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Home My WebLink AboutBLD2017-00435 - 01 PERMIT APPLICATIONt JEFFERS.N couNrY O DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend, WA 98368 360-379-4450 | email: dcd@co.jefferson.wa.us www.co.jefferson.wa. us/com mdevelo pment BUILDING PERMIT PERMIT #: SITEADDRESS OWNER: SUBDIVISION: PARCEL NUMBER BLD17-00435 40 ARDEN ST PORT HADLOCK, 98339 LEIGH O'CONNOR DEBRA SWANSON 40 E ARDEN ST PORT HADLOCK WA 98339-9634 9618 - IRONDALE 1.92 961800504 Section: 34 Received Date: lssue Date Expiration Date 912212017 912612017 9t2612018 PHONE: 360-643-1544 Townshio:30 N Ranqe: 1\A CONTRACTOR OWNER/BUILDER PROJECT DESGRIPTION: OPEN COVERED PORCH ADDITION TYPE OF WORK TYPE OF IMP VALUATION CODE EDITION: OCCUPANCY: OCCUPANCY: CONST TYPE: CONST TYPE: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: Exist: Prop: Total: 5N BATHROOMS Exist: Prop: Total: RES DEK 3,968.00 2015 R-3 SQUARE FOOTAGE: MAIN: ADD'L: HEAT BASE: UNHEATED: OTHER: GARAGE:DECK: 200 HEAT TYPE: HEAT TYPE: # OF STORIES SHORELINE: SETBACK: BANK HEIGHT: UH Type Amount Paid Bv: Date: Receipt: Permit Plan Check State Building Code Scanning Fee Total: $180.00 sRE $90.00 sRE $4.50 SRE $23.00 sRE 09122117 09t22t17 09122117 09t22117 171346 171346 171346 171346 $297.50 R105.5 Expiration. Every permit issued shall become invalid unless the work authorized by such permit is commenced within 180 days after its issuance, or if the work authorized by such permif is suspended or abandoned for a period of 180 days after the time the work is commenced. 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. Final lnspections require 24 hour notice. office Hours 9:00 am - 4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY Jefferson County Building on Permit Nu BLDl 7-00435 Applicant: O'CONNOR BUILDING PERMIT INSPECTION APPROVALS Appticabte Code: 2015 tnternationat Buitdins 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 & lndustries. The electrical permit must be signed off by the State lnspector prior to the County's Framing lnspection Inspection ltem Date Approval Signature Notes Setbacks Foundation Footing l7 6K Under Floor Framing 11 joists Framing t7 final inspection will not be scheduled until the following are completed and signed off by the applicable Department; . Building Permit Conditions ore met o Septic Permit Final/Complete lor any building contoining plumbing o Land Use Conditions met and signed olf o Public Works Permit Final (where applicable) FINAL INSPECTION .t/v//q sll ON MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR FINAL Lu, rorNc PERM rr APPr-rcnfi ru Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 BLD17-00435 Review Type: PERTI/IT #: SITE ADDRESS OWNER: SUBDIVISION: PARCEL NUMBER: BLD17-00435 40 ARDEN ST PORT HADLOCK, 98339 LEIGH O'CONNOR DEBRASWANSON 40 E ARDEN ST PORT HADLOCK WA 98339-9634 961 800504 Section: 34 9618 - IRONDALE 1-92 Block: Township: 30 N Range: Received Date: 912212017 PHONE: 360-643-1544 Lot: 1\ CONTRACTOR:OWNERYBUILDER REPRESENTATIVE: PHONE: PHONE PROJECT DESCRIPTION: OPEN COVERED PORCH ADDITION TYPE OF WORK TYPE OF IMP VALUATION CODE EDITION: OCCUPANCY: OCCUPANCY: CONST TYPE: CONST TYPE: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: Exist: Prop: Total: RES DEK 3,968.00 2015 BATHROOMS: Exist: Prop: Total: SQUARE FOOTAGE: MAIN: ADD'L: HEAT BASE: UNHEATED: OTHER: GARAGE:DECK: 200 Type HEAT TYPE: HEAT TYPE: # OF STORIES: UH SHORELINE: SETBACK: BANK HEIGHT: Amount Paid By: Date: Receipt Permit Plan Check State Building Code Scanning Fee Total: $180.00 sRE $90.00 sRE $4.50 SRE $23.00 sRE 09122117 09122117 09122117 09122117 171346 171346 171346 171346Approved/Date APPIICVED SEP 2 6 2017 Jefferson CountY DCD $297.50 \\lidamarlz\dala\farmc\tr Rl [1 Ann Rld rnf ol)rlri,t7 o DE,ARTMENT oF coMrut*r- DE'EL.,MENT 621 Sheridan Street, Port Townsend, WA 98368 T el: 360.37 9.4450 | Fax: 360.379.4457 !7eb: E-mail: dcd@co.iefferson.wa.us -Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued. For Department Use Only Building Permit # MLA#Related ication #s: Site lnformation Assessor Tax Parcel Number:6 troo so Site Address and/or Directions to Property:o GNS Access (name of street(s)) from which access will be gained:il-fLO€N 57. Present use of property: _S, F. K Description of Work (include proposed uses) I tz fr o?tN Co,/€{a€ Po6Lc lA ADo tVo N Wastewater - Sewage Disposal This property is served by Port Townsend or Port Ludlow sewer system? lf not served by sewer identified above, identify type of septic system below YES Nox Type of Sewage System Serving Property: X Septic Septic Permit #:S oA 7o -r>o3( 3 Community Septic Name of System:Case #: Are other residences connected to the septic system? Additions or repairs to sewage system: ls it a complete or partial system installation: Has a reserve drainfield been designated? L{o Complete Yes Partial No Date of Last Operations & Maintenance check:S /zo /zctt Attach last report to application Describe or attach any drainfield easements, covenants or notices on title, which may impact the property: Pcrmit ,tpplication Page 1 of 2 PERMIT APPLICATION Steps in the Permit Process: qtr ?1 zon -Review application checklist to ensure all information is completed prior to submitting -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application; it must be accompanied by a project specific supplemental NJO rheauthorizedagent/rep;ffifix'ffiilJ:'#i::ffi1'iil[Ti.iif;:?i:i:-""#lii,:;,"""t#iffi';:fl::ffiilii,lx""i,l,i,i.'l#!,, / e-mail requests and in $s \ below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. ltistheresponsibilityoftheauthorizedagent/representativeandownertoensuretheirmailboxacceptsCountyemail (i Cou email is not blocked or sent to unk mail" 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 or her 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 making any issued permit null and void. I further agree to all applicable fede that all activities I intend to undertake or complete associated with this permit will be performed in compliance with ral, state and county and regulations and I agree to provide access and right of entry to Jefferson County employees, representat or the sole purpose of app the property for lication review and any required later inspections. Applica request notice ofthe visits related to this application and subsequent permit i Print Name and its nt may nce. Applicant/Property Owner I nformation info. (select on e) Property Owner Signature:o^r", lbr/l , e PI ease contact A uthorized Propefi Owner: E-mailAddress: Name: Address: Phone #: ^ru,',',jJ,vew*hPro Note: For projects with multiple ffi, rrr^rTKupr,rt" rhF*Hach owner(s) information and signatures. Applicant: Authorized Agent/Representative (rf other than owner) Name: Address: Phone #:E-mailAddress Authorized Agent/Representative for thisls NOYProfessional: Engineer Name: Address: Phone #: ConsultantArchitectSurveyorContractor License # Professional: ls this an Authorized Agent/Representative for this project? NO YES Name: OorK ErZaz- License # Address: Phone #:E-mailAddress Professional: ls this an Authorized Agent/Representative for this project? NO YES Engineer Name: Address: Phone #: ConsultantArchitectSurveyor E-mailAddress Contractor License # Pc*[t .\ppLcatk>n Page 2 oi 2 Signature tn nter upon Date E-mailAddress: o o DEPARTMENT OF COMMI-INITY DEVELO 621 Sheridan Street, Port Townsend, WA 98368 Tel 360.379.4450 | Fax: 360.37 9.4451 Wcb: www.co.iefferson.wa.us /communitydevelopment E-mail: dcd@co.ieffcrson.wa.us RESIDENTIAL OR COMMERCIAL B Enter the square footage (sq/ft) that applies in each field Supplemcntal SFR 1 Site lnformation Owner Name of New Addition Replacement Repair Relocated _ Demolition _ _ * +A separate permit is required Select One: Single Family Residence Modular Other list Number of floors # new bedrooms # new bathrooms existing existing 2 total bed total bathI Select all that apply Electric Heating Oil wood "/ Propane Residentia I /Ao'mmercial Main Floor llto Residential / Commercial Second Floor Additional Floors - heated / unheated Basement - unfinished Basement - finished space or habitable Detached Garage - heated / unheated Attached Garage - heated / unheated Garage 2nd fl- unfinished storage Garage 2nd fl - finished space or habitable Carport - 2 walls or less Deck - uncovered Covered porch zoo J:t ! .1 Other (shed, barn, pole bldg,etc.) Estimated Cost of Project ut s S 769,- qh I ?0p For Department Use Only Receipt #: Related #s: LIAssessor Tax Parcel #: Proposed Building/Project Heat Source Existing Sq/FtStructure Proposed Sq/Ft ICC Valuatioh (office use) o Building Permit Fees Building Base Plan Check Review Land Use Review Septic Review Potable Water Technology/Scan State Fee Other Fees Shoreline Exemption Zoning Zoning Other New Address Total Fees o List exist ba mobile home 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 with respect to this of his or her kn Any material falsehood or any omission of a material fact made by the owner/agent may result in making any issued permit null and void. Signatu rint Name Date a s2ss.00 s129.oo S172.oo s21.00 54.so 9naec Auf R//A/r1/6 The signer of this statement certifies that they are the Owners of the parcel referenced herein, that they are not licensed ming the responsibility of the General Contractor for the proposed project. Signature:nt Name contractors and that they will be Date Receiot #Date Supplemental SI"R 2 Cash/Check/CC: All Existing Buildings on Propefi Use Builders Statement