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HomeMy WebLinkAboutBLD2000-00219 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD00-00219 SITE ADDRESS: 20 PEABODY WAY Received Date 04/5/2000 PORT LUDLOW, 98365 Issue Date 04/13/2000 Expiration Date 04/13/2001 APPLICANT: MABLE I KADLECEK 20 PEABODY WAY PHONE: PORT LUDLOW WA 983659709 SUBDIVISION: TRAILS END HOMESITES Block: 2,5 Lot: PARCEL NUMBER: 950100208 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: CDR SERVICE CO PO BOX 1157 PHONE: (360) 692-9990 SILVERDALE WA 98383 Contractor's License: CDRSEC*082D6 Expires: 10/24/2000 LOAN LENDER/ AMERICAN STATES BOND HOLDER: PROJECT DESCRIPTION FIRE DAMAGE REPAIR REQUIRED INSPECTIONS: [ ] Footings/Setbacks (Shoreline Setbacks): [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: [ hear Wall: [/- Framin tubing: e /< /zyo v _ ropane Tank/Lines: [X lnsulation: // /2 / [I Sheetrock: 7 e9, ©n7 Final/Occupancy Approval: K _2:-5—€,7,, HEALTH DEPARTMENT 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. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CASE BLD00-00219 1.) No occupancy without approval from Jefferson County Environmental Health. 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J 00 O • - W — O LA N r;-') 00 PO CI, Po C-' 2 (D = dam oar BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00219 Received Date: 4/5/2000 SITE ADDRESS: 20 PEABODY WAY PORT LUDLOW, 98365 APPLICANT: MABLE I KADLECEK PHONE: 20 PEABODY WAY PORT LUDLOW WA 983659709 SUBDIVISION: TRAILS END HOMESITES Block: 2,5 Lot: PARCEL NUMBER: 950100208 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: C D R SERVICE CO PHONE: PO BOX 1157 SILVERDALE WA 98383 Contractor's License CDRSEC*082D6 Expires 01/01/1998 /p12.4 (ZcSvv ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: FIRE DAMAGE REPAIR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: 1,463 VALUATION 335,600.00 ADD'L: HEAT TYPE: WOD CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OIL OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL STORMWATER: YES NO AREA BEDROOMS: BATHROOMS: Wetland Erosion Exist: 2 Exist: 1 Seismic Streams Prop: Prop: Flooding Landslide Total: 2 Total: 1 F&W Plat Conditions Routing Date: Shoreline Aquifer 7 — 0 0 Forest: Commercial Rural Proximity Type Amount Paid By: Date: Receipt: Approved/Date Permit $482.15 MAM 04/05/00 27168 Plan Check $144.65 MAM 04/05/00 27168 /► C� O\ State Building Code $4.50 MAM 04/05/00 27168 �`�r Total: $631.30i‘) � 1 3 � �;)4115k. rso Fount Planning & Building Qvpartnlert I:\F_BLD_App_Bld.rpt 10/29/99 Jefferson County Department of Conuinnity Development ��¢S ON °06. 621 Sheridan Street.Port Townsend WA 88368(360)378-4450 4. . ..,,......_„. yr.,,e---....::::'.. . permoi A 4`SkING,c) pi? ... , ,cactijon ____ Project Description: t1(:.T A'1 e, -'''l .-' .6A 6Ei {'O*Ie 4VLAl✓I 4.. 1 1 el tL 41 Building Type: Project Type: rame Type: 1:4'"Single Family ❑ New Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete ❑ Commercial 0'Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: 2 Existing: ___I____ ❑ Sewer ❑Community System ❑ Electricity Cl/Oil Proposed: . Proposed: Q'Individual System 2'Woodstove ❑ Propane Total: __z__ Total: If not sewer,fill out the following: ❑ Heat Pump ❑ Conventional ❑ Alternative ❑ Other Permit# SEP Water Supply: CrPrivate well ❑ Two Party Well❑ Public:Name of water system: • • Square Footage: For Office Use Only Main Floor l't(c'J UBC OCCUPANCY GROUP 2ND Floor � /w Base fee •1 3rd Floor "' fr..1 Plan Check I 'y Li �' Htd Basement U(14 State Surrhnrge fee 5 D Unhtd Basement u /4 Subtotal 31'• 31) Garage/Carport of/14 Pot Water Review fee Decks 911/Rd Approach fee Commercial .Uj a TOTAL I . Industrial ,..)/a Receipt # a-----1 I(o sk Other Cash/Check# 19 ``, .-7 Total Valuation: Initials (/1/4•x` � Or Date (4.,ate` Y_J M Estimated Cbt 3 1 , w If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark i 4 ft.Bank Height Ai/At. ft. By signing the application form,the applicant/owner attests that the information provided herein is true and con ecc to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 attomey'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. 1 further agree to provide access and right of entry to Jefferson County and it's employees,representatives or agents Mr the purpose of application review and any required later inspections. Access and right of enuy to the applicant's property or structure shall be requested and shall occur during regular business hours. Signature: a! %''Y A'r.^ °< Date: 'Y-— O(-) Jefferson County Department of Community Development w �N coG 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 w g.42/) ti )-C 4. b $ Universal Plot Plan /c i-i- N Cx` 0' Fill in the following blanks as completely as possible: Project Description: 9 Digit Parcel Identification Number (from your tax statement): 950/00203 I Site Address • 911#: 6 Road Name: Pf,4 i, ,, w ,,-.,t Zip Code: G'2' �'S— Legal Description Subdivision Name: 7°A ,/L S E/Jb 1/OM_E5/TtS Block: 2 Lot(s):5;6 7,f8 Section: Township: Range: Parcel Size (acres or square footage): 2 9,188, RPP2o), 0 K - 6 7,<lC eES Property Owner: M 1 5i.F I. i�A DL ECE K Phone: 360/437-03( Mailing Address: 20 P Ei oo -)3 VI/)Y — PORT L LJbLoV/, KA. 9(Q,365 Applicant/Occupant: c Phone: K (if different from owner) 7 Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: Or Manufactured Home Installer: 67 7D $;,e.vicc moo. Phone: � ,,v Q Z gem?) Mailing Address: p,U. `i- o k // S% S, t_u r.e_0,0 4-E Gad 9"g 56 s -//5'7 Contractor's State License Number: C, 2 S E� 0 8 z Expiration Date: ,G Z 4- ZOUv Septic Designer: Phone: Mailing Address: i Architect:/Engineer: Phone: 4J/A Mailing Address: If Loan Lender/General Phone: 1 Conlractor's Bond Holder: ti /4 iling Ma Address: ` FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan lLUU -00 I , C_e ,. ''-' BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00219 Received Date: 4/5/2000 SITE ADDRESS: 20 PEABODY WAY PORT LUDLOW, 98365 APPLICANT: MABLE I KADLECEK PHONE: 20 PEABODY WAY PORT LUDLOW WA 983659709 SUBDIVISION: TRAILS END HOMESITES Block: 2,5 Lot: PARCEL NUMBER: 950100208 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: C D R SERVICE CO PHONE: PO BOX 1157 SILVERDALE WA 98383 Contractor's License CDRSEC*082D6 Expires 01/01/1998 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: FIRE DAMAGE REPAIR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: 1,463 VALUATION 335,600.00 ADD'L: HEAT TYPE: WOD CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OIL OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS Cj WATER SYSTEM: PWELL STORMWATER: YES NO AREA BEDROOMS: BATHROOMS: Wetland AD Erosion pJ U Exist:rp 2 Exist:rp 1 S N-)(),, Lands del MUD 4r- Prop: Prop: Flooding Total: 2 Total: 1 F&W 1U ( Plat Conditions Routing Date: Shoreline t.10 Aquifer � Pcu,cxx Forest: Commercial 1iO Rural IOC Q Proximity Type Amount Paid By: Date: Receipt: rt itprIS Permit $482.15 MAM 04/05/00 27168 ' Plan Check $144.65 MAM 04/05/00 27168 State Building Code $4.50 MAM 04/05/00 27168 Review q/////0 91 ` ,(C Total: $631.30 ReqUire6 _ ) /M , I:\F_BLD_App_Bld.rpt 10/29/99 Jefferson County Department of Community Development April 11, 2000 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: MABLE I KADLECEK 20 PEABODY WAY PORT LUDLOW WA 983659709 Critical Area Review Case Number: CAR00-00136 Project Description: Parcel Number: 950100208 S-T-R: 16-27N-01 E Site Address: 20 PEABODY WAY PORT LUDLOW WA, 98365 FINDING: The development, as proposed and portrayed on the Universal Plot Plan, does not encroach on an identified critical area nor any associated buffers. CONCLUSION: The proposed development meets the waiver requirements established in Jefferson County Ordinance 05-0509-94. CONDITION: The development shall be as proposed and portrayed on the Universal Plot Plan. Deviation, additions or relocation of proposed development activities will require further review pursuant to the Jefferson County Critical Areas Ordinance. Department Lckt(t ommunity Dev gent Staff c File I:\F_CAR_Waiver_Standrd.rpt 12/13/99 • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name /7746L-6: e/elDt, cr.t„ Building Application Land Use Application Shoreline Application On-site Sewage Application _ Subdivision Application Other: /ergm7,6' 1 . Is there any standing or running water on the surface of the Yes IV 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 VNo 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: 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) a a 4 Q 4 a ❑ o , i ii //// / ,� / / / / / , , , iiiiii,/ '/ iiiiii „/,' = r/I//" ,,, 1//////,,/,//,�' - -- ---------------fl (Questionnaire Continues on Back) Page 1 of 2 6. Does the site have steep slopes with little to no vegetation? YES V No If YES, please describe: 7. Does the site contain high percentages of silt and/or very fine YES -V NO sand? If YES, please describe: 8. Does the site contain ground water seepage or springs near the _ YES ✓NO surface of the ground? If YES, please describe: By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. Signature -rz.& Date Val°o FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: E Frequently Flooded Area ❑ Fish & Wildlife Area 2 ❑ Erosion 0 Landslide ❑Seismic 0 Commercial Forest Section Township North Range Parcel Number: Parcel Size: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: Page 2 of 2 h:\home\pincntr\forms\c ar.doc 1/00