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HomeMy WebLinkAboutBLD2000-00325 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 #: BLD00-00325 Received Date 05/25/2000 SITE ADDRESS: 524 LAKENESS RD Issue Date 06/5/2000 QUILCENE, 98376 Expiration Date 06/5/2001 APPLICANT: GERALD TINGELSTAD PHONE: (360)598-3129 SUSAN TINGLESTAD PO BOX 681 QUILCENE WA 98376 SUBDIVISION: Block: Lot: T 9 PARCEL NUMBER: 702122011 Section: 12 Township: 27 N Range: 02 W CONTRACTOR: OWNER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION GARAGE REQUIRED INSPEC] NS: [ ] otings/Setbacks (Shoreline Setbacks): [ ] Foundation' / "-- r, (c) �� 71 [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] Propane Tank/Lines: [ ] Insulation: [ ] Sheetrock: [/J Final/Occupancy Approval:,/‹. 3/4/ 2(11/ 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 ! f BUILDING PERMIT APPLICATION . Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00325 Received Date: 5/25/2000 SITE ADDRESS: 524 LAKENESS RD QUILCENE, 98376 APPLICANT: GERALD TINGELSTAD PHONE: 779-2211 (messa SUSAN TINGLESTAD PO BOX 681 QUILCENE WA 98376 SUBDIVISION: Block: Lot: T 9 PARCEL NUMBER: 702122011 Section: 12 Township: 27 N Range: 02 W CONTRACTOR: OWNER PHONE: ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 4,800.00 ADD'L: HEAT TYPE: HTP CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: 480 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Flood Plane Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural — rQxlmlty - flat Conditions Type Amount Paid By: Date: Receipt: Approved/vote Permit $111.25 MAM 05/25/00 31540 AP P(- ROVED Plan Check $33.38 MAM 05/25/00 31540 raj State Building Code $4.50 MAM 05/25/00 31540 ( _ C Total: $149.13 JUN 0 L`�00 Jefferson County Planning & Building r3o artment I:\F_BLD_App Bld.rpt 10/29/99 r Jefferson County 1' I artment of Community Development -wQ ' °°G 621 Sheridan Street,Port Town:,:nd WA 88368(3601378-4450 i. W . r o s,,,.....„_ PermilD ppOc © Project Description: Building Type: Project Type: Frame Type: • Single Family y New X Wood Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular <C ❑ Alteration/Remodel ❑ Concrete ❑ Commercial 0 Repair ❑ Masonry E Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial Other: Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: 7 Existing. 0 ❑ Sewer ❑Community System ❑ Electricity ❑ Oil Proposed: Proposed: 2 Individual System ❑ Woodstove ❑ Propane Total: Total: If not sewer,fill out the following: ❑ Heat Pump Conventional ❑ Alternative ❑ Other .).,J fr2rtT'& Permit# SEP Water Supply: ❑ Private well ❑ Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor UBC OCCUPANCY GROUP 2ND Floor Base fee 1 11 , Z C. 3r Floor Plan Check fee 33 . 3t Htd Basement State Surcharge fee Li 6 SD Unhtd Basement Subtotal I y Ci - 1 Lea:aQe7/Carport 480 4 b t//�UO Pot Water Review fee Decks 911/Rd Approach fee Commercial TOTAL 1401 + 13 Industrial Receipt# 315(1 0 h Other Cash/Check# la VW 9 1A � Total.VaivatiL.— Initials — ` Or Date �j•ZS OV Estimated Cost: -4L�0� If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark ft.Bank Height ft. 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 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. I further agree to provi.,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 e to the applicant's erty or structure shall be requested and shall occur during regular business hours. Signat4' 0 td Date: Cc ZS d Jefferson County Department of Community Development ��vN cp 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 /` 1., �' j G '..\. \,,,, rk. $ Universal Plot Plan Fill in the following blanks as completely as possible: Project Description: 9 Digit Parcel Identcation Number (from your tax statement): I 1-3-.. I/ 2 ' <`-/ / Site Address 911#: ; ?:-; ( ( (E n e s S ec Road Name: ,, 4e1 ; -, i Zip Code: 96 33 7 Co Legal Description Subdivision Name: Block: Lot(s): Section: Township: Range: Parcel Size (acres or square footage): Property � �I d r. rievelsv6c( , �U ,JJ , I oll_1SFa(, P o Se- 3 / `'i - Mailing Addr,es / II q I ( . (` 11 C."-. l,)! t( (2f`f':' ( ,) / V 3-7 �') I 2 2 /J ��lYiessa5c� Applicant/Occupant: Phone: (if different from owner) n I 1)-- Mailing Address: Authorized Rep: l Phone: Mailing Address: n I General Contractor: Or Manufactured Home Installer: ` — Q(A)f•-Q-"%---- Phone: Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: , Phone: Tom 1 f Mailing Address: Architect:/Engineer: l A Phone: Mailing Address: Loan Lender/General I Phone: Contractor's Bond Holder: 1 I '`:- Mailing Address: FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00325 Received Date: 5/25/2000 SITE ADDRESS: 524 LAKENESS RD QUILCENE, 98376 APPLICANT: GERALD TINGELSTAD PHONE: 779-2211 (messa SUSAN TINGLESTAD PO BOX 681 QUILCENE WA 98376 SUBDIVISION: Block: Lot: T 9 PARCEL NUMBER: 702122011 Section: 12 Township: 27 N Range: 02 W CONTRACTOR: OWNER PHONE: ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 4,800.00 ADD'L: HEAT TYPE: HTP CODE EDITION: 1997 OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: 480 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: 02_I k , WATER SYSTEM: PARCEL TAGS: YES NO V/ BEDROOMS: BATHROOMS: STORMWATER: YES NO `1 AREA Exist: Exist: Wetland (r) Erosion Prop: Prop: Seismic Streams L , Total: Total: Flood Way t Flood Plane F&W NuJ Landslide Routing Date: Shoreline tsit?2 Aquifer Forest: Commercial Rural 00 1-'r ximlt - Nlat C;f,r+,,r s Type Amount Paid By: Date: Receipt: prgv=.1 i i Permit $111.25 MAM 05/25/00 31540 'APlan Check $33.38 MAM 05/25/00 31540 ' qieWiV„.5 State Building Code $4.50 MAM 05/25/00 31540 Total: $149.13 �� • I:\F_BLD_App_Bld.rpt 10/29/99 cVo /2.7 G 0 r? ) tz e, 7;LI ye cl."rd 1410a 4"-- • • • - ------- 1,4 Y i/ e7 e Ti g 1 1'5 1/1 . /7 1, c, / 77 1 ..1- i --o/ e ,2 5' 9 (24# / i i if --- _ (IL ---- / *- L>, (1) i • 1 1„ \ \ /\------• . \ , \ \ j , .. \ kL) \ \ i 4.Q1 ,1 •No c1 ' .1----_ '. 'l 1 min 4 'v at It e r 'C'1 1 Li 1 re d I 3 ItiPsi ik V)\) VN luem N.edaa 619W10 rj 61.1!Utiajd Alilf100 UOSJelpp 000Z S 0 t4 rs 1 cre5---,--D-7-0 a3Aoadc-iv frs c \/ STORMWATER CALCULATIONS Owner/Applicant: e f2 Cc t r 4 2osc-3 f elS{Cc c g 0 PROPOSED LAND DISTURBING ACTIVITY Site Address: Fie ss QJ. Drainfield area cleared sq.ft. V 11C�Y1� ut ) c j37(/ Driveway Length i ft. X Width t S ft. 9 Digit Parcel Identification No.:70 • - C I = Total Driveway -i- O sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. / v 0 sq.ft. INDICATE the following information. Total Land Disturbance 3 S C7 sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: One inch equals 0 IMPERVIOUS SURFACE Proposed Structures (all roof area) j OD sq.ft. C/ 1. North arrow Existing Structures (all roof area) }6O sq.ft. Z/2. All property boundaries and dimensions Sidewalks sq.ft. • 3. Names of adjacent streets Concrete Patios sq.ft. 0/4. Driveway/s & parking spaces Proposed: I] 5. Major features such as ravines, -) Driveway Length ft. seasonal creeks, bodies of water, etc. X Width ft. 0 6. Septic tank, drainfield and reserve area location, = Total Driveway sq.ft. existing or proposed, and distance to Total Impervious Surface /(.;'t1 sq.ft. closest structure ,./d,/ ❑ 7. Sewer lines /V 0.9 The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: ❑ 8. Wells and/or water lines • Construction Access Route Stabilization: EJ 9. Neighboring wells within 150 feet .�t�� Construction vehicle access shall be, whenever feasible, limited to one route. Access points shall be stabilized with C] 10. Paved surfaces (patios) —I quarry spalls or crushed rock to minimize the tracking of 0 1 1. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned ❑ 12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping. Street washing should only be done after the bulk of the boundaries, structures, banks, sediment has been removed by sweeping. and shorelines) • Stabilization of Exposed Soil: All exposed and unworried soil shall be stabilized by sodding, Li 13. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base on roads and driveways, or other appropriate means within LI 14. Arrows showing direction of slope-- days during the period from May 1 to September 30 assume an elevation of 100 feet at one and within two days during the period from October 1 to April lot corner and indicate the other lot 30. Mulch shall be applied to a minimum depth of two inches. • Protection of Adjacent Properties: corner elevations in relation to it Adjacent properties shall be protected from sediment deposition by appropriate use of vegetative buffer strips, sediment barriers or filters, dikes, mulching, or by a FOR APPLICATIONS ADJOINING SHORELINES, combination of these measures and other appropriate Best Management Practices (BMPs). INDICATE: • Maintenance: O 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of ❑ 16. Top of bank, if over 10 feet high their intended function. O 17. Slope of bank in degrees • Other Appropriate BMPs as required by Jefferson County to mitigate the effects of increased runoff shall be applied. H:\HOME\PLNCNTR\FOR MS\PLOTPLN.FRM9/97 . Jefferson County Department of Community Development - 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name Pe �r�IJ N., �O 1-M 41 h . S'a.(i 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 .� 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 I/ 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: 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) I: 4 Q ❑ ❑ ❑ / / , / / , , / / / / / , / / / / / / , , / , ,a , , , / / , , / , , / / / . , / / , , / , . , / / / : / / .— r , , , / / , / , r / , / „ . , ,, .4❑ / / / , / / , , , / / , / , , , , , /, / / / / / , , . �� 0 I,l //////"//////11/;/ ,,,=;, __ _Do (Questionnaire Continues on Back) Page 1 of 2 6. Does the site have steep slopes with little to no vegetation? YES •• Ncs If YES, please describe: 7. Does the site contain high percentages of silt and/or very fine _ YES ,h 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. Signatur x )(4721-'41-- Date 0'5 02 S. 0 FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR 0 Aquifer Recharge Area (zone_) 0 Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area 0 Fish & Wildlife Area 2 ❑ Erosion 0 Landslide :Seismic ❑ 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\car.doc 1/00 I