HomeMy WebLinkAboutBLD2012-00126 THIS BUILDING IS
NOT FINALED .
THIS IS AN INCOMPLETE
BUILDING APPLICATION . THE
PERMIT WAS NEVER ISSUED .
.�`� MLA12-00088
SJILDING PERMIT APPLICA I1�N Review Type: 1
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD12-00126 Received Date: 4/19/2012
SITE ADDRESS: 141 PARADISE COVE
BRINNON, 98320
OWNER: THOMAS BACHHUBER PHONE: 50-666-9642
MARGO BACHHUBER
17935 SE CHELDELIN RD
GRESHAM OR 97080-3338 PARADISE COVE
SUBDIVISION: Block: Lot: 9
PARCEL NUMBER: 983700006 Section: 29 Township: 25 N Range: 02 W
CONTRACTOR: TK DESIGN BUILD PHONE: 425-785-1246
PO BOX 3385
BELLEVUE WA 98009
Contractor's License TKDESSB915N8 Expires 8/28/2013
REPRESENTATIVE: ALAN JAMES PHONE: 360-531-1347
111 CHINOOK DR
BRINNON WA 98320
PROJECT DESCRIPTION NEW DECK, STAIRS AND ROCK WALL
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 5,255.00 ADD'L: HEAT TYPE
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 192 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0
Routing D.. e:
' -1q-0
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $125.25 LYK 04/19/12 131657
Plan Check $81.41 LYK 04/19/12 131657
State Building Code $4.50 LYK 04/19/12 131657
Total: $211.16
,SON co JEFFERSO�OUNTY •
1.:i- ' DEPARTMENT OF COMMUNITY DEVELOPMENT
'� 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
qS," p'� www.co.jefferson.wa.us/commdevelopment
SIN
Master Permit Application MLA: 1 a-gs
Project Description(include separate sheets as necessary):
)J S YN TI-E ri 1 C. °f e l< A00171.010 & x 29,`
Tax Parcel Number:1"P(V c 3 7 CO 00 fo Property Size:r1(�`3 A '�O'7$o' (acres/square feet)
Site Address and/or Directions to Property: •
1i-i 1 PARAD1 St COUE BKtiOVoAJr 1 'A �Qg3Z0 CSI' HCAJ)'101 WATER 9E t-G'P 313
Property Owner(s)of Record: TOM MAR GO 5A C 1-l\-W 132 R.
Telephone:(CO 3) 66 6- 'P 6AZ. Fax: email:
Mailing Address: 1 '74135 52 , CI4ELOELiA) R17: 4Rf$(-1AM) OR, eV/ORO - 333F1
Applicant/Aaent(if different from owner): ALAN l . :TA M'lE S
Telephone:(e 0)5 3 1 " 1 3 4 '7 Fax: email: a fl l"tre'.SdeS e(ko4 06,sw--
Mailing Address: lit CA 1NOVt! 0R . 6k91.100N1 WA, Qg3ZO
What kind of Permit?(Check each box that applies ❑Lot or Road Segregation
Building ❑Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor, Major or :--sonable Economic Use)
❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(• l-o C
❑ Manufactured Home .❑ Modular • • - ❑ Discretionary"D"or Unna, `4 fi ;o� V E
❑ Commercial* ❑Special Use(Essential P tic acl i ies
❑ Change of Use ❑Boundary Line Adjustme '
❑ Address ❑Road Approach ❑Short Plat IIII
❑Home Business ❑Cottage Industry ❑Binding Site Plan** ' I I ° A � 2012
❑Propane ❑Long Plat** u U
❑Sign -.. - ❑Planned Rural Residents I Deve•• ..-,, --• . ii-..i - *
•S
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration L DEPT • ON COUNTY
❑Stormwater Management ❑Shoreline Master Program Exe • :-4'-, 1 94 1'„ &YAM
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development**
0 Temporary Use 3 Shoreline Management Variance
❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference ❑Tree Vegetation Request
**Requires a Pre-Application Conference
Plode", idertlifq ally otlri.rlocal,atdtc'vt twit-rdl patrnits r■.gaticu fur ttrt*ptopftal; it'r nown.
DESIGNATION OF AGENT
i hereby designate A LA!) /3, ..TA l'f L$' to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE ' � Date: .31 C t I t &
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. Staff's 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 e.teivarits prior notice. i
Signature:.?C Xo a .�.L_ r. Date: l \ i ` I
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 lake"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 responsibili r adhering to�n d complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: i d c- . L, Date: L'ICI l i . ..
G:\PermitCenter\###FORMMS####\\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
-110.. - - BUILDER STATEMENT •
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
T K Ogs► 4 &//HIED . (425) g c' Da 5-4 ( )
MAILING ADDRESS: 3 VI pULALT Pr' RDA() EMAIL: 7-K 0614D J3c}/L00 4MMLeCLOr1
CONTRACTOR'S LICENSE _U n q WAINS
NUMBER: 1k q I.7 ter-A) S NUMBER
ARCHITECT/ENGINEER: iQrl}�R I1V 8A (LE�( 'T- 1 PHONE (56D)45j2,- ' R( FAX:(;6p) 4cz �4 Ig
MAILING ADDRESS: '71'7 prjl-gof : PT Ak 's 1jjA J EMAIL
9'£362
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
0 New tiI Wood Existing: ❑ Sewer
'E Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: 1d Individual System
❑ Repair ❑ Masonry (2.' SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
5yvm. Deeiew4 c Existing: Setback: ❑ Private well ❑ Two Party
Type of at: Proposed: .- a vf Public
, Total: Name of System:MPA D l5
COtl L a/A--rift '51/51--
If this is a Commercial Project you must an swer 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 / 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.
t
Square Footage Current Proposed R*Offiqe Use filly -`mount Revision .
Main Floor Heated '` EH Bld App Review: /
•2"0 Floor Heated - . _ Consistency.Review: �
Z 2._Z
•t er "ea e• :ase ee:
i 5 2
- Acktfenwerier--..„1-
Mezzanine 0
Heated Basement Plan Check fee: ' [,r,
Unheated Basement State Surcharge fee:
if S p
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL O 2-?`,
Decks g. i i Z.1 1 VI,Za ' ; _, 911/Rd Approach fee:
Other TOTAL: $/o 2:7 r/1O
Receipt Number: 131(051-r
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: ��(�
(air market value of all labor and materials foundation to finish _I
q 5'bO Initials: /Z
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from. the toe of step returning to watt or post.
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STAMP LIMITATIONS },
NTI Engineering and Land Surveying
has performed vertical and lateral iF j 2
TTIMED��OLtND.4TIONINSPECTION
structural analysis for plan sheets 1 and PROPERTY LINES MuSTSE MARY-ED gY ►�
2 provided by Alan B. James. This Deck \NE R. 6 STRING LINES TO VERIf:YSET&Ar-V- . _
�F w/{ q� IF PROPERTY LINES ARE NOT MftRK-6D fk
is to be located at 141 Paradise Cove, F m o %� REINSPECT,ON FEE MAY SE REQJ.tIRED
Brinnon, WA 98320, Section 29, O PRIOR TO ELIRTHER INSP6CT10N.
Township 25N, Range 2W TPN
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