HomeMy WebLinkAboutBLD2013-00011 ID
BUILDING PERMIT APPLIC ION MLA13-00008
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00011 Received Date: 1/14/2013
SITE ADDRESS: 821 SHINE RD
PORT LUDLOW, 98365
OWNER: ROBERT A BIRD PHONE: 360-779-2112
MARIE GALLAGHER BIRD
821 SHINE RD
PORT LUDLOW WA 98365-9285
SUBDIVISION: Block: Lot: T 50+
PARCEL NUMBER: 821343008 Section: 34 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP DETACHED GARAGE - UNHTD, NO PLMB (BUILT)
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 50,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 1,080 SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0
Total: 0 Total:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $643.75 LYK 01/14/13 139895
Plan Check $418.44 LYK 01/14/13 139895 APPROVED
State Building Code $4.50 LYK 01/14/13 139895 MAR 1 1 2013
Total: $1,066.69
Jefferson County DCC
\Hirimmnr4\ria+a\forme\R RI rl Ann Rid rn+ 1/1A/11114
CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
Carl Smith, Director/Building Official
PERMIT#: BLD13-00011
SITE ADDRESS: 821 SHINE RD Issue Date: 03/11/2013
PORT LUDLOW, 98365 Final Date: 4/16/2013
APPLICANT: ROBERT A BIRD PHONE: 360-779-2112
MARIE GALLAGHER BIRD
821 SHINE RD
PORT LUDLOW WA 98365-9285
SUBDIVISION: Block: Lot: T 50+
PARCEL NUMBER: 821343008 Section: 34 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: DETACHED GARAGE - UNHTD, NO PLMB (BUILT)
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/16/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 5/22/2013
y p r»-.6 :-. �
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Date /a
time received /.23
am I
Mon. Tu es.
Wed: h
_
Fri.
BLD: i 3 — 1 I 7
Date: 0
OWNER:
t rr(Cs
Contact Name:
ADDRESS: N2) S I f7`D Contact Number 360 27 I L5 7 SD"�.
Notes: STp 206 4
Foundation Plumbing - Framing Propane Tank' • Mechanical
Setbacks Under-ground Framing Underground Furnace
Footing Rough In Air seal Above ground — Gas
Stemwall _ Hydronic Exterior shear X Exterior lines Oil
Straps interior shear Interior lines • Ducts
Post Hole Ventilation
---_. Appliance _
Underfloor Gas/wood stove
Man Homes
Setbacks • Insulation-
— FinalIns Insp ection n
_Foundation _ t s;_ 4,
,,s-
1 to Biock&Te floor -wall ceilin g Address Postd
.DC CONSISTENCY REVoW ' '
Project Planner:
Master#MLA13-00008 Review Type Project Description
BLD13-00011 I DETACHED GARAGE-UNHTD,NO PLMB(BUILT)
Primary: ROBERT A BIRD Site Address:
MARIE GALLAGHER BIRD 821 SH
INE RD
821 SHINE RD PORT LUDLOW WA, 98365
PORT LUDLOW WA 98365-9285
Project Location: Parcel number 821 343 008, Section 34,Township 28, Range 1E, WM, located at 821 Shine Rd,
Port Ludlow 98365
Parcel Number: 821343008 S-T-R: 34-28N-01 E Total Acreage 5
Legal Description S34 T28 R1E TAX 50(LESS PTN TAX 55)TL TAX AS Land Use: 1100
PARCEL B SURVEY V3/PG
Flood District: Fire District: 3 Planning Area: 8
Flood Map(FIRM)Panel No: chool D 49 Zoning: f
COMP PLAN
DESIGNATION:
CO UNITY PLAN: UGA: UGA Trans
[ Plot plan states "property line"
[ Assessor's Map (Property lines bmitted plot plan must match the property lines as identified on the Assessor's 1/4 map)
[ Legal Access to Property NO
[ vr Parcel Tags or Scanned Documents YES NO
[ / ESA's: Special Reports Nearby YES NO
[VK Designated Ag YES r ..
[ vry
Shoreline Designation NO 3�1. ' S c. = c. 4 (4 C L_S(A,rcd ci.l
[ 14 Shoreline Slope Stability: YES NO
Stream Type:YES NO
Fish& Wildlife:YES NO
Wetlands: YES NO
Rare Plants:YES NO
Seismic: YES NO
Landslide: YES NO
0
Flood: YES NO
Erosion: YES NO
Aquifer Recharge Are . ES O •
SIPZ: none At High lsk Coastal
CMZ: none High Risk Moderate RiskDisconnected CMZ
[ Ftormwater site plan su�tted: YesNo
orest Lands: YES •
Adjoining Forest Lands: Commercial/ Rural/ Inholding
[ Mineral Lands: YES OW
[ pr Agricultural Lands: YES •
[1/1 Stormwater: New Impervi. face _ Land Disturbing Activity ESA's
Stormwater Req' in Req#2 Min eq#1 thru#5 Min Req#1 thru#10 ' Engineering
[r J Notice Provisions u sc . e:Al Ort YES NO MRL YES NO Forest Lands YES NO
[ I�Landscaping Required: Yes c)
[�Parking Spaces Rem., 'y-d NO Other
f Building Height: UBC Standard
[V( Impervious Surface coverage percentage:
Resource Lands&Public: 10% Rural Residentia: 25% Rural Industrial: Per UDC Sec 6.7
Rural Commercial: 60% Area of Building age:60%in Rural Industrial Lands only
[ VJ Total Building (s) Size:
RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to ptic&water constraints/None s cified
[ Setbacks: Front: `fZ Left Side: A Right Side: Rear:
Shoreline Setback:
[ VILSHA Setback:
Road Classification:
Road Approach: EXISTING Q'D RAP
[ SEPA Required: YES EMPT
[ Vr Flood Certificate:
[ k"."--Existing Case(s)&Condition(s)-.4
Violations: Yes No
[V Recorded Date of Subdivi ion: AFN Over 5yrs=UDC
Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance
[P-----Lots/Require Declaration of Restrictiv- •venant YE ubmitted: YES NO
[Or GA No Protest Agreement YES ° • .ubmitted: YES NO
[ ite Visit conducted YES NO-
[ }Require Final Zoning Approval YES NO
[ ADMIN: Setbacks entered in Permit Plan case YES
New Parcel Tags entered in Permit Plan � YES
Special Reports Scanned N/A YES
No parcel tags found for parcel
Associated CASES status issued finaled description
821343008
SEP85-00001 F 5/20/1985 8/13/2002 Residence on 821343008,transport line on 821343001 (exact
location of drainfield in relation to property lines is unknown)
BLD00-00224 F 5/30/2000 5/8/2002 SINGLE FAMILY RESIDENCE
MLA13-00008
BLD13-00011 P DETACHED GARAGE-UNHTD,NO PLMB(BUILT)
SOM85-00001 F
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1;sON
. CO3 JEFFERSON COUNTY
1,4 DEPARTMENT OF COMMUNITY DEVELOPMENT
in ` ''4 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
�� 0 www.co.jefferson.wa.us/commdevelopment
biINa ��``
Master Permit Application MLA: 1 "I
P oject DescriptiT(i Jude separate sheets as necessary):
Pine ui -c-tirlh no P.) -
Tax Parcel Numbe . j 3 LODos Property Size: 5, C e9/2_/7, (acres/square feet)
Site Address and/or Directions to.Property:
• n w•. . _ wary
Prope Owners)of Record: g E T' 1124Z)
Telep ne:'Z7(1'Z-/I 2- Inc-. tt-. r IN / E _ email:
Mailing Address: 92t S 41 N ■ s ` ;i Ea '! j_,�j=
Applicant/Agent(if different from owner):_i` i III
Telephone: Fajik I 1 :I email:
"
Mailing Address: ' ,'
t<
hat kind of Permit?(Check each box tha applhes--- r or Roa• Segregation
it
uilding i JEFFERSON COU
DEPT.OF COMMUNITY DE +'' ')Are•s Stewardship Plan
Demolition Permit • - lance inor, Major or Reasonable Economic Use)
❑Single Family Garage Attached - ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home .❑ Modular • - ❑Discretionary"0"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-App licafion Conference
Please identify any other local,state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date:
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
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 applica• n th/t he or she wan prior notice. 2
Oignature: t¢�'� 'mil Date: l2-- 3 - 212-
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-transfer res on biliittyfor ad ering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
ignature: s .' Date: /2.-- 3- Z 2J'-
H « • •
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 assum g the responsibility of the General Contractor for the proposed project.
'Signature: 414z t i '/. ft Date: I.--•c3- ZW:21 2-
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx:
( ) ( )
MAILING ADDRESS: EMAIL-
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: RtCE , f1,z4 PHONE Gat>77R- ' FAX:a09:05-4011
MAILING ADDRESS: Iy t L, 17f-, leg f WLS O,cti33WIL V p..0 t vtec,,v%c,l a'teal-e+tc/..- rc+;.i 1 .CO in
Prpject Type: Fra Ie Type: Bathrooms: -Shoreline: Type of Sewage Disposal:
l� New 'Wood Existing: ❑Sewer
• Addition C Steel Proposed: Bank ❑ C mmunity System
C Alteration/Remodel ❑ Concrete Total: -6— Height: kindividual System -
❑ Repair ❑ Masonry SEP Permit# p53- (
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: 0 F>vate well ❑ Two Party
Type of Hea • Proposed: ublic
(In 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 1 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 -F aff'tce Us ly Amount .Revision
Main Floor Heated EH Bld App Review: IA)r
2"°Floor Heated Consistency Review: 222
Other Heated Base fee: (P ' 17
Mezzanine '
ezzanine Additional Section:
Heated Basement Plan Check fee: O I ` 1-F
Unheated Basement State Surcharge fee:
' Other Unheated Pot Water Review fee:
Garage/Carport ) io SUBTOTAL
Decks 911/Rd Approach fee:
G(SY
Other TOTAL: $ ( ,(p21 1
Receipt Number: i-3q 3(�
Cash/Check Number: L --��
ESTIMATED COST(REQUIRED) Date: t- r
.Fair market value of all labor and materials foundation to finish
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BUILDING PERMIT S
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00011 Received Date: 1/14/2013
SITE ADDRESS: 821 SHINE RD Issue Date 3/11/2013
PORT LUDLOW, 98365 Expiration Date 3/11/2014
OWNER: ROBERT A BIRD PHONE: 360-779-2112
MARIE GALLAGHER BIRD
821 SHINE RD
PORT LUDLOW WA 98365-9285
SUBDIVISION: Block: Lot: T 50+
PARCEL NUMBER: 821343008 Section: 34 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: DETACHED GARAGE UNHTD, NO PLMB (BUILT)
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 50,000.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: SHORELINE:
GARAGE: 1,080
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $643.75 LYK 01/14/13 139895
Exist: 0 Exist: 0 Plan Check $418.44 LYK 01/14/13 139895
Prop: 0 Prop: 0 State Building Code $4.50 LYK 01/14/13 139895
Total: 0 Total: 0 Total: $1,066.69
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
• •
CONDITIONS for Building Permit# :BLD13-00011
1.) The site plan as submitted with the Building Permit application on January 14, 2013 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 March 7, 2013 shall be resubmitted for
review and approval by Jefferson County Department of Community Development.
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