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Home My WebLink AboutBLD2000-00672 * r • BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00672 Received Date: 10/11/2000 SITE ADDRESS: 4264 E QUILCENE RD QUILCENE, 98376 APPLICANT: DOUGLAS HARBORD PHONE: (503)266-8649 13150 S MACKSBURG CANBY OR 97013 SUBDIVISION: Block: Lot: T 23 PARCEL NUMBER: 701311018 Section: 31 Township: 27 N Range: 01 W CONTRACTOR: TOLLSHARK CONSTRUCTION INC PHONE: (360)732-4080 PO BOX 100 CHIMACUM WA 98325 Contractor's License TOLLSC1107D6 Expires 03/15/2001 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: RETAINING WALL & FULL HEIGHT FOUNDATION FOR MAN. HOME TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD .-'-� MAIN: VALUATION 11,440.00 Ct ADD'L:CODE EDITION: 1997 \ HEAT TYPE: UHHEAT BASE: .3 HEAT TYPE: OCCUPANCY: UNHEATED: �� #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: ��3 SHORELINE: CONST TYPE: DECK: -7a�� SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS 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 F&W Landslide Routing Date: /0 7/2/4 Shoreline Aquifer Forest: Commercial Rural 1-1r ximrty - Nlat G ltions Type Amount Paid By: Date: Receipt: a•. . d" ROVED Permit $209.25 MAM 10/11/00 34655 A - Plan Check $62.78 MAM 10/11/00 34655 � � hi , State Building Code $4.50 MAM 10/11/00 34655 OCT 7 0 Total: $276.53 Jefferson County Planning &Building Department is\F_BLD_App_Bld.rpt 10/29/99 III Jefferson County Department of Community Development �4soN c°e... • 621 Sheridan Street,Port Town :nd WA 88368[360]378-4450 o $ '-....� PI EU o o AOo � � cal) -oonNc,� 0 Project Description: Building Type: Project Type: Frame Type: ❑ Single Family E New E Wood ❑ Garage Attached/Detached ? Addition ❑ Steel /'Modular ❑ Alteration/Remodel K Concrete Commercial ❑ Repair E. Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: • Industrial ❑ Other. Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing: ❑ Sewer ❑Community System E Electricity E. Oil Proposed: Proposed: A Individual System ❑ Woodstove El Propane Total: —19 Total: If not sewer,fill out the following: ❑ Heat Pump ��.. ❑ Conventional ❑ Alternative .❑ Other /uel.f41e. Permit# SEP Water Supply: • Private well E Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor UBC OCCUPANCY GROUP. as �i� 2 Floor Base fee 3C� p?0'9, ��"a rd r, 3 Floor I Plan Check fee ° /g (o 07. 7 ? 69.9. Htd Basement State Surcharge fee 9',- S , 0Unhtd Basement ��0- Subtotal ' c -7(O. 5-3 ) a I.� Garage/Carport Pot Water Review fee ' a Decks j g,_C)_____ �OC) 911/Rd Approach fee Commercial TOTAL 4,2 7 ', 5-3 Industrial Receipt # 3 ' (0 S 5 Other Cash/Check# — Total Valuation: Initials Or t( (7\L-40 Date l v 10 Estimated Cost: L 0,A 0 O 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 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: Date: Irk f 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 #: BLD00-00672 Received Date 10/11/2000 SITE ADDRESS: 4264 E QUILCENE RD Issue Date 10/23/2000 QUILCENE, 98376 Expiration Date 10/23/2001 APPLICANT: DOUGLAS HARBORD PHONE: (503)266-8649 13150 S MACKSBURG CANBY OR 97013 SUBDIVISION: Block: Lot: T 23 PARCEL NUMBER: 701311018 Section: 31 Township: 27 N Range: 01 W CONTRACTOR: TOLLSHARK CONSTRUCTION INC PHONE: (360)732-4080 PO BOX 100 CHIMACUM WA 98325 Contractor's License: TOLLSCI107D6 Expires: 03/15/2001 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION RETAINING WALL& FULL HEIGHT FOUNDATION FOR MAN. HOME REQUIRED INSPECTIONS: [ 1 -F_Qptings/Setba4 (Shoreline Setbacks): OK ' / -/° / k]— Qunda : -- rC t--riy/01/C if' A.—WC( A_^-L' //., �-Cv �.. [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: -(__ ,77yo , [ ] Framing, plumbing: r;/4 ,V-V6 [ ] Propane Tank/Lines: [ I Insulation: 9/. Dy [ ] Sheetrock: [ ] Final/Occupancy Approval L,I , . -2 �c7 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 s; r . .. .. .. . ..... .,... .•.: :....,. : :.., ..,.• ..: • \:::: • .._ ., , .. ... . . • :..:.::::... :...... .. ::..- .:. ..... : : : : . .. ... ... .._. .•..: .• . ... ... .. .. :::\. •.4..,,.. „..1:. 1 . ''' . .. . . ... .. .. .. - : . . . G ... • +j.1 • • • 1.3 N " r a . ... t :: . . . ..... I - . 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' . .... \,;‘44' 11-A-4.1 -.. - . 112C 1 (r i• 11 1 1 , / i / t. /71 „i: f / . , , / / /,. , /i./ e..„„, '''''''' ' '' ,,,,,..,"(/' ,, \Nt 1/4 ...,',..0,' ' ,...,1" ; ....o, .11:(f4 A iddl kief, s4 ...----" ,..„.,. ..?„ .,,, / ;;;;;„-----'4r ,,. , . ,...-- ..,...„....--- 1 „.:-.----- ... ...----- 11 i. .07-----\\ ..-. .\\N„...... ji4timi j OI<s 14,041j. // ...._ ' .... ,_ .. ...,..„,..,......,„ .. .. ,d-,) i ,e'--) — •ILDING PERMIT APPLICATTN Cep/DO-- 00 D{Ci ' Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00672 Received Date: 10/11/2000 SITE ADDRESS: 4264 E QUILCENE RD QUILCENE, 98376 APPLICANT: DOUGLAS HARBORD PHONE: (503)266-8649 13150 S MACKSBURG CANBY OR 97013 SUBDIVISION: Block: Lot: T 23 PARCEL NUMBER: 701311018 Section: 31 Township: 27 N Range: 01 W CONTRACTOR: TOLLSHARK CONSTRUCTION INC PHONE: (360)732-4080 PO BOX 100 CHIMACUM WA 98325 Contractor's License TOLLSCI107D6 Expires 03/15/2001 ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: RETAINING WALL & FULL HEIGHT FOUNDATION FOR MAN. HOME TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD VALUATION 11,440.00 MAIN: CODE EDITION: 1997 ADD'L: HEAT TYPE: UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: CONST-TYPE: GARAGE: 1,144 SHORELINE: DECK: SETBACK: SEWAGE DISPOSAL: OSS BANK HEIGHT: WATER SYSTEM: BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Flood Plane Routing Date: F&W Landslide �Q /Z/,.,0 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: NrReQxlmltV Plat Condrtlons ceipt: A proved/Date Permit $209.25 MAM 10/11/00 34655 `---�-r ..� Plan Check $62.78 MAM 10/11/00 34655 ' , ((L CritiCal 4!- State Building Code $4.50 MAM 10/11/00 34655 Cl / . Total: $276.53 y., I:\F_BLD_App_Bld.rpt 10/29/99 • i Jefferson County Department of Community Development October 13, 2000 621 Sheridan Street, Port Townsend, WA 98368 (360) 379-4450 CRITICAL AREA STANDARD WAIVER Applicant: DOUGLAS HARBORD 13150 S MACKSBURG CANBY OR 97013 Critical Area Review Case Number: CAR00-00249 Project Description: manufactured home Parcel Number: 701311018 S-T-R: 31-27N-01 W Site Address: 4264 E QUILCENE RD QUILCENE WA, 98376 FINDING: The development, as proposed and portrayed on the Universal Plot Plan, does not encroach on an identified critical area nor any associated buffers. CONCLUSION: The proposed development meets the waiver requirements established in Jefferson County Ordinance 05-0509-94. CONDITION: The development shall be as proposed and portrayed on the Universal Plot Plan. Deviation, additions or relocation of propos development activities will require further review pursuant to the Jefferson County Critical Ar a Ordinance. D partment of Community evelopment Staff c: File I:\F_CAR_Waiver_Standrd.rpt 12/13/99 r • • Jefferson County Department of Community Development ,SON cpG 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 fg .:. \,;.,, 01 ,I.*s' o$ Universal Plot Plan TNT Fill in the following blanks as completely as possible : Project Description: A•1 API ite. 4A, 1,1 L- 4-�t 0f t_ 4-et 1114" -t o� "� . 491 9 Digit Parcel Identification Number (from your tax statement): .4.0t ..... 31 / • loli Site Address 911#: 42.64- Road Name: f. At s/c.ig...c to, Zip Code: ' e 3 7-6 Legal Description Subdivision Name: kat4 , l//i. 4, P1,. 4-7—1�y Block: un:Maxi3 Lot(s): d 2) 77 Township:wnship: 2 4 Ai ge: / tv. Parcel Size (acres or square footage): 4, '3 t 4x55 it/44,1- Property Owner: D003LAS b. 144KRa/4 Phone: 2-6‘ -St641 Mailing Address: 1 71 ct. 4 . �j 1 LA R CI C /4 F�s � el4'u�l yi D�Z 17.01 Applicant/Occupant: Phone: (if different from owner) Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: 7 l j jFJ_ L'd y,,cif. .744L 752 _ itofv Or Manufactured Home Installer: Phon�e:j/ t Mailing Address: ro 7o x /do /C#/ 41 4 ,�i!/if -f7J 725-- Contractor's State License Number: 76i-t. L1" io T A Z Expiration Date:d 3/100 i Septic Designer: Phone: Mailing Address: Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: Mailing Address: FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan