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HomeMy WebLinkAboutBLD2006-00260 - DENIED THIS BUILDING IS NOT FINALED . THIS IS AN INCOMPLETE BUILDING APPLICATION . THE PERMIT WAS NEVER ISSUED . •UILDING PERMIT APPLICAAN MLA06-00245 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00260 Received Date: 5/15/2006 SITE ADDRESS: 7425 THORNDYKE RD QUILCENE, 98376 OWNER: GREG L BARRON PHONE: (360) 765-3494 MARK D &TERESA W BARRON 7425 THORNDYKE RD QUILCENE WA 98376-8607 SEAHOME SUBDIVISION: Block: Lot: 11+ PARCEL NUMBER: 992600017 Section: 36 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW SFR ALSO AIG 200 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 882 VALUATION 108,874.00 ADD'L: 580 HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 570 SETBACK: 112 BANK HEIGHT: 50 SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 1 Prop: 1 Total: 1 Total: 1 Routing Date: 51 1LII loci Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,044.15 KAS 05/15/06 81179 Plan Check $678.70 KAS 05/15/06 81179 State Building Code $4.50 KAS 05/15/06 81179 Potable Water Application $55.00 KAS 05/15/06 81179 Total: $1,782.35 • .,;?. ON C wow ���� JEFFERSO OUNTY III DEPARTMENT OF COMMUNITY DEVELOPMENT `n ' `4 621 Sheridan Street • Port Townsend •Washington 98366 360/379-4450 • 360/379-4451 Fax q O$ www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: 0(0 _,a,_vs Project Description(include separate sheets as necessary): Ail l M ali ii1 uu U d I i Li l Tax Parcel # 9 L r 7 Property Number: Size: q• 4/ 7 `e (acres/square feet) Site Address and/or Directions to Property: 75/2 S• 7-4ax.A. 7W- c— �,1• Li/ems/ e.,...4-, rlrg3z Property Owner(s)of Record: 40,41a/r-, T2ie.e,A-1 -*ey / �,¢,ra,t,6)"/ Telephone: 3(pD 7(�S3y9cf Fax: / email: Mailing Address: 7425- The.~.+✓W /2i( . ®�jyetca•wei ' 4-. ?'37{. Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) , Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit U Conditional Use[C(a), C(d),or C1** Single Family 0 Discretionary"D"or Unnamed Use Classification 0 Garage Attached/Detached 0 Special Use(Essential Public Facilities)** 0 Manufactured Home 0 Boundary Line Adjustment 0 Modular IT Short Plat** 0 Commercial* U Binding Site Plan ** 0 Change of Use 0 Long Plat** 0 Address ❑ Road Approach 0 Planned Rural Residential Development (PRRD)/Amendments** ;jif,Propane 0 Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** 0 Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance 0 Temporary Use n Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* U Jefferson County Shoreline Master Program Amendment 0 Forest Practices Act/Release of Six-Year Moratorium *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 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 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.Access and right of entry to this property shall be requested and shall occur only during regular business hours. Signature: "72‘01.01(1 :3"1111.1.4- Date: /272-5'1 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-transferable_responsibili for adhering to and complying with the ESA. The Applicant has read this disclaim r and sig s and dates it below. Signature: .�GV 4 Date: �O and j G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc !!! OWNER 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 assuming the responsibility of the General Contractor for the proposed project. Signature: G!/!/e !� 62%61 ■— Date: /– 2& GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) 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: New „'Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: I Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _/ Height: 'Individual System/ ,��// ❑ Repair ❑ Masonry 5:, SEP Permit# ( 7 –� /O ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: _ y Setback: j{. Private well ❑ Two Party 1 ` ',,Type of Heat: Proposed: – ' - i ❑ Public • ri�yG�yYOOof Total: _f_ ///S 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: U Underground Tank Above ground Tank Size of Propane Tank: ?E3_C Ni Heat Stove „IN Cook Stove I 1 Woodstove 0 Fireplace Insert ..t-- Hot Water Tank ❑ Pellet Stove L; 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 For Office Use Only kt S a) 05,00 1 Current Proposed '✓ Amount Main Floor O / Consistency Review: t 2" Floor g Z �� '� IID•�B fee: 1� ) sego 37 11). 40 I b-1q. 15 3a Floor N Additional Section: _______ Mezzanine: Plan Check fee: / IS 7 Heated Basement State'Surcharge fee: 41 J Q Unheated Basement a Water Review fee: (I Other Unheated 911/Rd Approach fee: Garage/Carport TOTAL: $ a035.3 Decks 1/90 ( ( r,lq.30 Receipt Number: coil () Other n -(- Via_60�t1 NCash/Check Number: C1d ESTIMATED COST(REQUIRED) (p )ate: 1 /D.Fair market value of all labor and material foun 73 f O D Initials: (1<t-7, G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc o Z. t m 3 85 1 270 Na p �l I al1 p/ im I r i t, 43 Iowa co::- . . > /11,5 iliP -, 1 I ���� 1t)K1. .i0 !. WATER.L-i F AMe of 4 x;,- --t 'X I i. p co , �.p,Vc . , 1 5 • 1 I ELD i� I I ?5 �(r 0 u JOe,r�t', ,�„a ._: SEPTIG T#4'k' J I 0 pump T aN k .-7. 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