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HomeMy WebLinkAboutBLD2002-00471 R 11) BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD02-00471 Received Date 08/19/2002 SITE ADDRESS: 3624 OAK BAY RD Issue Date 09/4/2002 PORT HADLOCK, 98339 APPLICANT: WILFRED M POLK PHONE: (360)437-4133 JOAN B POLK 3624 OAK BAY RD PORT HADLOCK WA 98339-9730 SUBDIVISION: Block: Lot: T 114 PARCEL NUMBER: 921194077 Section: 19 Township: 29 N Range: 01 E CONTRACTOR: OWNER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION REPAIR DECK, EXTEND GARAGE (NO CHNG IN FTPRNT) REQUIRED INSPECTIONS: [ ] SFTBACKt / Footings: [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: r-.t_t) ,,ow0 s /" /o- 7 - [ ] Framing/Plumbing: riot .1 wuc OK 2/4/pd G / [ ] Propane Tank/Lines: [ ] Insulation: 6Z 2/10 y [ ] Sheetrock:fr- [ ] Septic System Final Approval: [ ] Zoning Final Approval: [ ] Final/Occupancy Approval: Z HEAL DEe(2f4/4/ TMENT 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. HOT LINE AVAILABLE 24 HOURS A DAY UILDING PERMIT APPLICAN BLD02-00471 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00471 Received Date: 8/19/2002 SITE ADDRESS: 3624 OAK BAY RD PORT HADLOCK, 98339 OWNER: WILFRED M POLK PHONE: (360)437-4133 JOAN B POLK 3624 OAK BAY RD PORT HADLOCK WA 98339-9730 SUBDIVISION: Block: Lot: T 114 PARCEL NUMBER: 921194077 Section: 19 Township: 29 N Range: 01 E CONTRACTOR: OWNER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI REPAIR DECK, EXTEND GARAGE (NO CHNG IN FTPRNT) TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 3,959.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 1997 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: GARAGE: 168 SETBACK: CK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PUBLIC PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: 4 Exist: 4 Wetland Erosion Prop: Prop: Seismic Streams Total: 4 Total: 4 Flood Way Floodplain Routing Date: F&W Landslide �/:ova Shoreline Aquifer // Forest: Commercial Rural Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $111.25 MAM 08/16/02 49485 Plan Check $72.31 MAM 08/16/02 49485 State Building Code $4.50 MAM 08/16/02 49485 Total: $188.06 • • Stormwater Calculations cPERVJ9URFAC )E NEW 6/v L EXISTING /� r� Structures (all roof area) "G sq/ft Structures (all roof area) �/` 2. / sq/ft Driveway sq/ft Driveway sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Covered/Solid Decks sq/ft Covered/Solid Decks sq/ft Other sq/ft Other ta,)' k; ., ) ( L-(-C E 6' sq/ft Total New l' sq/ft Total Existing / q. i 3 sq/ft TOTAL NEW+TOTAL EXISTING* sq/ft *This amount will be used to check total lot coverage Please also indicate the amount of land disturbing activity, in addition to the creation of impervious surface, that will take place: LAND DISTURBING ACTIVITY Drainfield area cleared sq/ft Well, Structures, Utilities, etc. sq/ft Driveway sq/ft Other sq/ft Total Land Disturbance sq/ft gO1V • 4iiJ% JEFFE SON COUNTY in.,?,, DEPARTMENT OF COMMUNITY DEVELOPMENT 4, .1 621 Sheridan Street• Port Townsend•Washington 98368 1 I_r�' fr �r, 'gszING'�,O 360/379-4450• 800/831-2678 • 360/379-4451 Fax il T,i'7 --i', ---) 1 r 1: www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Form i� 1 9 20(�2 � PROPERTY INFORMATION J '' I l Tax Parcel Number: © Q El El El CI ❑`7 '❑ di i''' ` ti �.;T j Subdivision Name: Lot Number: Property Size: / Gee f? (acres/square feet) Existing Use of Property: SS',:"�1,,, FGZ,rr1 jr //e,in c> Site Address and/or Directions to Property: .3 -2* od.k /74/ A Po 1- 1-- Hat,120c1( 1,1,1/2" cyy-fset APPLICANT&OWNER(INFORMATION Applicant(if applicable): / 2 f t--'d Al, /p M. Telephone: 34O 3 7 if/-33 Address: 3 4 Z o d_/< 3 dy Jl City: fa I- t 4'aM,0 A State: 1/t/t7, Zip Code: 911/ Email Address �y Applicant's Signature: . -L.— Property Owner(s)of Record: Telephone: Address: City: State: Zip Code: Email Address I acknowledge that the applicantli above is applying for a building permit on my property. 2 °ca Owner's Signature: 2. , /� I hereby designate to act as my agent in matters relating to this application for permit(s). (PROPERTY OWNER SIGNATURE) (DATE) DESCRIPTION OF PROPOSED USE OR ACTIVITY(include separate sheets as necessary) S' cF-e ap 5e)..59'415 t�c7 I /ovcvhd .�6C/( end &-x �ItJ 4 1-c�le 4-- got✓�� of 6'r1 � Gam-- 1!6"� f5 CA ( t ar2 cl 1" 1 o v e r c/ 16>e [THIS SECTION FOR OFFICE USE ONLY] Refer to the specific sections of the UDC referenced below for more information and further requirements. An asterisk (*) indicates that a supplemental application or questionnaire may be required. Type I Permits Refer to: ❑ Septic Permit/Evaluation of Existing System(EES) UDC Section 6.4.1 and Chapter 8.15 JCC ❑ Building/Demolition Permit UDC Section 3.2.1 and Table 3-1 ❑ Allowed"Yes"Use Consistency Analysis UDC Section 3.2.1 and Table 3-1 ❑ Home Business Table 3-1 and UDC Section 4.20 ❑ Stormwater Management* UDC Section 6.7 ❑ Road Access* UDC Section 6.8 O Boundary Line Adjustment* UDC Section 7.2 ❑ Minor PRRD Amendments UDC Section 3.6.13.15 O Sign Permit* UDC Section 6.15 ❑ Site Plan Approval Advance Determination(SPAAD) UDC Section 8.7 ❑ Shoreline Master Program Exemption/Permit Revisions UDC Section 5 ❑ Temporary Use(based on use may be Type II or Type III)* UDC Sections 4.38 and 4.39 (OVER) MASTER LAND USE PERMIT.DOC REV.01/03/2002 4�oiv cn • Jefferson Coontyyartmont of Community Development �1ww ,� =1 621 Sheridan Street,Port Townsend WA 88368[36D]373-4450 al '1\. _ o ��� ,� PI Mot A o Q S �` � i i �O : cal, - 001 FIIN 's p C' �Zz u, Project Description: r— cc Building Type: = w o Project Type: Frame Type: A Single Family u- New R Wood X Garage Attached/Detached ----�`� � r-• Addition _ Steel Modular u..4 X Alteration/Remodel = Concrete al Commercial ;i' Repair _ Masonry Multi-family/#of Units 1 Demolition I Other: Industrial Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: F/" Existing: 4 i Sewer 1, Community System IX Electricity Oil Proposed: Proposed: O Individual System 7(Woodstove 1 Propane Total: I Total: if If not sewer,fill out the following: 1 Heat Pump Conventional 1 Alternative Other Permit# SEP Water Supply: XPrivate well 1 Two Party Well Public:Name of water system: Square Footage: For Office Use Only ' Main Floor Consistency Review 2ND Floor Base fee 1/1 ' Z.S 3rd Floor Plan Check fee—65% 7c . 3 /) Htd Basement State Surcharge fee y, 50 Unhtd Basement Q / / Subtotal I el?: 0 G Gara e/ /7 la/ F" ca T 3 651'7� g ' +� Pot Water Review fee Decks 911/Rd Approach fee Commercial TOTAL IOe. C) Industrial Receipt# 4q L-165 Other Cash/Check# I 0 E(p Total Valuation: Initials �irj.Q r U Dat Z / 1 (.0 10 )-- e Estimated Cost: 6) o° J ) If wit fi 200'-ofth-e--htareiine,_------- Distance to Bank or Ordinary High Water Mark ft. Bank Height ft. i 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 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: 4907/Cf--'-' 7----- r Date: D -1 0^ e 2. OVER_ 0- H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01