HomeMy WebLinkAboutADR2009-00130 "
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ADDRESS REQUEST
JEFFERSON COUNTY PERMIT CENTER F E I3 1 8 _2111,9
621 Sheridan, Port Townsend,WA 98368 (360) 379-4450
APPLICANT: Please fill out item 1 through 8. Fee as per Jefferson Count} i1�C[
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1.4 New Address ❑ Correction El Change ❑Review DIFF LEFT M.P. RIGHT DIFF
2. Applicant Name: ei(Ma y({ / Mike_
3. Mailing Address: I 05Z4 iiwyn, -
Town/State/Zip 1A milli-Lou( SBo;- " 1
4. Telephone: Wor(R )7 3"1 Home: 111[WM
5. Location: Attach a Detailed Drawing or Map.
Additional Fees May Be Required if More Than One
Site Visit Is Necessary Mill e3 ' °
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*******PLEASE FLAG YOUR DRIVEWAY.*******
Date Flagged:Z /IS el Flagging Color eyA%\li■St..\
Nine Digit Tax Parcel Number q 3ow oco2 r ( 3, 39,a
Plat Name ] Block "t a- A) • 3 r i
6. Road Name: I d, - /IP - • t-f-
6.
Is this a PRIVAT : 0 IINTY road? CIRCLE ONE �i L I • -3
Nearest Cross Road: `C[
7. Neighbors'Address if Known: o I • a cO
Name/Address:
Name/Address: 'U I v I 0
8. Do You :ed Construct a Driveway?
YES o O CIRCLE ONE
FIELD NOTES
9. ', is Submitted With A Building Permit?
r NO CIRCLE ONE Z°h. I ' I \ ;lk 4e
SHADED AREAS OFFICE USE
f ONLY I bu� neepf -67 ado(
New Address: =�a 7 "`-'� W GTE{
1-0 r W 6, seS
Postal District: T rt 6. 1161\ ��✓� 3� ��1
Real Milepost: a�rj Road#:
(1'-Left)) Right Fire District Building Permit# pq.- 4j Plate Sent / /
Odd
Even Date Paid a /I $ !Q� Check# 13(obe Receipt# 165439 Date in Computer3 /c25/09
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JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMEN•
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ADDRESS REQUEST INSTRUCTIONS
o Complete the address request form in as much detail as possible. The most important
information to include is the complete name of the road where your property is located,
whether or not the property is in a plat, the nine digit parcel identification number and
the block/lot number. The fee is $1(04.00.
o You must also attach a vicinity map or drawing.
o Use the survey ribbons provided to flag both sides of your driveway. If your driveway is
not in yet, mark the location where the driveway will be. You must apply for a road
approach permit if your driveway will connect with a county road.
o The address technician from the Permit Center will assign your address within 5 working
days. The technician will visit the site and determine the address according to the
nearest milepost distance from the start of the road.
o The red address plate will be sent to your current mailing address, as indicated by you on
the address request form, within one week to ten days. The plate is to be posted at the
end of your driveway and is to be clearly visible from both directions.
o The Permit Center will notify the appropriate postmaster, fire district and emergency
services of your new address.
****************************************************
ROAD APPROACH INSTRUCTIONS
o If you are constructing a driveway that will connect with a county road, you must apply for
a road approach permit. The fee is $164 00.
o To complete the application for the permit, you will need to indicate the nature of work
and to include a simple sketch of the proposed work. You will also receive a survey
ribbon to mark the site.
o Once the permit inspector has visited the site, a permit will be drawn up and will include
the general conditions as well as any specific requirements concerning your site.
o The permit will be sent to you for you to read and sign. You are then asked to return the
permit to the Permit Center for the permit inspector to sign. You will receive a copy of the
signed permit. The permit is valid for a period of one year.
IF BOTH THE ADDRESS REQUEST AND THE ROAD APPROACH PERMIT IS APPLIED FOR
AT THE SAME TIME, THE TOTAL FEE $156.00.
If you have additional questions, call the Department of Community Development at(360) 379-4450.
h home\pIncntOinfodpw\instruct.doc 2/00
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JEFFERSON COUNTY FEB t
i_} DEPARTMENT OF COMMUNITY DEVELOPMENT EB 1 8 2-t-'.I 3
` 1-4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 - 360/379-4451 Fax r{r + gin,rp n- �, ,
`Sfl www.co.jefferson.wa.us/commdevelopment �C1I L;k .. j �„jnY D,
Master Permit Application MLA: , CL—Lt
Project Description(incl de eparat shee as necessary
Icy .0/ Clg2ea _ '
Tax Parcel '36, 0 0 2 1•, / Proper(;)c3 P / ty / ,
Number: J L/ ( (� Size: �''I a r (acre- square feet)
Site Address and/or Directions to Property: attach
Property O ner(s of R'ecord:: ib & nit / J o t f �
Telephone: . 9c/ / Fax: email:- 40iPo Fho--lo,tip[• o
Mailing Address:
Applicant/Agent(if different from owner): Town and Country Post Frame Bldg./Rebecca Cort
Telephone: (425)743-1555 Fax: (425)742-4378 email: permits @pem,ablu.com
Mailing Address: 16521 Hwy 99.Suite C,Lynnwood WA 98037
What kind of Permit?(Check each box that applies
fdBuilding ❑Variance(Minor,Major or Reasonable Economic Use)
❑ Demolition Permit ❑Conditional Use[C(a), C(d),or C]
❑Single Family VI Garage Attach /Detached ❑Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)"
❑ Commercial` ❑ Boundary Line Adjustment
❑ Change of Use ❑Short Plat**
❑ Address LI Road Approach ❑ Binding Site Plan**
❑Home Business Cl Cottagetndustry ❑ Long Plat"
❑Propane ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign ❑ Plat Vacation/Alteration"
❑Allowed"Yes°Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑ Shoreline Management Substantial Development"
❑Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request
*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:
/ DESIGNATION OF AGENT
I hereby designate tX e-c G1 to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE bL([�i..t{ - + e—e6; Dater. _L ( 7 0 9
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 attorneys 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 applirq,��tlon that he or she w is prio notic}�C� (� p a1- j C�
Signature: 1.�?�.. B f `s`- i J Date — 1
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-transf ble responsibility for .•henn land comp) • the ESA. he Applicant has read this disclaimer and signs
and ates it below.
- Date: 6"
Signature: _S 41nQ
C-.\Documents and Settings\coal\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
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Site Plan
TO �Oun Highway Lynnwood, Doing Septic ❑Lot size Thaw North Arrow in Circle
�t tr suite c•16521 8 n71 99•L nnwood,wA 98037-3161 Pie a Check After Doin Site PI ❑Se tic and d aintield
11 1ttttttttttttititititit�tttttttttt�ts POST FRAME BUILDINGS Everett:(425)258-4171 Puyallup:(253)640.9552 ro er dimensions ❑S wet lines property
❑Elevation of
DIVISION OF Administrative Headquarters: (425)743-1555 g ling buildings tbacks of proposed&existing buildings ❑Bodies of water
Ilamemx -11.
PERMA BI LT FAX: (425)742-4378 TO5 Free: 1.800-824-9652 Proposed building aln road with name ca
r Contractor's Lie.e:TOWI4CPF099LT ❑Floorplan
Qualm:Our Future Depends On It n, ❑Easements .Blccess tp proposed building rl Slopes&Contours(5'increments)
Job Name: 1a-.4iLA I Job Site Address:� 7`r ��il 0,0)
Tax Account#: 1 •/p ) Z�! Legal Description:
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DO NOT SIGN INCOMPLETE SITE PLAN!
Customer has verified and approved the location of the building,orientation of a building to the North,and verifies that all White-Customer Copy White-Office Copy 9_,utilities are shown on this dra �g in the correct I. ate /•
CUSTOMER SIGNATURE • 11 ' . • 0 LEAD# LS /Z�
01995 Perma-Bill industries FR-34 6/07 1 111111 Iilll IIII IIII
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Map Output Page 1 of 1
ArcIMS HTML Viewer Map
602234040 _...
936(00204
602234004 3a ........
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943223400 9390:9201 1__
936000
602234030
602234029
60223404'
9-90-.13,191......66e9344 C wty C*wi SEN.CY. S
FOR INFORMATIONAL PURPOSES ONLY-
Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respec
in this map is limited by the method and accuracy of its collection. Mon Feb 23 15:33:02 2009
http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&Cl ientVersion=4.... 2/23/2009
' Address Database Comparison Page 1 of 1
Enter Street Name String: Or Enter Parcel Number:
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PUBLIC WORKS DB ADVANTAGE DB ASSESSOR DB MASTER
ADDRESS PARCEL ADDRESS PARCEL ADDRESS PARCEL ADDRESS PARCEL
101 TOG RD 101 TOG RD 936000116 21 TOG RD 936000119 101 TOG RD 930000,,!0
121 TOG RD 121 TOG RD 936000114 101 TOG RD 936000116 12.1 TOG RD 936000114
161 TOG RD 936000111 161 TOG RD 936000111 121 TOG RD 936000114 791 TOG RD 936000109
191 TOG RD 191 TOG RD 936000109 161 TOG RD 936000111 21 TOG RD 9300001/9
21 TOG RD 21 TOG RD 936000119 191 TOG RD 936000109 221 TOG RD 936000107
221 TOG RD 221 TOG RD 906000107 221 TOG RD 936000107 234 TOG RD 936000200
234 TOG RD 936000208 234 TOG RD 936000208 241 TOG RD 936000105 241 TOG RD 936000105
241 TOG RD 241 TOG RD 936000105 281 TOG RD 936000103 281 TOG RD 936000103
281 TOG RD 281 TOG RD 936300103 322 TOG RD 936000203 322 TOG RD 936000203
30 TOG RD 322 TOG RD 936000203 335 TOG RD 602234017 335 TOG RD 602234017
32 TOG RD 335 TOG RD 602234017 352 TOG RD 936000202 34 TOG.RD 936000214
322 TOG RD 936000233 352 TOG RD 936000202 365 TOG RD 936000101 352 TOG RD 96000202
333 TOG RD 365 TOG RD 936000101 433 TOG RD 602234029 361 TOG RD 936000101
335 TOG RD 433 TOG RD 602234029 433 TOG RD 602234029 •
34 TOG RD 936 COO 214
352 TOG RD 936000202
36 TOG RD
365 TOG RD 936000101
433 TOG RD
For an address search, leave the parcel field blank. This is the signal that you want an address search. For a parcel search, enter the
nine digit parcel number. During a parcel search it does not matter what you have in the address box.
This tool uses a "fuzzy"search so if you enter"ZELATCHED" you will get all addresses that have that word in it. If you enter
"ZELATCHED POINT RD"you will only get the addresses that have that exact sequence of characters in it. This should allow you to
identify the source of many of the discrepancies between the data sources. For instance, searching for"AZALEA LN"gives only 5
addresses in the Advantage DB. Searching for just "AZALEA"adds another address because one was entered incorrectly as "AVE".
I purposely did not make a street picklist so you can have flexibility in your searches.
The far right column is the final list of addresses that will be loaded into the AS400. Clicking on the
address field will give you details about the address. On the details page you can click on links to get a map of the road or search
for more addresses on the parcel. Addresses that have a parcel that is not on our parcel map will not show up on this list as a
hyperlink.
There are many "dummy" addresses in the Advantage DB. Most of these have been filtered out by checking for a blank street
address number. The Assessor DB has been filtered by checking for null in the street address number field.
Let me know if this tool is useful and/or how it can be made more useful.
http://www.co.jefferson.wa.us/idms/devtest/address.asp?street=TOG+RD&parcel= 2/23/2009
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