HomeMy WebLinkAboutBLD2013-00029 110
BUILDING PERMIT APPLI•ION MLA13-60019
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD13-00029 Received Date: 1/24/2013
SITE ADDRESS: 20 HERON RD
PORT LUDLOW, 98365
OWNER: DONALD S CLARK PHONE:
ANITAJ CLARK
20 HERON RD
PORT LUDLOW WA 98365-9300 LUDLOW BAY VILLAGE
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 968600023 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: WARREN ENTERPRISES PHONE: 360-871-9388
PO BOX 626
CHIMACUM WA 98325
Contractor's License WARREE*947BR Expires 2/13/2014
REPRESENTATIVE: MICHAEL WARREN PHONE: 360-981-9388
PO BOX 626
CHIMACUM WA 98325
PROJECT DESCRIPTIOI DECK ADDITION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 650.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 20 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Pro
Total: otal:
Routing Date:
Type Amount Pai• = Date: Receipt: Approved/Date
Permit $152.00 LYK 01/24/13 139934 APPROVED
Plan Check $98.80 LYK 01/24/13 139934
State Building Code $4.50 LYK 01/24/13 139934 MAR 2 8 2013
Total: $255.30 Jefferson County DCD
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JEFFERSON COUNTY
' DEPARTMENT OF COMMUNITY DEVELOPMENT
i- `4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
4' Q'. www.cojefferson.wa.us/commdevelopment
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Master Permit Application MLA: t t
Project Desciption(include separate sheets as necessary):
T1 -/Vc uh on
Tax Parcel Number: C-i(oWncyz-,Q:213 Property Size: '3 r 5 e)1 •51-i (acres/square feet)
Site Address and/or Directions to Property:
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Property Owner(s)of Record: PDe1\1 C'.1_AAe <
Telephone: iss/tq Fax: IS/yr email: N
Mailing Address: t7•b• 3 016 fat.
Applicant/Agent(if different from owner): i r o\ t 3 Ckt-r to
Telephone: (3(0(3, 4 iS i --9 3 $$ Fax: email: tWi Wct'relA tg(oba,
Mailing Address: i? . 13c (,24 Ch;tMncrumt W Or G$325 live-- ccrw
What kind of Permit? (Check each box that applies ❑ Lot or Road Segregation
building ❑ Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family ❑ Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]''
❑ Manufactured Home .❑ Modular 0 Discretionary"D"or Unnamed Use Classification
I 0 Commercial* ❑Special Use(Essential Public Facilities)`*
0 Change of Use El Boundary Line Adjustment
El Address 0 Road Approach 0 Short Plat**
❑ Home Business ❑Cottage Industry ❑Binding Site Plan * ^� I LG
❑Propane 0 Long Plat*e \`
I , (///'���-� I /J --�
El Sign - • 0 Planned Rural Re'siyientlal-Developrri=• -J-/=c 7: „ments**
❑Allowed"Yes" Use Consistency Analysis ❑ Plat Vacation/Alt riation'* ii j I
❑Stormwater Management ❑ Shoreline Master Program ExeTption/Per, 11,,Revisio s"*
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Manage ment' Subbfthtia (D4vel' ritent''t
❑Temporary Use ❑Shoreline Management Variance ) !� 1
❑Wireless Telecommunication* ❑Comprehensive Plan/UbefEend-Use-District Men a dment
❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shornel(4e(> aJt #tr6glsiWt Amendme t
*May require a Pre-Application Conference ❑Tree Vegetation'RequestNP Ct'mMUN1n DPVELOPMENT
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
•
n DESIGNATION OF AGENT
I hereby designate 1 r li I /�/ ' • to act as my agent in matters relating to this application for permit(s).
\\OWNER SIGNATURE -' t .ii Date: 1 — 7.:4 - 7_v13 --
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By signing this application for, • e 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 feel ' ed la r inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap•,Irp••, ' Jth-/ e • e wants prior notice.
Signature: (//r it i/! Date: 1 2_' ' 2_013
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The action • .• i. s 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 lake"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)eve, if ou are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trans • :•t.,espo sibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: ,/ � / Date: I — Z`f — ? r3
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11,
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD13-00029 Received Date: 1/24/2013
SITE ADDRESS: 20 HERON RD Issue Date 3/28/2013
PORT LUDLOW, 98365 Expiration Date 3/28/2014
OWNER: DONALD S CLARK PHONE:
ANITAJ CLARK
20 HERON RD
PORT LUDLOW WA 98365-9300 LUDLOW BAY VILLAGE
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 968600023 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: WARREN ENTERPRISES PHONE: 360-871-9388
PO BOX 626
CHIMACUM WA 98325
Contractor's License WARREE*947BR Expires 2/13/2014
PROJECT DESCRIPTION: DECK ADDITION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 650.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
GARAGE:
CONST TYPE: DECK: 20 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $152.00 LYK 01/24/13 139934
Exist: Exist: Plan Check $98.80 LYK 01/24/13 139934
Prop: Prop: State Building Code $4.50 LYK 01/24/13 139934
Total: Total: Total: $255.30
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
SPECIAL CONDITIONS APPLY-SEE ATTATCHED
Jefferson County Building•Division Permit Dumber: BLD13-00029
Applicant: CLARK
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 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
Setbacks (L` t?T iL4
Erosion Control 1
Foundation Footing I)i 736 '1
Framing 1
2310
FINAL
FINAL INSPECTION 12
I,z3/iV
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD13-00029
1.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
2.) The site plan as submitted with the building pemit application on January 24, 2013 has
been reviewed for consistency under the UDC, and has been approved by Jefferson
County Department of Community Development. Any modifications, changes, and/or
additions to the stamped, approved site plan dated March 28, 2014 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
\\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 3/28/2013