HomeMy WebLinkAboutBLD2008-00210 JILDING PERMIT APPLICA BLD08-00210
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00210 Received Date: 5/16/2008
SITE ADDRESS: 1100 NESS' CORNER RD
PORT HADLOCK, 98339
OWNER: PETROSUN WEST, LLC (75%) PHONE:
BEDROCK OIL, INC (25%)
22026 68TH AVE S
KENT WA 980321939
SUBDIVISION: Block: Lot: TX68a
PARCEL NUMBER: 901024061 Section: 2 Township: 29 N Range: 01 W
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: PHOENIX SIGN CO PHONE: 360-532-1111
STEVE HAMPTON 360-249-0578
PO BOX 497
PROJECT DESCRIPTION REPLACING SIGN (FACE ONLY, WITHIN EXISTING FOOTPRINT) -NO
MLA REQ'D
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP SGN MAIN:
VALUATION 1,500.00 ADD'L: HEAT TYPE:
CODE EDITION: 2006 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: /O%
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $54.00 AMS 05/16/08 100210 APPROVED
Plan Check $35.10 AMS 05/16/08 100210
State Building Code $4.50 AMS 05/16/08 100210 MAY 19 70U8
Total: $93.60
Jefferson County Planninc
&Building Deeartment
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�.4gON O�
, JEFFERSON COUNTY
w
►.� � DEPARTMENT OF COMMUNITY DEVELOPMENT
� O� 621 Sheridan Street • Port Townsend • Washington 98368
&11INOS 360/379-4450 . 800/831-2678 . 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
Sign Permit Supplemental Application
MLA# a - PROJECT/APPLICANT NAME: A-ArtQ(/ 11
Purpose
The purpose of the sign permit process is to ensure consistency with the applicable sections of the Unified Development Code(UDC).
You will submit a Master Permit Application Form in conjunction with this supplemental application. Refer to the materials
accompanying the Master Permit Application Form for additional information.
Process
Signs are reviewed administratively as Type I permits by the Department of Community Development (DCD). An administrative
determination to approve a sign application will be made when the proposal is consistent with section 6.15(SEE ATTACHED)of the
Jefferson County Unified Development Code. An administrative determination to deny an application will be made when the
proposal is not consistent with the UDC. Denials of applicationS for sign permits will be accompanied by a written statement
identifying specific areas in which the proposal is deficient.
Supplemental Information
Are there any signs currently on If yes, list type, dimensions, square footage of sign area,
site? location.
DIMENSIONS: 7 X l SIGN AREA(SQ.FT.):TYPE: $1 ( ) 42 LOCATION: 6641.77.1/2
TYPE 1,4Y}444.- DIMENSIONS: .2 10 SIGN AREA(SQ.FT.): 0 0 LOCATION: r' 100_00
TYPE DIMENSIONS: SIGN AREA(SQ.FT.): LOCATION:
List proposed signs:
TYPE OCC: DIMENSIONS: 7� SIGN AREA(SQ.FT.): 42 LOCATION: r
TYPE DIMENSIONS: SIGN AREA(SOFT.): LOCATION:
The applicant hereby certifies that the statements contained in this application are true and provide an accurate representation of the
proposed amendment;and the applicant(s)hereby acknowledges that any approval issued on this application may be revoked if any
such statement is found to be false.
c -
APPLICANT'S SIGNATURE DATE
RECEIVED
MAY 16 2006
trip DN CHO BCD
SIGN PERMIT.DOC REV.9/22/2004 Page 1
• •
O JEFFERSON COUNTY
x ' IA DEPARTMENT OF COMMUNITY DEVELOPMENT
(" "< 621 Sheridan Street• Port Townsend • Washington 98368
$ 360/379-4450 • 360/379-4451 Fax
www co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: I\J O MLA R`p t D
Project Description(include separate sheets as necessary)
Tax Parcel f A Property
(,
Number: '-' Size' (acresisquare feet)
Site Address and/or Directions to Property
Property Owner(s)of Record: or Sty I Si
Telephone: Fax- etnail
Mailing Address: £UMtSEr-ratk i.D CEkta"le •BLDG l ZZ'ZI lr� Ads S •
Applicant/Agent(if different from owner): Wok- (m" '611C£ ,..4► o
Telephone:7(ffJ-5-52-/II Fax 'gam-1'4 ,�S"7S email. 'efiO (S(f, S'(� ` eftj•C11 fetiveT
Mailing Address To IX 47 A-$612-, �4 Q$W
What kind of Permit?(Check each box that applies
EBuilding Variance(Minor Major or Reasonable Economic Use)
�l Demolition Permit D Conditional Use[C(a).C(d).or CI**
Single Family D.Garage Attached/Detached El Discretionary`D'or Unnamed Use Classification
D Manufactured Home El Modular E Special Use(Essential Public Facilities)**
El Commercial* E.Boundary Line Adjustment
D Change of Use Ei Short Plat**
Address _Road Approach E.,'Binding Site Plan**
Home Business El Cottagelndustry D Long Plat**
Eropane E Planned Rural Residential Development(PRRD)/Amendments**
Sign Plat Vacation/Alteration**
Ell Allowed"Yes"Use Consistency Analysis -Shoreline Master Program Exemption/Permit Revisions'"`
Stormwater Management :1 Shoreline Management Substantial Development`*
u Site Plan Approval Advance Determination(SPAAD)* El Shoreline Management Variance
Temporary Use .:Comprehensive Plan/UDC/Land Use e' i �y nF l v
Wireless Telecommunication* El Jefferson County Shoreline Master Pr.i� +{l. '�-:t I,�
El Forest Practices Act/Release of Six-Year Moratonum El Tree Vegetation Request 1
*May require a Pre-Application Conference **Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known: MAY 16 2008;
DESIGNATION OF AGENT
I hereby designate rtt 0\I7 C-1154 to• to act as my agent in matters relating to this apply g.tignrttK i�js► ?1,+I U�0
�r liU. 1
o
OWNER Slcrta T uRe •°' _�.:�- 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 it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save.indemnify and hold harmless Jefferson County against all liabilities,judgments-court costs.reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
i further agree to provide access and right of entry to Jefferson County and its employees representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the a ti hat h or she wants prior notice. 0
Signature v Date:
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and could lead to a potential take-of an endangered species as those terms are defined in the federal law known as the
Endangered Species Act'or-ESA"Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he.she or it holds individual
and non-transfe ble responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and sips sgps and dates it below
Signature: i Date Ce —04r
• •
BUILDER STATEMENT
' .a_signer-i this statement dues here[[x oeifittiv that they are'he .e?wrers of the parcel referenced zee fl 'ra,they are r7,stt.;zersed . . .a :
they mil ce assuming me re5 ar s b!i y of ne:..-metal Cont acfnr for the proposed protect.
{ +�- P h P
Signature 04 Date
GENERAL CONTRACTOR OR M UFACTuRED HOME INSTALLER PHONE FAX
1 h/ cLL —7 p /� V i 5-V-1( 1 1 ( =7,44 572
MAILING ADDRESS- j f-�D.�12.L.� "t.�500 EMAIL- � "�l�l� ___ 1 � ...__i Te_cd Ater
CONTRACTOR'S LICENSE ���""�� WAINS
NUMBER re(t )4 SC 4Z-g110° NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX.( )
MAILING ADDRESS: EMAIL
Project Type: ? Frame Type: Bathrooms: Shoreline: ! Type of Sewage Disposal:
New Wood Existing: Sewer
Addition l Steel Proposed Bank , Community System
"Alteration/Remodel Concrete Total Height Individual System
Repair l Masonry SEP Permit#
Demolition l Other Bedrooms: Water Supply:
Existing: Setback Private well Two Party
Proposed:
Type e of Heat: Public
Total Name of System.
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces.
Number of
occupants(includes owners.tenants,employees.etc) Current Proposed
IBC Occupancy: IBC T e of construction: Will you have Food Service? Yes I No
Type Y
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
Underground Tank I Above ground Tank Size of Propane Tank.
1 Heat Stove ; Cook Stove ' Woodstove l Fireplace Insert Hot Water Tank 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.
I
Square Footage ; Current Proposed For Office Use Only i Amount 1 Revision
Main Floor Heated � ! EH Bid App Review i
g
2"a Floor Heated Consistency Review. t ■ �\Y .
Other Heated ? Base fee. 5 DO
Mezzanine Additional Section: A 2008
Heated Basement Plan Check fee: 1
Unheated Basement State Surcharge fee [\ G�J L i t; Id 1 4 l,D
Other Unheated Pot Water Review fee
Garage/Carport SUBTOTAL
Decks ` 911'Rd Approach fee _________ _,
Other — TOTAL , $ Q3.(,„O
Receipt Number: I o 0 `&I b
Cash/Check Number: All p f+� —T
ESTIMATED COST(REQUIRED) Date: b! �� __ ____
. ar market value of all la or and mates s`ouncOtron to frnash (0
00 C Initials: M'
Jefferson County Building D sion Permit Nunik
ti
Applicant:
BUILDING PERMIT INSPECTION APPROVALS kpplicable Code: International Building Codes
To schedule inspections,call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
I(-2`- 4 yti�,
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR