89.00.0143 PERMIT SCANNING FEE 143-000-010 346.22.30.0040 DCD WATER REVIEW 143-000-010 389.40.00.0000 CASP-NON-REVENUE CUST DEPOSITS 180-000-010 322.40.40.0000 MISC APPLICATIONS& PERMITS 180-000-010 322.40.50.0000 RIGHT-OF-WAY APPLICATIONS 180-000-010 343.20.10.0000 DEVELOPMENT REVIEW FEES 650-511-000 386.00.00.0000 STATE BUILDING CODE FEES TOTAL REFUND 1524.90 0.00 Authorized person signature: Treasurer's check# Date: Treasurer's signature: 1 . • JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT REFUND REQUEST/POSTING MEMO DATE: 11/1/14 The amount of: 524.90 received from: EVERGREEN DESIGN BUILD for(case#): BLD14-00368 is to be refunded to: EVERGREEN DESIGN BUILD IT WAS DETERMINED THAT THIS CASE SHOULD HAVE BEEN ENTERED AS A REMODEL- NOT AS A CHANGE OF USE PERMIT. as a result of: Date & number of original receipt: 10/13/14 RECEIPT#151626 REVENUE FUND CODE NO. REVENUE SOURCE NAME AMOUNT 001-250-000 369.90.00.0000 BAD CHECK FEE 127-000-010 346.23.11.5200 WATER AVAILABILITY FEES-EH H2O 127-000-010 346.23.11.5400 DCD BLDG REVIEW-SEPTIC 158.00 127-000-010 346.23.11.5800 SHORT/LONG PLAT FEES 143-000-010 322.10.00.0000 BUILDING BASE & INSPECTIONS 143-000-010 322.10.10.0000 BUILDING PERMIT RENEWAL FEE 143-000-010 322.40.80.0000 ADDRESSING FEES 143-000-010 341.60.00.0000 DUPLICATING SERVICES 143-000-010 341.75.00.0000 SALE OF MAPS& PUBLICATIONS 143-000-010 345.70.00.0000 DCD TECH ASSIST FEE 143-000-010 345.81.00.0000 SUBDIVISION APPLICATIONS 143-000-010 345.81.20.0000 SHORELINE SUBSTANTIAL DEV. PERM. 143-000-010 345.81.30.0000 CURRENT USE TAX ASSESSMENT APP 143-000-010 345.81.40.0000 ZONING APPROVAL APPLICATIONS 366.90 143-000-010 345.81.60.0000 CONVERSION OPTION HARVEST PLAN 143-000-010 345.83.00.0000 PLAN CHECK FEES 143-000-010 345.83.10.0000 FIRE MARSHALL PLAN REVIEW 143-000-010 345.89.00.0000 SEPA/ENVIRONMENTAL REVIEW 143-000-010 345.89.00.0143 PERMIT SCANNING FEE 143-000-010 346.22.30.0040 DCD WATER REVIEW 143-000-010 389.40.00.0000 CASP- NON-REVENUE CUST DEPOSITS 180-000-010 322.40.40.0000 MISC APPLICATIONS& PERMITS 180-000-010 322.40.50.0000 RIGHT-OF-WAY APPLICATIONS 180-000-010 343.20.10.0000 DEVELOPMENT REVIEW FEES 650-511-000 386.00.00.0000 STATE BUILDING CODE FEES TOTAL REFUND 524.90 "' Authorized person signature: Treasurer's check# Date: Treasurer's signature: • • Sally Ellis From: David Cervenka<evergreendesignandbuild @yahoo.com> Sent: Saturday, November 01, 2014 8:16 AM To: Sally Ellis Subject: Re: Tim Green permit status Sally, Thank you again for your help with this project. It doesn't really matter to me how this permit is routed, and a green light on Monday would be very nice. Also, is there any status as far as the Septic permit, and do you know if the building permit for the proposed new residence has been OK'd aside from the septic permit? Also, do you know an approximate timeline for getting those permits? Again, thank you for your help and replies. David Cervenka On Friday, October 31, 2014 2:17 PM, Sally Ellis <SEllis @co.jefferson.wa.us>wrote: Dear David I got your voicemail- thank you- In fairness- Frank Benskin is not in our office on Friday, so I should wait and speak to him on Monday when he returns to our office-to ensure he also agrees that this permit should have been taken in as a Remodel- vs. A Change of Use. Once I have spoke with Frank I will let you know how and or if I should do a refund. I appreciate your patience and understanding. I do believe either way- this permit should be ready to issue by Monday. I will call you as soon as I have figured it out. Thank you and Happy Halloween! Sincerely Sally Ellis Jefferson County DCD Permit Tech. From: David Cervenka [mailto:evergreendesignandbuild @yahoo.com] Sent: Friday, October 31, 2014 7:49 AM To: Sally Ellis Cc: timr2green @comcast.net Subject: Tim Green permit status Sally, Thank you for your quick and informative replies. However, I am curious why the pole barn "Change of Use" permit application is waiting on the septic approval, since the pole barn was initially approved for construction over twenty years before the property even started designing a septic system, and it will not be hooked to the septic system anyway. Also, my understanding was that the violation at the pole barn (which we have tried to address through the Change of Use permit, as advised by your department) needed to be resolved BEFORE the septic could be approved, according to a letter we received from Randy Marx. This is somewhat contradictory and confusing to us. As you well know, we are hoping to resolve the violation as quickly as possible, and hoping to move forward with the proposed building and septic system. 1 Thank you for your help, • • David Cervenka Evergreen Design and Build (360)-774-0908 cell 2 ' . . ���y �� ���� • �� Sh.0 La d hC1-1L,Q 1902..,r1 4-0., ey) ui a4 CA.... tre_tvAocte. .... ily cj36,6,,(00( cosf .1 500' --PJ,b Pee ' ,s s to PIC-ry k/ ik5-iorneef- 1A-44 Cila&cu 43r collo . 1,e, .,..., . ,,,...: .,l1 Cliculc . of u„5-e LA Sip ,S Li -€C) ` ~A _�. _ --_______'_______-__ ‘.,i lit Or. P_6 9- C'L a e di' . trO diA.e, \.,,j kAf.) a.) 0A:f i/0 nof u all/ wk a Lc, czn9c , ct cl)cuics,,( oF Lug-Q p-w f_vvie __ laQ.Q.J.,) ,,Q.JIA-lei ect co a , v-Qmodcl viy,1/44.1-4...._ .4"- . � - -.:r > O • O • P O < „ C O C C C O O O © cl C C C C O C ..� .� O d' = 614 X d J , V w w w w 003 ? � � G � G (/) W ` G G G G 0 C7 u 'v^ Z z z z z z z z m w ❑ it Z k 4.' N N N N ■z.■ C7. .. ' ,-. ,-, ,-. ^" Gz7 W 0 rg a> O 0 O 0 i.cs - o O o 0 N N N N ;Sy 00 GS - 0 ' - Cr M ka A y Czt U O O' h o Tr cn 69 u d 4 fJ, O t !" b 0 V to w chi [i b b 0 0 W aQp. • p ' g o i m A: W' 0 0 � cr) t°11 . O' o 0 0 do _ M N V' vp ..1 N : N, L csk rn ON N d' W cr —, —k M_- M_ M M _ ,: O o O. G: v ..:t. v f ..W N N. N N U • S • 111312014 SRE MAN Review Type:, 41. Ploject: ..,,,..,,,, L PERMIT TO REMOVE ALL PLUMBING TO a sTING POLE BUILDING CH A 4-::-:-,-1, ',,---:-.„ -,,--,,:,, ,',:).,-;,,,,,,,,,,:-,4,,es:, EE)JS11N . , ., _„.,.. , .,1-..,,,...1. , 4.,..',,i,,,=?•"if,".,,:',,t,t',..,,'p,2',.::-.,,'=„44-=;=.2-',", ".‘.' .,........ •felkssociated w-th 6..014ah,.. 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II*T, Change of Use or Occupancy 32 10.03 5456.00 50.00 1011312014 11.40:58 ORE ,!tAvo:#01,,,,-,-1,44 -,..',,,,,,,m,,::,,t,,,,,$1,-,,,,,w net f Samirg Fee 34S.89.03.0143 019.00 50.00 1011312014 11:40 58 ORE '''!'''-'•is'".4-t'F4'.'1.15,4,t . 0-, ,',,ki-wel.', ,..1',..,--,?•:.,3,V,k1,"; ,,V,-*.;1,,:1'....,-; ,==,.47,..,=, ..,,:v„v.,,,,,,,,,==4,-; State Euidilg Code A cc 54.58 50.00 101124'2014 11 40 58 ORE ...,4,i.:.,.„7:i''',,kge14 :i&r.,..,*,...q *1 4T4-4,,A1`k4-1-15,-.*f4":,;,?,),,,i14-}-,iii taied lb .litlm.sAl ,:,714.4.4;rAomitfoit,41 ,,,,cctqw,A1;1 k-,--a,-4,-,,3',4m,v,;-4.....04.kze,:;;..,,,,4 wii,„;.2-z,,,,,,,.: ode E4 '"4,41014-4114 ,,-4A,4*,,,,,,,,0:4• 4,4„,,,y,L,2-,,, Cancel] Off4(1",4444t71,174Vittiti4`-feg41, nafyP.:1 ',•7.k.T.''AZ"'''':*04141iTIf:''''''t,'‘''..'i''-'N , . 4.714,-,nokkAN:•,:nio.*-tett,44-,VV*1 "4PW' kV , ..4.',•''''04-,,0144.. ,t,fwmite;.,„"*.iir,t.tzi_,!,..v., ,-,7:,,A,Wv4P...k?.t.k.'4Vt.,*050440nv,Sf:TiIite -ir.e441.!--...: ::4Fv.,,v4:‘,:?,.4,.---z,;,Vv:.,-.4„,.,,,,.,,,,,,,p4y.m.;,• ', --nrfv4:•-tio,-,itt,;,,.%.,w,,,,,..yw,kfg,,,ia,,f, -,,......— o. , .4,4...F.4 eiC itel 104,ilk..'il:41=4;:tgAriek:8.A4•44,41(91.4.1 ,44‘Atg = i",„ trill tit,O,WA=0:41''A,:ititae&ifteflit,flg441..,' alleig'ig iiiligt:7::AI,Y.g.fcifiStatigtOrtC1A.i,` itot114 - iigMlb'Olii.11-41tialfilViAii 6 Associated fees C Paid history Totals: S637.50 $0.00 I A.411:4 1 1 1 4L,1,404.014,-,*,-.1•44,.,.,. ,.:-.`:4"tfRItliwiFA'''4-gt.;41;* 4 ---•a5,1-1,'-4.,W,, ,--A:',-..%,„:,--1:-ArlYq;').04,m..,.. -.A.„, 4;ili:V1.!..,5,,7 ,':; ,*,,,44 titge.t:%'PV,144.triVt4W.!""4,MSTY4til .2i ;,litittittliliti%tiARikilf; ::;:,it: ':.114...,1f,•:>:?0, 44,!=tti..... I i At..74461',k'..‘::kkgii•'1Vi*°11;4,4,7',„*A.'`",',!-..t. 9C4 , 10 t 1 LI '(;)11? r<142 4713Lin(I - - -, (G. -- 't e r‘(.171€-,. 1 -- - - : i C , kLi-(-1, .1.- `--) 4----1 r,„,4- C c ":„t t--1 L , i . , _.. C4 C, r")..., i 1,, , 1 - 1 ke‘-t CAX-f-et 1 / ON 0,06. JEFFERSO•OUNTY *DI q (3(,,.P) e. ,s� r� DEPARTMENT OF COMMUNITY DEVELOPMENT _ 1 L.� '" .: ` '4 621 Sheridan Street • Port Townsend • Washington 98368 4. — 360/379-4450 • 360/379-4451 Fax �q p'ti www.co.jefferson.waus/commdevelopment AIN� Master Permit Application MLA: Pro ect Description(include separate sheets as necessary): �,rC�U1'l 10 5Unk S 4' use. St? le COAA 111-3Gr '�,�u Nu_ w ra we.. ._ - Pt2FJU I r tn0 Tax Parcel Number: 801-O 1 002 Property Size: 20 . r (acres/square feet) ue Site Address and/or Directions to Property: ` 7tI i i A6t,.t.1-1(9vl. r Ili. ' TbRT ri'DwN5` 1„�9> W,/� l el b S Property Owner(s)of Record:- `�I H 1,c L) Telephone: J-2 3 1 1 3 -'63747 Fax: email:-Ii,rvNV'25cet'cors.c i .Ytet Mailing Address: Applicant/Agent(if different from owner): kAvlh 6Ek\relivtA, Telephone: '60 771i -ISO$ Fax: email:ever �oke. Mailing Address:i �110v1.7r Rb PT- wA ge3b8 ,A‘►op.co,� , t . What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) O Single Family ❑ Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home .❑ Mcdulat • ❑ 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** 0 Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** O 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/Lary•'• tic Et ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Mat I a*gra ;i•n:,l:i rriS ji *May require a Pre–Application Conference ❑Tree Vegetation Request I i – **Re.wires a Pre-Applicatrp]r Conferences Please identify any other local, state or federal permits required for this proposal, if known:QCT 1 3 2014 (II l DESIGNATION OF AGENT r_i r r d COUNTY I hereby designate 1>b<V1 I> C.,, ,..-k\f E WC, to act as my agent in matters relating,to th is-pp M99!StP rtiM T OWNER SIGNATURE Date: 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 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 A i • . later inspectio' Staffs -ccess and ••• of entry will be assumed unless the applicant informs the County in writing at the time of the apiefig • he or sh: a is . for �otice. z, Signature: - = . / _ Date: 10 r I-�.– f 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 applicantlhat 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 p County development code.The Applicant acknowledges that he,she or it holds individual action(s)even if -.0 a - in com lia..: with the Jeffer Co and non-transf-iale r' ••nsibili for adhering d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Date: 1-5— I V Signature: r 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 the responsibility of the General Contractor for the proposed project. Signature: Date: G NERAL CONTRACTOR 0 MANUFACTURED HOME INSTALLER: PHONE: /t FAX: AILING ADDRESS: 0 1 1�u 1 1) J �"'I i'i> ( ) 771 -P'o: ( ) `ho0 94<bi z.viovoi-- Pip. )Pr. ) 10 j EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: eke=-A��goi L1L NUMBER ARCHITECT/ENGINEER: �` 7 PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New 0 Wood Existing: C Addition ` Sewer Steel Proposed: Bank U Community System e m Alteration/Remodel U Concrete Total: Height: ❑ Individual System Repair U Masonry SEP Permit# I y -1 03 U Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: pp y: Type of Heat: Proposed: ❑ Private well Two Party WOCCt Si 0u-e_. Total: ❑ Public 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 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 1 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: 2"d Floor Heated Consistency Review: - Other Heated CA ►- P c USE �J bV Base f : Mezzanine A ien0l3ecItisn: — Heated Basement - SCAts 1 UU Plan Check fee: Unheated Basement , State Surcharge fee: ,_ y - so Other Unheated. -- — — -- Pot Water Review fee: -- Garage/Carport SUBTOTAL -- Decks 911/Rd Approach fee: Other — TOTAL: $ �.co Receipt Number: 1 5 402 w r _ Cash/Check Number: S'2._S'2._ ESTIMATED COST(REQUIRED) Date: -Fair market value of all labor and materials foundation to finish , �/I a✓l� Initials: 62 ,. (:•\FPr,„;,C,,,„\ffj,6 R(1R\iCNNHlrior\c,,n.rr,.- ,...._, f 4�w¢s°N q JEFFERSON Y ELb v L DEPARTNT -©2 OF COMMUNITY DEVELOPMENT N1��� v ; 621 Sheridan Street I Port Townsend,WA 98368 Web:www.Co.Jefferson.wa.us/communitydevelopment ys4,1NGo� Tel:360.379.44501 Fax:360.379.4451 I Email:dcd @co.jefferson.wa.us Building Permits&Inspections I Development Consistency Review/Long Range Planning I Watershed Stewardship Resource Center LIFE I FIRE AND CONSISTENCY REVIEW APPLICATION Please check one: dlit CHANGE OF USE L1 REVIEW SITE ADDRESS: 71 t ' Lr--Mpvir` aCl?. t �', I 5 ' ZIP CW45 OCT 1 3 2014 il 9 DIGIT PARCEL ID NUMBER f30 1 —094 — 001 ; it Legal Description: 3 „TY Subdivision Name A I Q 721 e Block )f,iri DFF s� tt�� Loi J�LQPm r,'T , Section Township - 1'1 North, Range I ' J WM —_ APPLICANT >WU> VVI4tiLf PHONE 774.- 0908 MAILINGADDRESS 226o Aati-10 i PP, 'rORT iD1niN`c , NAJA ,. ZIP 95365 PROPERTY OWNER tA (AkE u PHONE '°JO'7-2- -637 6 MAILING ADDRESS I Sod As'PrLwOO i> 'R LAw. oaP1 CO ZIP 50Z-1 Z 821 CURRENT USE(S) PE-CI"l t' T .-);› 1"121, 15Ut l L>I Nib (;) _ 19 7 R tc-vE 511vit wA"nE R-v5 t - SHowR i p ROPOSED USE(S) �1"D Vto,A`n Q� CD ti- i R6RIJ D STOPkb /VTJ U'T( r APPRo'1 c:ts- i N& nvF Y SEPTIC PERMIT NUMBER IBC OCCUPANCY IBC TYPE OF CONSTRUCTION Classification Classification NUMBER OF BEDROOMS NUMBER OF BATHROOMS WATER Lip "yJi .R ''ro 'tA1,l IJ'& PROPOSED 0 PROPOSED O ❑ Public Water �� G�ztrth EXISTING 0 EXISTING 1 ETD kF Route ❑ Private Well TOTAL 0 TOTAL ❑ 2-party Well EXISTING#OF PARKING SPACES PI/A #OF HANDICAP PARKING SPACES 1.ili. CURRENT NUMBER OF OCCUPANTS(includes owners, PROPOSED NUMBER OF OCCUPANTS(includes owners, tenants,employees,etc) tenants,employees,etc) CURRENT TOTAL SQUARE FOOTAGE(includes decks,porches,outbuildings,shed...etc) 1.11 b PROPOSED TOTAL SQUAR •STAGE(includ-: 'decks,porche. .>*.uildings,shed...etc) 1 7 1.b -C+--t APPLICANT SIGNATURE' • DATE 10 / 13 / C 1 o{"k 'C � J FOR• USE ONLY VIEW $___I+ '�-iJ F� I5Itez BAS FEE l�p � RECEIPT# cp STATE SURCHARGE 4.50 CASH/CK# ` 1. n:9 l cC.>)7J i TOTALS�� 1 DATE `O / 13/ Lac ''° • (4SON co G JEFFERSON COY • !� DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitydevelopment 9sk Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd@co.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center LIFE 1 FIRE AND CONSISTENCY REVIEW CHECKLIST A COMPLETE APPLICATION CONSISTS OF: MASTER PERMIT APPLICATION. Must be signed by property owner of record. FLOOR PLANS. One floor plan showing existing structures and uses. One floor plan showing proposed structure and uses. THE SITE PLAN. Please include all information requested on the site plan checklist. If the size of the site plan is larger than 11"x 17" you must provide us with 7 copies at the time of application. We cannot copy documents larger than 11"x 17". LIFE I FIRE AND CONSISTENCY REVIEW APPLICATION. The application asks for number of employees, number of bathrooms, number of parking spaces, square footage, heat source, and water source. Please sign and date. LANDSCAPE PLAN. Please include location and type of signs, vegetation, parking spaces, including handicap parking and route of travel. PRE-APPLICATION CONFERENCE.The Development Review Division will determine if your project requires a zoning permit or a pre-application conference. This may be accomplished by phoning the Planner of the Day. PERMIT FEES. Payable at time of application. Parcel Details 0 1-'age I or Z 4 ,al ' -:;:r. . erson County I __,_, , ... ,:,,,,,,-,,.. ,:;,3ii,„ . , :ff_.-:1->�._,�._ - - ,sue. Home ': County Info Departments _ Search Parcel Number: 801054002 SEARCH Parcel Number: 801054002 Printer Friendly Owner Mailing Address: TIMOTHY GREEN 1805 APPLEWOOD DR LAKEWOOD C080215-2521 Site Address: 3744 EAGLEMOUNT RD PORT TOWNSEND 98368 Section: 5 School District: Port Townsend (50) I Qtr Section: SE1/4 Fire Dist: Discovery Bay (5) Township: 28N Tax Status: Taxable Range: 1W Tax Code: 0151 Planning area:South Chimacum/Inland Valleys/Center (6) Sub Division: Assessor's Land Use Code: 8800 - Designated Forest Land Property Description: S5 T28 R1W TAX 14 (INC PTN IN S4) BND TGTH THRU BLA#107248 Tax,A/V,Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Survey Septic Monitoring Info " i i Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH ; Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac l [--- Enic-z- [ vE -) 6 ' . \, ,LI ---- --' kALP0-4 .-- e2-- k i ' OCT 1 3 2014 1 J;: ), 0!i'TY Cases Associated with a Parcel Page 1 of 2 • • 4 I Jefferson C ount -- 4. - Home County Info r-Departments Search Cases Associated with Parcel No: 801054002 This may not be a complete listing of information that exists for this parcel. There may be other information pertinent to the property on file. Please contact the Department of Community Development for additional information. Case Number BLD14-00352 Description NSFR WITH ATTACHED GARAGE, NO HEAT OR PLUMBING IN GARAGE PROPANE TANK Last Name GREEN Received Date 10/1/2014 3:27:07 PM No Images Case Number SEP14-00103 Description Last Name GREEN Received Date 8/1/2014 12:48:30 PM No Images Case Number USR14-00013 Description Last Name GREEN Received Date 4/21/2014 4:24:07 PM No Images Case Number SUB05-00050 Description Boudary Line Adjustment Last Name FOX Received Date 10/31/2005 No Images Case Number % BLD93-00197 Description pole building Last Name MURRAY j/ Received Date 4/6/1993 No Images http://www.co.j efferson.wa.us/commdevelopment/ppquery/cm.asp?value=801054002 10/13/2014 • Sally Ellis Subject: David Cervenka Start Mon 10/13/2014 9:00 AM End: Mon 10/13/2014 10:30 AM Recurrence: Weekly Recurrence Pattern: every Monday from 9:00 AM to 10:30 AM E CLEOVIE r .) Organizer: Mary Blain OCT 13 2014 ,L David Cervenka Evergreen Design and Build ':RSUN WUNTY 1:UNITY DEVELOPMENT Change of use permit eir\OLAT of- use Cee Name of Appt person: Phone Number: Name of Property Owner: cee 1,5?) °I) Parcel Number: Address, if applicable: (n * ()() f Project: (NSFR,SPAAD etc?) ;, ee__ Si-ct-te co TD at\A - 0,0k - Wtkp voyer-11 owner s deal Lui coikki - B9 0 Pp e \c pfivvvii unclex `tif›)3 10eCo,frre 0\c -ilor‘ CoN,i _-6c1 _ n - rreoloos owner ptciciecl iiL V 44\Arcorie\- tirEtt v \Nj cc,\373,1e 6 0,0 On IS ro/koocl all wavkAc - Sint 40 WIArcoriA- keePil \Nocd o - 1 Print • 1lttps://us-mg5.mail..o.comineol1aunch?.rand=6cOnt gJ:adforn#2 .. Subject: application authorization From: timr2green @comcast.net(timr2green @comcast.net) To: evergreendesignandbuild @yahoo.com; Date: Monday, September 29,2014 7:06 PM To whom it may concern: I, Timothy R. Green hereby appoint David Cervenka of Evergreen Design and Build as my authorized agent for the purpose of filing applications for the building of a proposed single- family residence on my property at 3744 Eaglemount Road, Port Townsend, Jefferson County, Washington. Timothy R. Green 303-238-6376 timr2green@comcast.net • :17-2)", r.-'-_- ff .. J \---, ,---:-,,-,_, , , ,V E \ 4 OCT 1 3 X014 1j` r V 1,,Ylw1),i OPM T 0R0/2014 9:56, Evergreen Design and Build Page 1 of 2 • Washington State Department of Labor & Industries Evergreen Design and Build Owner or tradesperson 2260 Eagle Mount Rd Cervenka, David PORT TOWNSEND, WA 98368 360-732-0428 Principals JEFFERSON County Cervenka, David, OWNER Doing business as Evergreen Design and Build WA UBI No. Business type 603 037 431 Individual License Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. EVERGDB901 NS Effective—expiration 08/10/2010—08/15/2016 Bond CBIC $12,000.00 1 LE Bond account no. ' � SI7086 Received by L&I Effective date OCT 1 3 2014 08/10/2010 08/09/2010 Expiration date Until Canceled 'L f1r,RT,DE FI gpMENT Insurance Contractors Bonding &Insuranc $300,000.00 Policy no. C11 517086 Received by L&I Effective date 06/23/2014 08/09/2011 Expiration date 08/09/2015 Insurance history Savings No savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603037431&LIC=EVERGDB901NS&SAW= 10/13/2014 Evergreen Design and Build Page 2 of 2 Lawsuits against the bond or save No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 198,546-00 Doing business as EVERGREEN DESIGN AND BUILD Estimated workers reported Quarter 2 of Year 2014"Less than 1 Workers" L&I account representative TO/CAROLYN CRAWFORD(360)902-4715-Email: CRA1235©Ini.wa.gov Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept.of Labor&industries.Use of this site is subject to the laws of the state of Washington. Access Washington* {414 ¢;;gg d'e'0.tif4iiP!#aYP Wi,ks https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603037431&LIC=EVERGDB901NS&SAW= 10/13/2014 Print http s:il us-mg5.mail.yahoo.conl'neo!launch?.rand=6e0rnsAc2df6m#2... Subject: application authorization From: timr2green @comcast.net(timr2green @comcast.net) To: evergreendesignandbuild @yahoo.com; Date: Monday, September 29,2014 7:06 PM To whom it may concern: I, Timothy R. Green hereby appoint David Cervenka of Evergreen Design and Build as my authorized agent for the purpose of filing applications for the building of a proposed single- family residence on my property at 3744 Eaglemount Road, Port Townsend, Jefferson County, Washington. Timothy R. Green 303-238-6376 timr2green@comcast.net r�- / f 9/10/7014 9:56. Sally Ellis From: Stacie Hoskins Sent: Thursday, October 09, 2014 3:39 PM To: Charles Law Cc: Sally Ellis Subject: RE: MLA13-00050 Building permit Hi,Charlie, Great! So glad to know you're making progress. Given you're submitting revised building plans,you'll need to make an appointment with Sally Ellis,our Permit Technician. She can assist you with any new fees or building requirements for your revision. I've copied Sally with this message to connect the two of you. Best regards, S Z. l b/1-b/1 L4 -- Planning Manager,Jefferson County Department of Community Development 621 Sheridan Street * Port Townsend,WA 98368 Phone 360-379-4463 * Fax 360-379-4451 shoski ns g co.jefferson.wa.us Jefferson County DCD Mission: To preserve and enhance the quality of life in Jefferson County by promoting a vibrant economy, sound communities and a healthy environment. All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. From:Charles Law[mailto:chas-law @live.com] Sent:Thursday,October 09, 2014 3:25 PM To:Stacie Hoskins Subject: RE: MLA13-00050 Building permit Hi Stacie This is Charles Law and I am nearing completion of my revised building plans and would like to make an appointment for the week of October 20, 2014 for submittal. Is that something that will work for you. A Monday works best for me. From: SHoskins @co.jefferson.wa.us To: chas-law @live.com CC: ZLamp@co.iefferson.wa.us Subject: RE: MLA13-00050 Building permit Date: Wed, 16 Jul 2014 21:32:47+0000 Hi, Charles, I've extended the time to submit the requested information for MLA13-00050 another three months through October 12, 2014. Once you provide the additional information we'll assign your case to a new planner. Best regards, Ste lea Z. qedead Planning Manager,Jefferson County Department of Community Development 621 Sheridan Street* Port Townsend,WA 98368 Phone 360-379-4463 * Fax 360-379-4451 shoskinsAco.jefferson.wa.us Jefferson County DCD Mission: To preserve and enhance the quality of life in Jefferson County by promoting a vibrant economy, sound communities and a healthy environment. All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. From: Zoe Ann Lamp Sent: Wednesday,July 16, 2014 8:19 AM To: Charles Law Cc: Stacie Hoskins Subject: RE: MLA13-00050 Building permit Charles, It's good to hear from you! Hope you and Rosemary are well and you're enjoying Summer! A few weeks ago I accepted a position with the Public Works Department so I no longer review permits in Community Development(DCD). Stacie Hoskins, Planning Manager for DCD, is cc'd on this email so she can forward your message to the planner who has been assigned to your case. Best wishes and hope all goes smoothly with the new house design and construction! Sincerely, Zoe Ann Lamp,AICP Transportation Planner Jefferson County Department of Public Works 623 Sheridan Street,Port Townsend,WA 98368 Ph:360.385.9162 Fax:360.385.9234 Email:zlamp @co.iefferson.wa.us Web:www.co.iefferson.wa..us/publicworks From: Charles Law [mailto:chas-law()live.com] Sent: Wednesday,July 16, 2014 7:03 AM To: Zoe Ann Lamp Subject: MLA13-00050 Building permit Zoe Ann I have not quite completed the new house design. I am going to need a bit more time to finalize the plans. I do believe I have a design that will satisfy our unique requirements. It's just a bit more involved than I expected. 2 Thank you Charles Law 3 Jefferson County Building Division Permit Number: BLD14-00368 Applicant: GREEN BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next 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 Miscellaneous ' fy 1 V� remove sinks WH tub shower Septic System Finaled ` iv ! THIS PERMIT SHOULD HAVE BEEN TAKEN IN AS A REMODEL- TO REMOVE ALL PLUMBING TO DESOLVE COMPLAINT# COM14-39 A final inspection will not be scheduled until the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION ti‘\ 6 \(.// FINAL INS C ION M ST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD14-00368 1.) DWJ 2.) The project shall adhere to the Best Management Practices(BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 3.) The site plan as submitted with the Building Permit application on October 13, 2014 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated November 3, 2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. \\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 11/3/2014 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00368 Received Date: 10/13/2014 SITE ADDRESS: 3744 EAGLEMOUNT RD Issue Date 11/3/2014 PORT TOWNSEND, 98368 Expiration Date 11/3/2015 OWNER: TIMOTHY GREEN PHONE: 303-238-6376 1805 APPLEWOOD DR LAKEWOOD CO 80215-2521 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801054002 Section: 5 Township: 28 N Range: 11,11 CONTRACTOR: EVERGREEN DESIGN AND BUILD PHONE: 360-732-0428 DAVID CERVENKA 2260 EAGLEMOUNT RD PORT TOWNSEND WA 89368 PROJECT DESCRIPTION: REMODEL PERMIT TO REMOVE ALL PLUMBING TO EXISTING POLE BUILDING CHANGED TO HEATED SHOP/STORAGE PERMIT EXISTING WOODSTOVE. TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION ADD'L: HEAT TYPE: WOD 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: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Change of Use or Occupar $456.00 SRE 10/13/14 151626 Exist: 1 Exist: 0 State Building Code $4.50 SRE 10/13/14 151626 Prop: 0 Prop: 0 Permit $54.00 SRE 11/03/14 151626 Total: 0 Total: 0 Plan Check $35.10 SRE 11/03/14 151626 Refund-Change of Use or -$456.00 SRE 11/03/14 Total: $93.60 Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE ATTATCHED AIIIIII 44,,-ON °OO JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT A M / ,,,,,„,,.., 9'rHI N 6C Date: PP Time Received: i;2-1e am& Mon. Tue. We . Thur. Fri. ,! Date: ii / 6 BLD: 14 -- '3 4,a Contact Name: Owner: GeEeo Contact Number: 360 7 711 Of o 1, Address: 3 7 Q-4 1:-7 M(e-lur kb 206 Notes: ° ��1�s K I u Foundation Plumbing . Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Q1,,,.4 2, Tiles Ceiling