HomeMy WebLinkAboutBLD1997-00397 cr) r DEPARTMENT OF COMMUNITY DEVELOPMENT
Z. 621 Sheridan Street,Port Townsend,WA 98368
Tel:360.379.4450 Fax:360.379.4451
-,: �, Web:www.co.'efferson.wa.us communi development
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TEMPORARY CERTIFICATE OF OCCUPANCY
PERMIT #: BLD97-00397 Issue Date 07/11/1997
SITE ADDRESS: 212 COUNTRY RIDGE RD Inspection Date 07/11/199
CHIMACUM, 98325
2016
APPLICANT:
RUSSELL DUKEK PHONE: 732-4206
TERESA DUKEK
212 COUNTRY RIDGE DR
CHIMACUM WA 98325-8767
Block: Lot:
SUBDIVISION:
PARCEL NUMBER: 801045010 Section: 4 Township: 28 N Range: 1W
PROJECT DESCRIPTION: TWO STORY STUDIO GARAGE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE INTERNATIONAL
BUILDING CODE EDITION.
OCCUPANCY GROUP:
UBC TYPE OF CONSTRUCTION:
THE PROJECT RECEIVED ITS TEMPORARY SIGN OFF ON 7/14/2016
THIS DOCUMENT IS VALID FOR 30 DAYS. THE BURARY OCCUPANCY WILL BE NULL AND VOID ILDING MUST RECEIVE A FINAL CERTIFICATE OF
OCCUPANCY WITHIN THAT TIME OR THE TEMPO
Acting Building Official,
Patty Charnas
JEFFERSON COUNTY BUILDING PERMIT
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD97-0397 DATE ISSUED. : 07/11/97
SITE ADDRESS: 212 COUNTRY RIDGE RD
:CHIMACUM, WA 98325
APPLICANT. . . :TERESA DUKEK
PHONE: 732-4206
MAILING ADDR: 212 COUNTRY RIDGE
:CHIMACUM WA 98325
CONTRACTOR. . :OWNER PHONE:
MAILING ADDR:
CONTR. LIC #: EXPIRATION DATE: / /
LOAN LENDER. :
MAILING ADDR:
•
•
PARCEL NO : 801045010
LEGAL DESC : STR 04-28-01 WWM, TAX #
LOT 10, BLOCK , COUNTRY RIDGE
DESCRIPTION OF IMPROVEMENT: TWO STORY STUDIO GARAGE
n. e 'a .= (Shoreline Setback) :mbiltp q 7
( Foundation: ff0) .f ,• po y . __ AVOW
( cundergroun P um i7tr9/Underground Insulation: NJ7 , P - £ . 'Pl/ '
" C12
( ) Framing/Plumbing/Chimney: it.001412--21'0y
�ef4-4't coR2Qv-,6� b K —
( ) Insulation:G4W-to LI D 7/ )
( ) Sheetrock:
( ) Final/Occupancy Approval: 9-7114114,
THIS PERMIT IS VALID FOR ONE YEAR.
24 Hour Recorder for Inspections
CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS
Office Hours 9 a.m. to 4 : 30 p.m. Inspector's Phone Hours 8 - 9
JEFFERSON COUNTY BUILDING APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD97-0397 DATE RECEIVED. : 06/23/97
SITE ADDRESS: 212 COUNTRY RIDGE RD
:CHIMACUM, WA 98325
APPLICANT. . . :TERESA DUKEK PHONE:732-4206
MAILING ADDR: 212 COUNTRY RIDGE
:CHIMACUM WA 98325
CONTRACTOR. . :OWNER PHONE:
MAILING ADDR:
CONTR. LIC #: EXPIRATION DATE: / /
ARCHITECT/ . . : PHONE:
DESIGNER •
MAILING ADDR:
PARCEL NO. • 801045010 ___, landslide 110 plat cond wetland r1floodingii
LEGAL DESC:STR 04-28-01 W WM seismicell:' streams ierosion /T7 f & w Au
LOT 10, BLOCK , TAX # 40(--e ✓z-t
COUNTRY RIDGE
DESCRIPTION OF IMPROVEMENT: TWO STORY STUDIO GARAGE
BUILDING TYPE •GAR BEDROOMS--- BATHROOMS-- MAIN FL. . . : 428 sf
TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 0 sf
GARAGE/CARPORT • PROP. . : 0 PROP. . : 1 HTED BSMT. : 0 sf
WOODSTOVE • TOTAL. : 0 TOTAL. : 1 UNHT BSMT. : 0 sf
UBC OCCUPANCY GROUP: SEWAGE DISP. . :ALT OTHER • 0 sf
TYPE OF CONST WATER SUPPLY. :PWELL CRPT/GAR. . : 529 sf
UNITS. : 0 STORIES: 2 HEAT TYPES. : DECKS 0 sf
DIMENSIONS: COMMERCIAL: 0 sf
FRAME TYPE:WOOD INDUSTRIAL: 0 sf
EST COST. $: 27623 BANK HT. . . : 0 ft
PROJ GRP. . : 7257 SH SETBACK: 0 ft
Owner/agent FEES
Signature: type amount by date recpt
PRMT $ 376.75 EMH 06/23/97 1132599
Date: PLCK $ 113 . 03 EMH 06/23/97 1132599
B.C. $ 4 . 50 EMH 06/23/97 1132599
Issued By:
Date:
(te24 $ 494 . 28 TOTAL
i0-li /.' la- 2&' '' ,
Jeffeson County Permit Center Date
621 Sheridan Street
Fee
Port Townsend WA 98368 Rec #
CRITICAL AREAS QUESTIONNAIRE Ck #
Case #
Applicant Name (e 5c -o�AL,e,k
t/ Building Application _ Land Use Application _ Shoreline Application
On-site Sewage Application _ Subdivision Application _ Other:
1 . Is there any standing or running water on the surface of the YES )4.NO
property or on any nearby property at any time during the year?
If YES, please describe:
2. Has any portion of the property or any nearby property ever been YES V NO
identified as a wetland or swamp?
If YES, please describe:
3. Are any willows, skunk cabbage, alders, or cottonwoods present • -"YES NO
on your property or adjacent properties?
If YES, please describe:
A- ce-Ado
4. Are there any indications on any portion of the property or on any YES
•/ NO
nearby property of rockslides, earthflows, mudflows, or landslides?
If YES, please describe:
5. Please indicate which line best represents the steepest slope found
on your property. (Check appropriate box)
D 4 4 4 4 ❑
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,5 -- (Questionnaire Continues on Back)
6. Does the site have steep slopes with little to no vegetation? YES ✓NO
If YES, please describe:
7. Does the site contain high percentages of silt and/or very fine YES ✓NO
sand?
If YES, please describe:
8. Does the site contain ground water seepage or springs near the YES ;
surface of the ground?
If YES, please describe:
The applicant hereby certifies that all of the above statements and the information contained in any other
transmittals made herewith are true, and the applicant acknowledges that any action taken by Jefferson
County based in whole or in part on this application may be reversed if it develops that any such statement
or other information contained herein is false.
Signature J Date ! `
FOR OFFICE USE ONLY
❑ Wetlands ❑ Seismic
CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1
IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2
❑ Erosion
❑ Landslide
Zone:
Parcel Size: Status:
Comprehensive Plan Land Use Designation: Reviewed by:
Community Plan: Date:
Owner/Applicant: 1)I) t 'l STORMWATER�.�U l� l � . CALCULATIONS
�M
Site Address: ���-- kr-ex ❑ PROPOSED LAND DISTURBING ACTIVITY
���-= �-
Drainfield area cleared sq.ft.
Driveway Length ft.
�>�, �,t! X Width ft.
9 Digit Parcel Identification No.: r5L% TS of
= Total Driveway sq.ft.
Permit Number:
Clearing and Grading for Site Development
(Well/Structures/Utilities/etc.) sq.ft.
Total Land Disturbance sq.ft.
PLOT PLAN
INDICATE the following information.
❑ IMPERVIOUS SURFACE
Draw entire parcel to scale. Indicate scale of plot plan:
Proposed Structures (all roof area) 57{_
4, sq.ft.
One inch equals
Existing Structures (all roof area) f 7'1 o sq.ft.
Sidewalks sq.ft.
01-1. North arrow
Concrete Patios sq.ft.
(3--2. All property boundaries and dimensions
Proposed
O 3. Names of adjacent streets
Driveway Length , - ft.
Cf Driveway/s & parking spaces X Width ft.
O 5. Major features such as ravines,
= Total Driveway 5-76 sq.ft.
seasonal creeks, bodies of water, etc.
�`� sq.ft.
Total Impervious Surface
a-6. Septic tank and drainfield location,
existing or proposed, and distance to The Stormwater Manual sets forth the following Small
Parcel Minimum Requirements:
closest structure • Construction Access Route Stabilization:
O 7. Sewer lines Construction vehicle access shall be, whenever feasible,
limited to one route. Access points shall be stabilized with
Q-8"Wells and/or water lines quarry spalls or crushed rock to minimize the tracking of
9. Neighboring wells within 150 feet sediment onto public roads. If sediment is inadvertently
O transported onto public roads, roads shall be cleaned
10. Paved surfaces (patios) thoroughly at the end of the day by shoveling or sweeping.
G1-1--1":- Structures, existing and/or proposed Street washing should only be done after the bulk of the
sediment has been removed by sweeping.
O 12. Setbacks (distances to property • Stabilization of Exposed Soil:
boundaries, structures, banks, All exposed and unworked soil shall be stabilized by
sodding, seeding, mulching, plastic covering, application of
and shorelines) gravel base on roads and driveways, or other appropriate
O 13. Easements for access or utilities means within seven days during the period from May 1 to
September 30 and within two days during the period from
O 14. Arrows showing direction of slope-- October 1 to April 30. Mulch shall be applied to a minimum
assume an elevation of 100 feet at one depth of two inches.
• Protection of Adiacent Properties:
lot corner and indicate the other lot Adjacent properties shall be protected from sediment
corner elevations in relation to it deposition by appropriate use of vegetative buffer strips,
sediment barriers or filters, dikes, mulching, or by a
combination of these measures and other appropriate Best
FOR APPLICATIONS ADJOINING SHORELINES, Management Practices (BMPs).
INDICATE: • Maintenance:
All erosion and sediment control BMPs shall be regularly
O 15. Ordinary high water mark inspected and maintained to ensure continued performance
O 16. Top of bank, if over 10 feet high of their intended function.
• Other Appropriate BMPs as required by Jefferson
O 17. Slope of bank in degrees County to mitigate the effects of increased runoff shall be
applied.
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JEFFERSON COUNTY BUILDING APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD97-0397 DATE RECEIVED. : 06/23/97
SITE ADDRESS: 212 COUNTRY RIDGE RD
:CHIMACUM, WA 98325
APPLICANT. . . :TERESA DUKEK PHONE:732-4206
MAILING ADDR: 212 COUNTRY RIDGE
:CHIMACUM WA 98325
CONTRACTOR. . :OWNER PHONE:
MAILING ADDR:
•
CONTR. LIC #: EXPIRATION DATE: / /
ARCHITECT/ . . : PHONE:
DESIGNER •
MAILING ADDR:
PARCEL NO. : 801045010 landslide _ plat cond _ wetland _ flooding _
LEGAL DESC: STR 04-28-01 W WM seismic _ streams _ erosion _ f & w _
LOT 10, BLOCK , TAX #
COUNTRY RIDGE
DESCRIPTION OF IMPROVEMENT: TWO STORY STUDIO GARAGE
BUILDING TYPE •GAR BEDROOMS--- BATHROOMS-- MAIN FL. . . : 428 sf
TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 0 sf
GARAGE/CARPORT • PROP. . : 0 PROP. . : 1 HTED BSMT. : 0 sf
WOODSTOVE • TOTAL. : 0 TOTAL. : 1 UNHT BSMT. : 0 sf
UBC OCCUPANCY GROUP: SEWAGE DISP. . :ALT OTHER • 0 sf
TYPE OF CONST • WATER SUPPLY. :PWELL CRPT/GAR. . : 529 sf
UNITS. : 0 STORIES: 2 HEAT TYPES. : DECKS 0 sf
DIMENSIONS: COMMERCIAL: 0 sf
FRAME TYPE:WOOD INDUSTRIAL: 0 sf
EST COST. $: 27623 BANK HT. . . : 0 ft
PROJ GRP. . : 7257 SH SETBACK: 0 ft
Owner/agent FEES
Signature: i. k type amount by date recpt
F PRMT $ 376. 75 EMH 06/23/97 1132599
Date: ' n PLCK $ 113 . 03 EMH 06/23/97 1132599
B.C. $ 4 . 50 EMH 06/23/97 1132599
Issued By:
of c oocs
Date:
$ 494 . 28 TOTAL
JEFFERSON COUNTY PE•T CENTER, 621 SHERIDAN ST, PORT•NSEND WA 98368
• BUILDING PERMIT APPLICATION
PROJECT DESCRIPTION: a Sku S I th 0 Cl1«,.;(.1 `t_
BUILDING TYPE: PROJJ T TYPE: FRAr YPE:
❑ SINGLE FAMILY ®''NEW ®''WOOD
®�ARAGE ATTACHED/DETACHED 0 ADDITION 0 STEEL
❑ MODULAR 0 ALTERATION/REMODEL ❑ CONCRETE
❑ COMMERCIAL 0 REPAIR 0 MASONRY
❑ MULTI FAMILY/# OF UNITS 0 DEMOLITION 0 OTHER
❑ INDUSTRIAL
❑ OTHER
BEDROOMS: BATHROOMS: TYPE OF SEWAGE DISPOSAL:
EXISTING EXISTING 0 SEWER 0 COMMUNITY SYSTEM
PROPOSED PROPOSED I 611--115VIDUAL SYSTEM ❑Conventional
TOTAL 95 TOTAL ___L— PERMIT # SEP fd-lt, QC2 DICIT native
WATER PPLY: TYPE OF HEAT:
IVATE WELL 0 TWO PARTY WELL 0 ELECTRICITY 0 OIL
❑ PUBLIC Name of water system: 0 WOODSTOVE 0 PROPANE
0 HEAT PUMP 0 OTHER:
SQUARE FOOTAGE: FOR OSCE USE ONLY:
MAIN FLOOR
IJBC OCCUPANCY GRQUP
2ND FLOOR 9 -.E ON iNISItp {
3RD FLOOR 2
BASE FEE 7 ,F��7•_
HTD BASEMENT
BLA1 CHECFf
UNHTD BASEMENT
STATE SURCHARGE 9 50..;::;
SUBTOTAL
CARPORT n
GARAGE 5)-9 5"agD POTABLE WATER : ::
DECKS /
921/ROAD APPROACH
COMMERCIAL
GRAND. TOTAL --.4f .:
INDUSTRIAL
OTHER RECEIPT #
TOTAL VALUATION 9
51 ......
CAS CK
or INITIALS..
yy
ESTIMATED COST _ t
,,o• - . . . .. .... .............::::':d'''. 47"'""""""""'
IF WATERFRONT PROPERTY, 13 r 7 -G1:3 9'7
DISTANCE TO BANK OR HIGH WATER LINE ft BANK HEIGHT ft
SIGNATURE L DA Atik DATE / / z 7
NAME (PLEASE PRINT) (etega.. DO c H:\Home\Plncntr\Forme\Bldapp.DOC 6/97
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