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Home My WebLink AboutBLD2013-00033 • BUILDING PERMIT APPLI ION BLDI3-00033 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00033 Received Date: 1/28/2013 SITE ADDRESS: 71 CHICKADEE LN QUILCENE, 98376 OWNER: CARL F SMITH PHONE: 360-765-3692 PO BOX 868 QUILCENE WA 983760868 QUILCENE BAY VISTA SUBDIVISION: Block: Lot: 7 PARCEL NUMBER: 701205007 Section: 20 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP INTERIOR KITCHEN REMODEL TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 3,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $83.25 LYK 01/28/13 139945 APPROVED Plan Check $54.11 LYK 01/28/13 139945 State Building Code $4.50 LYK 01/28/13 139945 JAN 2 8 2013 Total: $141.86 Jefferson County DCD \\+irlcmor4\ri o+o\fnrmelP RI r Ann Rid rn+ 1/W/1(11'I • Smith residence 71 Chickadee Lane Quilcene, WA 98376 Proposed scope of work for building permit Kitchen remodel, including installation of new cabinets, new sink and connection to existing plumbing, with some modification. No new living area or heated space. ECIEOVE JAN 282013 ¢i ti JEEFERSQr;COUNTY P+ LPF COMIAUNITY DEVELOPMENT .asON CO • w t, JEFFERSN COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ` ''4 621 Sheridan Street• Port Townsend Washington 98368 360/379-4450 • 360/379-4451 Fax q• p$ www.co.jefferson.wa.us/commdevelopment 1rNG Master Permit Application MLA: no uR Project Description(include separate sheets as necessary): Cf-FclleK e'_yidaWe Tax Parcel Number: 7o/ 2 0 S 007 Property Size: acres" (acres/square feet) Site Address and/or Directions to Property: 77 Ch(c/Lkc'ee L4.14e Lir(tePtc ��:,- I V Property Owner(s)of Record: CA i-i 5141/ c Telephone: 3‘u 76c 3 6 qZ Fax: email: Ca l` i (e ot1vG11<, me-t Mailing Address: A D (SOX &6 F Qv/l'ee'r i 37‘JAPl 2 8 2013 Applicant/Agent(if different from owner): v Telephone: Fax: i email: Mailing Address: ! JEFFERSON COiiNTY What kind of Permit?(Check each box that applies ❑Lot or Road Segregation Auilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) `BI Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or Cj** ❑ Manufactured Home .❑ Modular ❑Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat** El Home Business ❑Cottage Industry ❑Binding Site Plan** ❑Propane ❑Long Plat** ❑Sign -- ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: iff/A- 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. ''s access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that h r she i •• /2b 2�`1 Signature: /' 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 a e in compli.i ith the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferab r spo i i►! - '1g to and complying with the ESA. The Applicant has read this disclaim r and signs and dates it below. Signature: Date: //2 e f Zol3 Jefferson County Buildinggvision Permit Aber: Applicant: BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 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 FINAL INSPECTION 3 I- 13 t tir FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00033 Received Date: 1/28/2013 SITE ADDRESS: 71 CHICKADEE LN Issue Date 1/28/2013 QUILCENE, 98376 Expiration Date 1/28/2014 OWNER: CARL F SMITH PHONE: 360-765-3692 PO BOX 868 QUILCENE WA 983760868 QUILCENE BAY VISTA SUBDIVISION: Block: Lot: 7 PARCEL NUMBER: 701205007 Section: 20 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: INTERIOR KITCHEN REMODEL TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 3,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 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: Permit $83.25 LYK 01/28/13 139945 Exist: Exist: Plan Check $54.11 LYK 01/28/13 139945 Prop: Prop: State Building Code $4.50 LYK 01/28/13 139945 Total: Total: Total: $141.86 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