HomeMy WebLinkAboutBLD2005-00762 - 01 PERMIT APPLICATION 0 •
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD05-00762 Received Date 12/13/2005
SITE ADDRESS: 52 7TH AVE Issue Date 12/14/2005
PORT HADLOCK, 98339
APPLICANT: BROOKE TAYLOR PHONE: 360-379-8193
PO BOX 664
PORT HADLOCK WA 983390664
SUBDIVISION: IRONDALE Block: 2 Lot: 23&24
PARCEL NUMBER: 961800205 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: REPAIR FIRE DAMAGE OF RESIDENCE NO MLA REQUIRED
CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT.
SETBACKS: N/A-
UFFER: N/A
Footing: (1ti/
Foundation: NI A-
Stormwater FINAL Approval:.
Underground Plumbing: N
Underground Insulation: [/A"
Shear Wall : N`
Sheathing:
6
Framing:Fercvrr.*eel izt--(,•-25-`a7
Plumbing: c -2-—o 7
Propane Tank/ Lines: r.".* : /l4 ,,� ,
Insulation:;,e147v cs Loom`\ irvu .s_-7 f 0
,'l lL '7
Sheetrock: �-?""`- 7)4 V(t7d7
Septic Sytem Final Approval (If not on sew )
Road Approach Final Approval:
Zoning Final Approval:
Final/Occupancy Approval: l a/i CI 14
HEALTH DEPARTMENT AND 1UBLIC 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. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9:00 a.m. -4:30 p.m.
PERMIT # BID HOT LINE AVAILABLE 24 HOURS A DAY
0 5 — 0 7 6 2
O RSON CBflNTY BCD
I:\F_BLD_Permit_Buildng.rpt 10/29/19
•
•UILDING PERMIT APPLICA•N B ReviewTy7pe62
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD05-00762 Received Date: 12/13/2005
SITE ADDRESS: 52 7TH AVE
PORT HADLOCK, 98339
OWNER: BROOKE TAYLOR PHONE: 360-379-8193
PO BOX 664
PORT HADLOCK WA 983390664
IRONDALE
SUBDIVISION: Block: 2 Lot: 23&24
PARCEL NUMBER: 961800205 Section: 34 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr REPAIR FIRE DAMAGE OF RESIDENCE NO MLA REQUIRED
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP REP MAIN:
VALUATION 20,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2003 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PUBLIC
BEDROOMS: BATHROOMS: PERMIT # BLD
Exist: 2 Exist: 2 Il D
Prop: 0 Prop: 0
Total: 2 Total: 2 0 5 - 0 7 6 2
Routing Date:
t a\ Q JEFFERSON COUNTY OCR
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $321.25 SLE 12/12/05 77498 APPROVED
/
Plan Check $208.81 SLE 12/12/05 77498
State Building Code $4.50 SLE 12/12/05 77498 DEC 14) 2005
Total: $534.56 Jefferson County Planning
& Building Department
7ON'
co JEFFER COUNTY F! LLciIr
, ,
IA DEPARTMENT OF COMMUNITY DE4' OPMENT ,
`'Q 621 Sheridan Street• Port Townsend'•Wash n 6
360/379-4450 • 360/379-4451 Fax � 5 '
'1`% CI www.co.jeffersan.wa.us/commdevelopment
Master Permit Application
MLA: NO MLA
Pro EN!sf P• n N► � �s/�h/eets,aecessary): Q >1
Tax arcel q /(fl o Proey / i ber Size:
1 ( V )(/ t2� ��(acres/square feet)
Site Address and/or Directions to • •perty:
Property • GO- of "ecord: • !t,l , i1('�1.�
Telephone: , , 1"- ' 'L ax:F
[� email:
Mailing Address: p.o. ;Q , 1 /' / 9
Applicant/Agent(if different from owner):
Telephone: Fax:
email:
Mailing Address:
Wyet kind of Permit?(Check each box that applies)
" 'Building ❑Variance(Minor,Major or Reasonable Economic Use
Vernolition Permit ❑Conditional Use[C(a),C(d),or C]*' )
ngle Family ❑ Discretionary"D"or Unnamed Use Classification
❑Garage Attached/Detached ❑Special Use(Essential Public Facilities)**
❑Manufactured Home ❑ Boundary Line Adjustment
❑Modular ❑ Short Plat*`
❑Commercial* ❑ Binding Site Plan**
❑Change of Use ❑ Long Plat**
❑Address ❑Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments**
Propane ❑ Plat Vacation/Alteration**
❑ lowed"Yes"Use Consistency Analysis 0 Shoreline Master Program.Exem Exemption/Permit Revisions
❑Stormwater Management i "*
0 Management Substantial Development*'"
❑Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment
❑ 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 f'%'
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 ownefiagt nt gtbistsliilhe 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 en to Jefferson County and its employees,representatives or agents for ■ - sole purpose of application
review and a • ired I- -r i : ,: L, '•.- and right of entry to this property shall be requested and shall •.« r• I duriNsegular business
hours. 4 r
Signature: �1.1 V /.A L 1, da Date: / I
1 .
The action or actions Applicant will underta!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)eve• " •u are i corn. -• ' 1 e •fferson County development code.The
and non-tr. sf- .1: - .,. •.it,, `. � ,, Applicant adknowled!- that h-,she or it holds individual
hill , h'.Ji,4 iii` complying with the ESA. The Applicant has read this i -Iiir and dates it below.
Signature: �i hill%t / /• �o f f Fir
Date: / /
G:\PermaCen ter\FORMS\Dill)FORMS\Master P. t Application 7-8-04.doc
■
• I
OWNER BUILDER STATEMENT
The signer of this statement•• ereby ce fy that they are the Owners of the parcel referenced herein,that they are not lice nsed contractors and that
they wil be ing1. res• _....7. of y heralt,m for the proposed :
„Signaire: ii, /( .i�, I ill. Date: , 0
GENERAL CONTRACTOR OR MANUFAC RED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Fr ifie Type: Bathrooms: Shoreline: Typo of Sewage Dismal:
❑ New Wood Existing:
...
❑ er
❑ Addition ❑ steel
Proposed: Bank ❑ unity System
❑ rahon/Remodel ❑ concrete
Total: Height: Individual Sys / ,-p
Repair ❑ Masonry 3�
❑ Demolition ❑ Other. � '` Setback: ❑ Private we� ❑ Two Party
Type of Heat: Proposed: ❑ Pubis
Total: Name of System:
ff this is a Commercial Proiect you must answer the foliowina:
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 Pro• ne Tank an• or • • i: ce Installation • =rm mark all items below th /�q,�
o Underground Tank Above ground Tank Size of Propane Tank: , P �l Yf
1 ;Ffeat Stove Cook-Stovee ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ P Stove ❑ Other
Is this appliance being Installed Ina Manufactured I Mobile Home? Yes l No
When applying for a penult 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,
Includin r the reserve area.
S•uare Foo . For Office Use Only .� � *,
Main Floor • ti f! ►-, -,q x ?s+�� `� .,I as as '1k
2 Floor = "" _ `� T g a ;,� =
l',1--;'1,*", s,,:,1 ,r.- az� d � .;ter'` .
.3� Floor � ;s � �?�,�i-. «i e ti � �4 '� 'ae; ��_ `_ � w,��sm•R,,, -r.�, ",�,
Mezzanine: �4 -4" -$
e ax � t7., .�. =r�x tea. ',,-,4-4,-- �. :IL. �x 1 .r
Heated Basement ,• - ., .
mar. :_:c.�t.�. w,fit ��•..ce t�--.�:� '3 ��a �^r....a`�* '•e
Unheated Basement • ft'
Other Unheated ; = �* °>3 � .'
Garage&Carport TOTAL• $ t1 ,
Decks } , 1 yY 4 ,
Receipt Number. .
Other Cash/Check Number: r �x
COST REQUIRED Date: '
.Fair mari va/ ail labor and/�aterials foundation to finish
DW.OV Initials:
G:\PemutCenter\FORMS\DRD FORMS\Master Permit Application 7-8 04.doc
•
w •
JEFFERSON COUNTY r(j) ` �=k" ! r,z
;L ' DEPARTMENT OF COMMU NITY DEVELOPMENT ; fw__ _ __�i ,
I
621 Sheridan Street•Port Townsend•Washington 98368 DEC 1 2 '
= .� tr
360/379-4450.360/379-4451 Fax
httpJ/www.co.Jefferson.wa.us/commdeveiopment/
Stormwater Calculation Worksheet _
I # PROJECT/APPUCANT NAME: i ' /1' / f I 1 - i ilii if All
4F-- for-
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first
to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in
with a stand-alone stormwater management permit application,building permit conjunction
involves stormwater review. The basic information will also be helpful for completing a Stormwater Sit Site required.rep r application t
PARCEL SIZE tIE.,SITE)
Size of parcel .21 acres An acre contains 43,560
square feet. Multiply the acreage by this figure.
sclift
Size of parcel in square feet ��Q
Land-disturbing activity is any activity that results in movement of earth,or a char
non-vegetative) and/or the existing salt change in the existing soil cover(both vegetative and
excavation,and topography. Land disturbing activities include, but are not limited to clearing, grading, filling,
compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,saimonbeny,
and salal;herbaceous plants such as sword fern,foam flower,and fireweed.
LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL
Calculate the total area to be cleared,graded,filled, Answer the following two questions related to
excavated,and/or compacted for proposed developme 1 -'." conversion of native vegetation:
project. Include in this calculation the area to be cl 1. -' for. ,
Construction site for structures
I. the project convert 34 acres or more of
=vege = fo lawn or landscaped areas?
Drainfield,septic tank,etc. sq/ft Circle: Yes
No
Well,utilities,etc. ',`h i } .- the project convert 2%acres or more of
Driveway,parking,etc. .„�� sq/ft =five vegetation to pasture?
Lawn,landscaping,etc. .I Circle: Yes No
Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance sglft Cut Fill
(cam)
[over]
stoma/water calc worksheet—REV.10/1/2003
1
•
Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include,but are not limited to roof
tops,walkways, patios, driveways, parking lots or storage areas,concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.
• ' STORMWATER CALULATIONS–IMPERVIOUS SURFACE
NEW EXISTING
Structures(all roof area) sq/ft Structures(all roof area) sq/ft
– Sidewalks ..� sq/ft Sidewalks l 0 sq/ft
Patios Sciat Patios sq/ft
Solid Decks sq/ft Solid Decks 178' sgfft
(without infiltration below) ' • (without infiltration below)
Driveway sg/ft Driveway /► h sqft
/
Other sq/ft Other W _ v sq/ft
Total New 9g/ft Total Existing sg/ft
TOTAL NEW+TOTAL EXISTING* , sq/ft 'This amount will be used to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v.REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: I %
Does the site have 35%or more of existing impervious surface? Circle: Yes
FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be
used to determine the applicable Minimum Requirements. If the answer is no,the proposal is considered new development and the
attached Figure 1 should be used. At this juncture,the applicant should refer to the applicable Flow Chart to determine the Minimum
Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements.
For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stomlwater Pollution
Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction
Stormwater Pollution Prevention (SWPP)Best Manage t Practices(PUPS). rents of"medium'projects—those
that must meet only Minimum Requirements #1 throug i -,t. `a r i ,'r'. ::, c■ that must meet all 10 Minimum
Requirements—are required to submit a Stormwater Site f Vila v - t->':M itt if emplate of a Stormwater Site Plan,
principally for rural residential projects. Complete the template: t e Stormwater Site Plan InstiUctions and Submittal Template or
prepare a Stormwater Site Plan using the step-by-step guidab ei' the 1p1 ` r Manage =nt ual.
APPLICANT S 'ATUR .„
By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my I also certify that this application-la being made with the full knowledge and consent of all
o • he aff, -• • arty.
11" ►/ A �J1 )-
( "s ER OR AUTHORIZED-4-°17-= ATIVE SIGNATURE) (DATE
stoanwater caic worksheet—REV.10/1/2003 2
ft
_ _____ __.
.,...., . _ _ .
,9,,-/e ii
w
(i, ,,,,,,,,
,
Tii '''.,.._
„,,, ,”
\ ,
. _.
:tv
.., t
cn .11
IZI ,.),
)
i
1
b_ I
I
6,1
I r
■ 1.., il (11,
) i
fs.
....
'11,,,,,
skt.
I Ii(j1
z i
:t / /
7 .'kl
,
:-.4,,,,
, Z. ■
ifr'''+ 1 I ,::,,
,,,,., ,
17
,
i --;„--... ,
q' '
,›
(NAZI 1 .,
I
I (.;
IC i N:
, I
1
:'7 1 e f
0
I r q)
1 - '•-,
i 1 i 1
o 7'
x .N) I— 4■ I
- c 7
9 f 1-----
GI
/1> &J
. .
)4
1---
1
rm %
11 Q.3
11
rti 0
c:..).".•4‘‘)
co .....,-,,,
....... 0
■ , - 0
..._
(,,ni,, ,,, fq, :.) cic ., N) rp
..4,›, , F 5 ,,,rik „„.„ Illt„, IN. vin
4")
r---.
-....--- , A....„, j %,,,,>, kr,
.9`—'
.>\ t, 1
-ti
1„4,..._
70
I
,
(f)
i 1
9
3 P
Li_ _____i -_:------ I
..*-,
1 /
1
ILL i 1 I
■
I I
I
_
'AJ -.._ rs, :
zzi c.. qix
.y.K%ZS' I 1
' tt '•:.'1\.1 N f
•••3 Z;,..: ',. 1
i :•„t c) ! .. 41 i, t.:*:.. .2 SZ,. I\
•.....
--1 - 1.411 CO
",:t3__ •
"''' ,. :.4...
0
-..)t.- C' I lj .•...c. '^i '
-771:4;3,
'''-i1 ',-.,-----
‘.1 I
- 1 1 It-_-11
-----7
L i
eiHr:
i irt
NJ
r=3
1 I 0
rn
1 i
--■ : '7' ,
I
i ‹*
0 0
ki: 0 0 1
, N
Z5 17,21
,',....
ID -.... 0
1
Va —1
k F
t-t-i
1
Ei) , ...
1 I■ 0
IL,1 1>
1 _ LLI \.......„—__
..... i c.h
I- cz1r) N_
I 1 ii;
r
0
c4
Y'4 ,
,...
CY 1
ill
4Y3677r/4425-'
L
)
_ 1 E __ _
A/V6Y0c/
gr -
----
_
„7.1:3&:7, 1VO,
7' .
.:=!.
.... ,
lir — I P ' MIT # OLD
,
, ,
_
0 5 .. 7
0 6 2
'''' '' U0,-8/ -I' „as •---- FERsoN COUNTY DCD
, -FILE coPY___ v-,s----
# ,
P
t
R
ipl
G 3
Z
c •
£ b o
A
r •
1
V
-o
/ E
A it sx
, T t...._
il ii,
___\
I! 0 L A'A . 14 ,,,A:A.r.40#* ,v r A'.A ,,,01
h
w- b 1
,,..
�� o
30 •
z.
V1
-.. --.
N)
r,.
r
•
1C
n 7
N
[RMIl # BID
Co
}m. 111irri `5 0762
FiERStIN E01.1%11( IICD
1
. 1
. 1
Elf6ENE 57: .
. .
. • • .
. . .
. . _ •
• . . ;
',, - . ....,
E__
............
_._.,,
.
.... 1
I —4? I
S .....\...\
/S /
',..s.
.....wI... .z,s
.
Ni.,,..39.R.......,.,,,....._ .c:,-,),, ._z
1 1f!'..4—.. A
O.,.‘mmoimt, ..zi.
V S.'4 7C:14 I
. . ii......, "...
-7-r-C):
i
,
1 4
4
:
...,
1 c..... N ,...4.;
„ . -;-,-- ..,-
rt1 ,
I r...._____1..... i
......—*....
.%
I
I
1
I 1,
•
:."*".• .7....1
r>
. ...... rt..)
9\
!al) 77.i I
ki '....4 ..11M.....
. I
....c.„
. . , .., . . .
1 .
,..
. . . , .... .,,,,
,........c.,„ ,
..../....
,....D . ...............
oN„
. T.
7...-A .
. . .
. .
. ;
. . . ,
,.... y . ' .
.., .
•
-....
,
, .
•
•
• t\1
. • 1
c3... 1,-..
_I I
., .
i.--T--,
k-1: ..." ..
. - -:
: rn I ,r77.,, I•,... C.... t,
• . c-) 1.,::,, e, i 1;z1 Q) ''''
I ,
. .i. PERMIT # B 11
:„...,
..... ... ....,„.
.,......____
...• ...., 1„...
:::: ,,9 . NI
. ._ ..7..;:.::;" 3iffERSON CNTY DCD
'1. 7e/f1A/3a/93"o t\.5
1
r
y
41
s.
J
f
•, ,
, ,W
i i
d t
i/if_ _ i
CZ 1
--T\ .
iY
;
f i r
/
„yam
r .
1 , ... .,
1 cs. i
.t) !
j - 1 c9 !�
`
,
/�;o/
1
,�(�, Q1-`' __.+%
r,
St 1
I :
Cl-t I '
*ID Cs)
_ Pl. IQ \\''''1..:.1)—;211.11 17-, _7,---.......77 1./6";'at
I
r-
E
o ›. � `
rn
1 n Cr-C.V1„.:li
N _,-- 4 CIS
0 CD
{ �1
.-._
_ O t"
SXo9
v
01 4=1
____,
i
T.,. ..._. —. __ ..__._.___-
/ f
,, /lr
0
0
E -
f
I
r
ti
•
i
O 1 ,
i LA
PI
O"
/4— H '
!yam
'
Z\
ill
Q
rn
n
ur
N ;
O G r5
l
7