HomeMy WebLinkAboutBLD2008-00330 •UILDING PERMIT APPLICAT ON MLLA0800313
Review
Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00330 Received Date: 7/24/2008
SITE ADDRESS: 10 TIMBERLINE RD
PORT TOWNSEND, 98368
OWNER: AMANDA WEBBY PHONE: 360-385-1444
10 TIMBERLINE DR
PORT TOWNSEND WA 98368-9089
SUBDIVISION: Block: Lot: TX 4+
PARCEL NUMBER: 001203010 Section: 20 Township: 30 N Range: 01 W
CONTRACTOR: TOWNSEND BUILDERS INC PHONE: (360)385-1938
PO BOX 1347
PORT TOWNSEND WA 98368
Contractor's License TOWNSBI088JA Expires 3/30/2010
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION GROUP B PUMP HOUSE
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 2,422.00 ADD'L: HEAT TYPE:
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
/a51o �
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $83.25 KAS 07/24/08 100583 APPROVE[
Plan Check $54.11 KAS 07/24/08 100583
State Building Code $4.50 KAS 07/24/08 100583 AUG b 2008
Total: $141.86 Jefferson County Planning
& Building Department
JeJerson County Building DiPsion Permit Nu , BLD08-00330
Applicant: WEBBY
BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that 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 --pg
Foundation Footing � __ � taW0
Ext. Shear Wall Nailing t'I.6 9c_
Rough-in Plumbing )_1(40ct
Framing 2112-(D
Airseal
Insulation:Walls
Insulation: Floors
Insulation: Ceiling
Int. Shear Wall Nailing
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
— •
CONDITIONS for Building Permit# :BLD08-00330
1.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP)
Elements#1 through#12 of the Department of Ecology's Stormwater Management
Manual for Western Washington 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 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.
rici,
gC�N c JEFFERSO UNTY •
W } DEPARTMENTlI/COMMUNITY DEVEl70PACIENT
�' '� 621 Sheridan Street • Port Townsend •1/Vashington 98368 -
360/379-4450 • 360/379-4451 Fax
�gsmN�,p"i www.co.jefferson.wa.us/commdevelopment JUL 2 4 2008
Master Permit Application rc.t_„�. ,, Cut I�j�MLA: 0�o _ )
Project Description (include se, crate eets as nepessary): "L , ' t C u j1f I I F u
004 P7 ' Rrn? V\&.
Tax Parcel Number: 60; Z 03 )i C) Property Size: /J , to 51 a�,� (acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record: aul.c-K .
Telephone: ', -(Cl c-(Li Fax: 3S s -(�{ `i email: 0.vw= Q�,.,>�l�,f La .:1.
Mailing Address: I e , 1lw.�c1".c�..C, ,.ti 4- r s�r...-�C"w`
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Maili g Address:
W t kind of Permit?(Check each box that applies
Li
\1421` \ns - ❑ Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
0 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification
0 Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
❑ Address ❑ Road Approach 0 Short Plat**
❑ Home Business 0 Cottage Industry ❑ Binding Site Plan**
❑ Propane ❑ Long Plat**
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/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 a cess and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and any required I r inspections. Staffs access and right of entrywill be assumed unless the applicant informs the ounty in writing at the
time of the application t t e or e wants prior notice.
Signature: ------L----------,, Date: `/f kl ()
The action or actions plicant will undertake as a result of the' s ance of this permit may negatively impact upon one or more threatened or
endangered species and could lead to a potential"take"of an en ngered species as those terms are defined in the federal law known as the
"Endangered Species Act"or"ESA."Jefferson County makes no s urances to the applicant that the actions that will be undertaken because this
permit has been issued will n violate the ESA. Any individual,group or a neje can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in c pliance with the Jefferson County devel ent code.The Applicant acknowledges th t he,she or it holds individual
and non-transferable respo ilit for adhering to and complying w' the ESA. The Applicant has read this disef i `an. ates it below.
Signature: (f �
Date: rand ig s C)
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• 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 Co itr=tor for the prop'osed project.
' r
Signature: �U• e1 Yr 1—t" Date: J�t.`t)zLt )0S
GENERAL CON IR MANUFACTURED HOME INSTALLER: PHONE: FAX:
0\NY\SE,-N(1( t\). v(VS S -- K c 1,., \ ( 01 V)-c, t ( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Prot Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
W New Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: LI Private well LI Two Party
Type of Heat: Proposed: ❑ Public
Total: 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:
i Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove i 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 Current Proposed For Office Use"Only' Amount Revision
Main Floor Heated EH BId App Review: IC .5*1, hIS no kt, 1 e�
n*F Irteit 5.0p(A oP
2nd Floor Heated Consistency Review:
Other Heated E C F 1 �Y 't Y` Base fee:
Mezzanine Additional Section:
Heated Basement JUL 2 4 41/114. Plan Check fee: 4. L I
Unheated Basement v.+ State Surcharge fee:
t,t ,1, �� 4-5C
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL V-1-1,`
6(0
Decks 911/Rd Approach fee:
Other (4i 1 I
V1 Oc c,4_,,.._ `1 I `T f)). TOTAL: $ I`t l. Vt0
f C5B�
Receipt Number: 10
Cash/Check Number: 30DS
ESTIMATED COST(REQUIRED) Date:
.Fair market value of all labor and materials foundation to finish '7/a 41 og
SA WO Initials:
G:\PermitC.•nter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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