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HomeMy WebLinkAboutBLD2009-00179 THIS BUILDING IS NOT FINALED . THIS IS AN INCOMPLETE BUILDING APPLICATION . THE PERMIT WAS NEVER ISSUED . • BUILDING PERMIT APPLI TION MRAOW OO Type: 1 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00179 Received Date: 6/18/2009 SITE ADDRESS: 1920 SWANSONVILLE RD PORT LUDLOW, 98365 OWNER: ALAN E ANDERSON PHONE: (360)437-9220 DAVID W ANDERSON & SANDRA J 1920 SWANSONVILLE RD PORT LUDLOW WA 98365-8716 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 821053009 Section: 5 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW ADU TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADU MAIN: 1,250 VALUATION 92,888.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 3 Total: 2 Total: 3 Routing Date: 10/ I /6 Type Amount Paid By: Date: Receipt: Approved/Date Permit $944.75 KAS 06/18/09 108652 Plan Check $614.09 KAS 06/18/09 108652 State Building Code $4.50 KAS 06/18/09 108652 Potable Water Application $62.00 KAS 06/18/09 108652 Total: $1,625.34 ON co • • ,.- 4 JEFFERSON COUNTY I DEPARTMENT OF COMMUNITY DEVELOPMENT '' _ 621 Sheridan Street• Porn trend S Wp bin6tori,96368 360/379-4450 • 360/379-4451'Fax- Zs ' �$ www.cojefferson.wa.us/commdevel opment JUN 1 r 2u0 Master Permit Application MLA: 061-a0 1 Project Description(nk ude,se/parate sheets as necessar �rr k p(tU TV gco Tax Parcel Number: 32( 053 00 ? 1'E LUUPrrollperty Size: (acres/square feet) Site Address and/or Directions to Property: l[T y 2C S wo.r\ S 3 r, i1k, r cn a c l \--•-'4(--- ,--v„ Property Owner(s)of Record:7 Telephone: 37- W.20 Fax: — email: Mailing Address: Sd r.nr.rc Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation Building El Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) VI Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** ❑ 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'* ❑ 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** CI Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑ Comprehensive Plan/l1DC/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: 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appli -tion that •-• she pip j prior notice. 41—.~42.... ^f Signature: h T .t. Date: 1. — © 4 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-tran rable�rpepygAsibili o dhering to and complying with the ESA. The Applicant has read this disclaimer a signs and tes it below. Signature: (/t f/s� Date: 9.._.v°-[ 0- • Ilk 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 assuAinli the rgspo sbility of the General Contractor for the proposed p ojeot. Signature: 6.1- Date: .L.",. i V r e" 5) GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( )4x`5'7- 122 0 (, MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: - PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New to Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: �— Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Z VL Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: . Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Type aHe t:1.61,e-- Proposed: ❑ Public Total: L 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: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 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. •• E ""w 6'� �" x ;e a ri : � S�uareFoota_e Current Pro sect �„, �� _ �� �,. , . � . _t��. rbA D ago w�• �.�:.. Main Floor Heated , .}�� re ,�D '` H Bid App Review: H la 2 ' Floor Heated `" consistency Review: 013 OD Other Heated 4-.-„'_ Base fee: 44' G 5 Mezzanine 1 L t , a A.t itional Section: -- Heated Basement ' '`n , , .. Plan Check fee: Unheated Basement 4-1 State Surcharge fee: '` �JD `t Other Unheated r .t [Trpt Water Review fee: LfIt.H. t t r, to I, DD• DIP Garage/Carport ::. SUBTOTAL 614(1. 54 Decks �, ' 911/Rd Approach fee: Other TOTAL $ L"l(p5• 34. , Receipt Number: 106(05a 1111 � '; Cash/Check um C /Check Nber: ESTIMATED COST(REQUIRED) Date: p •Fair market value of all labor and materials foundation to finish U ilia 5 C Initials: i G:\Pe nitCenter\###i'ORMS###\DRD FORMS\Current DRD Forms\Master Pem,it Application 5-29-0&doc �. 3> -•I 0 -+5 m O -1 -I) x -I -I CD m -• -• m v CO co x 2 n r- x CO 0 O Ol < a 0 01 0 CD S D CC -• CO CC CD CD Z CD r4- O CD - D X o -3 E 's -• m m o n it CC co N CD n -P Ul W '3 d O O �I � 0 U1 -• O O 3! 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F--3 ---1 Z to rl• d 33 3 Q =., •'.•c.:.> G7 -3 0 0 - 1..c. s.0 (` r LO - c O G> a> m co Cn U.) - m -13 � t 0 MI •••.. .. •• O N L 1 N O H O l .) • TI z CS 0 -+ T E7 CO C CO H � M -< Map Output Page 1 of 1 ArcIMS HTML Viewer Map 821053014 C•SY.72,3 821O53002 212'.0530c, 82 055.:22 ; 8210530'C. 82°013020 B210-5302, 8.2/053018 8.2105301,2 8;21053017 621064014 E:2'Crb.2,1:6H: 8210530C! 0, 821063006 821054001 821051C054 U'OS400t 1-.,2`,1:53004 82105300/ 82'0530'5 !!+!. U nknoorn---- R e u b e n Joh nson Rd F.2"C,a2C'-'1 1061037 821082002 82108200' 821( 82'0UO2" ar-064.C-1 82105100/ 821082003 8.210f 821082032 821083015 821082004 52CC13 82'0FC09 MaoswandorltrionCcurgyCergraiSennomGLS 6b'il 82'08 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. Thu Jun 18 14:48:00 2009 http://gisserver/servlet/com.esrLesrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 6/18/2009 :z w• ` zit. 'w�;r •:Y •r iik . r 1920.Swansonville Rd, Port Ludlow, WA 98365 US Ill ■ erill."1.5111.11111. ,.,:.■ ' 1411 era Map Output Page 1 of 1 ArcIMS HTML Viewer Ma. 1 I I 4211111D i R 82 aswo< 82 053001 Mirmil 400 4. ' Is -11 q I F - e rasa a Legend us:J•2 `a.utn�: III Selected Feature s , ,y, tia Towns OEM . , - "t 82'013A5. b�v ten•, :1-N.,, JC Roads -r'ryf I Parcels-*l e2t0i3pJ4 • k /, Y 2013 Aerial Photos 82 Q:fT99 T I S 82'0530'5 �. YY +. II • •" ""° `° Reuhen iahnwn R -w� I ' s c ,iii L a 52 49'01. _ _M 5. __- a. 0w O. .., ;rr_ nto N. -._ . ` 821082025 • _t . $2108103'. st_. ' az "wemerntl �,: I 8T'092028 `r � a1'w•m3 l:.7.:::'-T &2'tll'U3''+Yri3235,82108211'8 :.-'Oetaea. 82"09'0]8 y'S ^ -- MovwdadNJdbrmCOnySe'eUa..,re.W i ho, • FOR INFORMATIONAL PURPOSES ONLY- efferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity.Data contained n this ma. is limited . the method and accura of its collection.Thu Se. 18 11:11'.38 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 9/18/2014 Nr 'D LA, intAoct , obi CAS l o Pr JEFFERSON COUNTY PERMIT CENTER u APPLICANT NAME: / I (t11 E 7P6,V I ) U7 5 l llVYGL, PHONE: ( ,D) 437- J fln SC)rk SITE ADDRESS: 1 q aD O n'Or1 VI I) p. 11D DATE: (p lj Qh 1. HEALTH APPROVAL SEP= PERMIT # SEP aq- v(P) A 9xy' -14 2 ATER FOOD SERVICE 2. SHORELINE BANK HEIGHT SETBACK 3. FLOOD ZONE 4. FOREST PRACTICE APP (CLASS ) 0 PLANNING APPROVAL 03 CRITICAL AREA REVIEW '�n 7. ZONING 8. HEIGHT 9. LOT COVERAGE 10. ADDRESS A- D(Jk `P lccd-L .6) be rnape 231.-b 1,5,541 n it_ 11. FEE 12 CONTRACTOR'S LICENSE D n JLT �jLJJQ 13. ENERGY SHEET 14. BOND HOLDER/LENDER 15. NTT 16. SETBACKS 17. PROVIDE WA STATE ENGINEER STAMP/ARCHITECT'S STAMP 18. STORMWATER SITE PLAN 19. D.O.T. ACCESS APPROVAL 20. FIRE FLOW FOR COMMERCIAL STRUCTURES ter/ 01 PLAN REVIEW r- -(- - . -. - OCCUPANCY: 2. TYPE OF CONST: 23. EXPOSURE: 24. WIND: 25. SNOW: 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. H:\HOME\P LNCNTR\IN FOBLG\B LDCKLIS\2/2000 , , i , rl 9 « W4 t, 4; / \ 1'.. . N, Notes: ;" SCALE: 1"=5D' 1.Proposed THIS IS NOT A SURVEY posed 2 bdrm r ■ connected to existing 2 bdrtn septic system. • 2:Existing house tt5 be'• cted to proposed 3 bdrm septic system 3.All septic componen• , ••e>10' from any existing or future water lines 4. Disconnect Existing ,Tank from sand filter and connect to transport line to new drain field.Thep d controler for the new ADU will need to be moved to the new tanks which wil.4,„.0.-. "+; the existing sandfilter• ¢ LEGEND ��% 10' •No Build a t Soil Log ---- Building Envelope Setback Existing Componet Atfi Tree • O, Property Corner (A) Clean Ouutevation (B) Septic Tank zr (C) Filter Sock (D) Pump Tank Approximate location of proposed ADU (E) Splitter • '70, 37 � Al..A�1 a • ,.• Well �!/ (90.1—F t5 f •• '+a I . ��Sl 4)k Mori -+o O Y 'qT: VQ9 A a0 4. L fl 51 , , �� r�ne�tanv.se k -.ail �4 I`oCl' - So, 50We O Existing H2O . Man Made % Pond oA F 571' .• Bi D A�8 £Y I5Y1K 3 f7 X) C SFP_ - 50' Min. M , \1 • J ■ t"- �- ,. Tanks, Sandfilter,& Drain I-, ` (See '0•••2-424 Asbuilt on file) _ F-----. \ly le g m ICY \ •ole Barn (No Plumbi • '7 Existing SL 3 100%Reserve Area for both dwellings. Man made 100'setback 62'x46' Pond ��� - 100%Primary Drainfield SL'' >!ma (4) 50' Laterals 6-9' 0.C. as 2% I SL 1 L- • 4 E E• Reuben Johnson Road N than Cleaver Septic Design, inc. Phone: (360) 598-6546,Fax: 360-598-6548 I✓' = CUSTOMER:Alan Anderson • TAX ID#: 821053009 LOCATION: 1920 Swansonville Rd 4.31:1 = DRAWN BY: NNC DESIGN BY: NATHAN CLEAVER DATE: 3/21/2009 . _ -,.. . ... ,1..• . . f ,e," I 3L --)r4- XI ",.< - ------ ------)4 1 , ; I -- - , , . , „...._ -, thi • OS 0,4 otS 04'r 1 , , ,es ,. 1- i i i i 1 1 s . Ai , t H 1 rici 1 1 1 4 1 1 1 I ,./....„....„ . rot co?: I / 2 t-.,--4---'4 - - 0 i ' ____.k _ -.: I A, , ------_, , i-i _... 0'At ()L. , . ' Lc TD-) t t , . .1,-_._-. 1 ! 0 . C A. • .."111 I - el " _____ti t71.)131') --17 i ji 1 ,_-- 1 _____, ._ --41 Q' 0 .i /7 7,t-' - ° , , ; 4--1 i Ct 44 -4 4 rimrs::<!i t 4 / ,.... r ; ; It .....als . - / \ « /Z '70 :* i .7:•jj . \np ■,cl n\-1 - - . , I , 1 1 . . , ' 1 „ : i ,,, ,, 0. •.. • £ ( ) 1 ! _ . 4\ 411 . , Nap 1 -- øt . - . . . I —> ' t I e I i 1 ; 7 CPS 94 i ( z C■I = 1 £ 1 ', at i r ‘, = a= -"II Li....1 L.- 4-1-1 g ---"a 1 I...4.3 .. ._ ..v...j_ 1 - .