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HomeMy WebLinkAboutBLD2002-00554 BUILDING PEAMITrAPPLIC ION MLA02-00498 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00554 Received Date: 9/19/2002 SITE ADDRESS: 729 SCHWARTZ RD NORDLAND, 98358 OWNER: WILLIAM F ANDERSON PHONE: (360)385 7565 PO BOX 1437 PORT HADLOCK WA 98339-1437 SUBDIVISION: Block: Lot: PARCEL NUMBER: 021291006 Section: 29 Township: 30 N Range: 01 E CONTRACTOR: OWNER/BUILDER PH0NE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 780 VALUATION 63,606.00 ADD'L: HEAT TYPE: PRO CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: 896 # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL PARCEL TAGS: YES____NO_ _ BEDROOMS: BATHROOMS: STORMWATER: YES_ _ NO___AREA Exist: Exist: Wetland_ Erosion Prop: 1 Prop: 2 Seismic _ Streams Total: 1 Total: 2 Flood Way__ __Floodplain Routing Date: F&W Landslide Shoreline _Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $741.75 MAM 09/19/02 49650 Plan Check $482.14 MAM 09/19/02 49650 State Building Code $4.50 MAM 09/19/02 49650 Potable Water Application $50.00 MAM 09/19/02 51003 Total: $1,278.39 ��s©zv �© Moroil�Co �partnumt of Camnunrty bagmen �� 621 Sl dam Street,Port Townsend WA 88368 13601 378 4450 �� t „S' N S�.,4 Ppc ?U� 1 r Project Description: ry i�,i L,1_ 111 1 1 I BuildingType: 1 yp Project Type: Frame Type: Single Family YNew a i .-Wood_ '' r ❑ Garage Detached DEPT. OF (: UEVELOPt,1FNT g / ❑ Addition .- ❑ Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: • Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing: ❑�ewer ❑ Community System , ❑:Electricity ❑"Oil ' Proposed: — Proposed: I M7 Individual System ❑ Woodstove O'Propane Total: (7y Total: ---I--- Ifnot sewer,fill out the following: ❑ Heat Pump lir Conventional e Alternative ❑ Other Permit# SEP W er Supply: Private well ❑ Two Party Well❑ Public:Name of water system: ' . Square Footage: 7 �} For Office Use Only Main Floor O U 50Ct l 31 Consistency Review 47,00 2ND Floor Base fee '[IN- 74- 3rd Floor Plan Check fee-65% 4.8Z•1'T Htd Basement State Surcharge fee C'•SO Unhtd Basement 8 76 12 ri . Jn Subtotal •.y Garage/Carport -ice Pot Water Review fee .O Decks 64C)I° 911/Rd Approach fee Commercial TOTAL p Industrial Receipt# 6SO 5l00� Other b Cash/Check# t 0 O Total Valuation: C1 -�-- 0,`7 00 Initials Pe--63 Or Date I lq/b2_— Estimated Cost: ! 6 2 D d 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 struc shall be requested and shall occur during regular business hours. Signature: L�(/L�;G�-- Date: ! `1?^6) OVER, H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 • Stormwater Calculations IMPERVIOUS SURFACE NEW EXISTING Structures (all roof area) / 1 ,�Z sq/ft Structures (all roof area) 2 2. sq/ft Driveway sq/ft Driveway 7 2 0 sq/ft Sidewalks 12.0 sq/ft Sidewalks sq/ft Patios 0 sq/ft Patios sq/ft Covered/Solid Decks n sq/ft Covered/Solid Decks sq/ft Other sq/ft Other sq/ft Total New )4 2.,'1 Z sq/ft Total Existing q 7 2_ sq/ft TOTAL NEW+TOTAL EXISTING` 2 12 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 (2,OOC) sq/ft Well, Structures, Utilities, etc. 2, 21i I sq/ft Driveway sq/ft Other sq/ft Total Land Disturbance 1 2 G 11 sq/ft LVi1IIEIr V Icy' \ \\--. 'i SEP 1 9 2O02 I.._; Jcr, RSG!� '"OU1Y DFP1. Of COS;tv'�^Ntil'Y DE ELOPb1FNT • 64/rgrAll AAed 4A-ParCiAmaZi,-- r,.12f,ist -70Z---. 7e Notif.o.e/ Gt/a/2• • tfil-"7114:74 //34:ff C W r tip 24 at jEFFERSON COUNTY DEP-T. OF COMMUNITY-rAVELOPM.-ENT ii\ \ ` / ^ \ * \\ v� «: \ , va : > & . : 2 y } r : , $« © ,« , > \ \ © z ± \ c &&, 5 a . ` �» ��: & y . , > > w C // % ¥ ( / $ \ \ :\ . \ \ \ . ` . \ , b . # } } / \\ ~ / ^/1d (,ci. f \ A� �, JEFFEISON COUNTY . ! lit �- 0'Z-- 44'$- --cti pi ti = ,4 1 DEPARTMENT OF COMMUNITY DEVELOPMENT , ,�,., '. , 621 Sheridan Street• Port Townsend •Washington 98368 "t 1,9. of .,0 360/379-4450•800/831-2678 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment SEP 1 9 xi [,-9 Master Land Use Permit Application Form PROPERTY INFORMATION .N T Tax Parcel Number: 14 f ® 11 17 ® E I Subdivision Name: Lot Number: Property Size: /Q AGR i S (acres/square feet) Existing Use of Property: f3ArE L A$r Site Address and/or Directions to Property: 7 2 9 S G u w A IZ.TZ-- (0 A P'> I f Q(tp/-AN 1D t(,m,"6.8. APPLICANT& OWNER INNFORMATION Applicant(if applicable): ik•)t[t I A t/4 F; A Ik)rJC-Yc SoN Telephone: 360 - 385. 75 66 Address: JO. /30,< isi 3"7 City: i aaT 14 A n i.Oe{C State: um. Zip Code: // 9g 3 39 Email Address Applicant's Signature: (k X-____. Property Owner(s)of Record: 5A ill E Telephone: 3 R 1.1N Address: City: i * State: " Zip Code: 7 % Email Address I acknowledge that the applicantl above is applying for a building permit on my property. Owner's Signature: Gt/ l `� 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) R '.5 DoEuc 1- [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 ❑ Boundary Line Adjustment* UDC Section 7.2 ❑ Minor PRRD Amendments UDC Section 3.6.13.15 0 Sign Permit* UDC Section 6.15 ❑ Site Plan Approval Advance Determination(SPAAD) UDC Section 8.7 0 Shoreline Master Program Exemption/Permit Revisions UDC Section 5 0 Temporary Use(based on use may be Type II or Type III)* UDC Sections 4.38 and 4.39 (OVER) i ,1 , SCALE: 1" s 100' 1 ZOOz 61. AS . 1 1 A ., .y 71 O - n z • ...9, g D Ntp u, IL___I __ l I L. i _ if4 1 __ an rr • xz / 0 7 . c.) 1-1 4....)-\ a �/ J/ / , (!L' I . \ "1...,,,,,„. ,"..v,,N,,',:,.1 . o P .{.- ,. O , rn Sp f r— cn Z m rn )1 d in cn% rrr 00t - u, 0 00 I ',-,);\ a...... • +- N.4 ....4 Zoo ' „ vl i1 0 z • s 13 r ,)'a R4Tic)._ N1 u`1 Go 7 4�2 � C • FR . Z. _ cR __ !! - - REVISIONS MATE b 1 SEPTIC SYSTEM DESIGN f4 N FOR WILLIAM ANDERSON SITE PLAN E OINE I 0, INC. . - LA 1 I i $ i PARCEL NO. 021-291-006 -