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HomeMy WebLinkAboutBLD2003-00224 • --:_ 3:, t II -0 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD03-00224 Received Date 04/7/2003 SITE ADDRESS: 21 BOWEN ST Issue Date 05/6/2003 QUILCENE, 98376 APPLICANT: WILLIAM J BEISLEY PHONE: (360)275-5783 PAULA V BEISLEY PO BOX 2355 BELFAIR WA 98528 SUBDIVISION: CAMPBELL'S H.W. ADDITION Block: 5 Lot: 1 PARCEL NUMBER: 937200503 Section: 24 Township: 27 N Range: 02 W CONTRACTOR: BEISLEY INC PHONE: (360)275-5783 PO BOX 2355 BELFAIR WA 98528 Contractor's License: BEISLI*027LC Expires: 10/01/2003 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: FOUNDATION REQUIRED INSPECTIONS: / / [ ] / SETBACKS /Footings: ®k & C r i Z ea/ 7/2 2 f 3 A4 [ Foundation: c /le_. /3// [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] Framing/Plumbing: f 1 Propane Tank/Lines: [ ] Insulation: f 1 Sheetrock: f 1 Septic System Final Approval: [ ] Zoning Final Approval: f 1 Final/Occupancy Approval: ck cot-- e/o I/15 O f HEALTH DEPARTMENT APPROVAL R QUIRED 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 • • BLD03-00224 BUILDING PERMIT APPLICATION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD03-00224 Received Date: 4/7/2003 SITE ADDRESS: 21 BOWEN ST QUILCENE, 98376 OWNER: WILLIAM J BEISLEY PHONE: (360)275-5783 PAULA V BEISLEY PO BOX 2355 BELFAIR WA 98528 SUBDIVISION: CAMPBELL'S H.W. ADDITION Block: 5 Lot: 1 PARCEL NUMBER: 937200503 Section: 24 Township: 27 N Range: 02 W CONTRACTOR: BEISLEY INC PHONE: (360)275-5783 PO BOX 2355 BELFAIR WA 98528 Contractor's License BEISLI*027LC Expires 10/1/2003 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI FOUNDATION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 6,000.00 ADD'L: HEAT TYPE: OIL CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 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: 3 Exist: 1 Wetland Erosion Prop: Prop: Seismic Streams Total: 3 Total: 1 Flood Way Floodplain Routing Date: F&W Landslide 41 /03 7 j Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: 'TT m a V ED Permit $125.25 MAM 04/07/03 55997 V Plan Check $81.41 MAM 04/07/03 55997 MAY - 6 2003 State Building Code $4.50 MAM 04/07/03 55997 Total: $211.16 Jefferson County Planning & Building Department iiii/14.06.,),1 f gif • Jefferson Cougkepartment of Community Development �a ON °�, 621 Sheridan Strait,Port Tow , ,,,,, _, ,, ,i i l.; ,h, L. . -� ti .< 111 Oct , li K4S ��° ?CM._ A p'd _ a Cl „1 U�y'R - 7 2003 " r JEFFERSON COUNTY Project Description: A. , ,r ()FPT 1'.F cr-7. V r '?=:C - . Building Type: Project Type: am'r ame Type: ""u ~— �'9M 71, Single Family 0 New )(Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete ❑ Commercial X Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: I Existing: 30 ❑ Sewer ❑ Community System ❑ Electricity %Oil Proposed: 0. Proposed: Individual System ❑ Woodstove ❑ Propane Total: Total: If not sewer,fill out the following: ❑ Heat Pump "3.Conventional ❑ Alternative ❑ Other Permit# SEP Water Supply: Private well ❑ Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor z1 ' Consistency Review 2ND Floor Base fee (2S Z. d s� 3r Floor Plan Check fee—655% 'R1 • i Htd Basement D State Surcharge fee 1t Sc' Unhtd asement v Subtotal 2I t • 1 11/> C,/i5 Garage/ 2 6• l Pot Water Review fee Decks CT 911/Rd Approach fee Commercial CD TOTAL 7-.1 1 .1 Industrial 0 Receipt# 5SRCi. i Other li Vo`�� .s Cash/Check# (�j 3�7 Z- Total Valuation: Initials P Or rr Date ` ! -110� Estimated Cost: b ,(� D If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark \J A . 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. ------j‘-' Signature: Date: 2 rat,,... 0 3 Off_ H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 • 40 gt N , Iiá) iLwth7 JEFFERSON COUNTY f ��i' I 4 killi , DEPARTMENT OF COMMUNITY DEVELOPMENT APR �03 f 4. �i �� 0� 621 Sheridan Street• Port Townsend •Washington 98368 JEFFERSON COUNTY F 360/379-4450 • 360/379-4451 Fax 0[PT OF CCh�UNl11 hT !)EVE�Of��,%t� http://www.co.jefferson.wa.us/commdevelopment/ ,,, Stormwater Calculation Sheet MLA# PROJECT/APPLICANT NAME".:, YC-*L'''.-� � , / r lk .-e)e k'S k, _ - This stormwater calculation sheet should accompany stand-alone stormwater management permit applications, building permit applications,and other land use approval applications that involve stormwater review. STORMWATER CALULATIONS-IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) sq/ft Structures(all roof area) Z Z``•=O sq/ft Driveway sq/ft Driveway a a ° sq/ft Sidewalks sq/ft Sidewalks .5—C) sq/ft Patios sq/ft Patios C) sq/ft Solid Decks sq/ft Solid Decks G sq/ft Other sq/ft Other sq/ft Total New sq/ft Total Existing 2- LI 5 0 sq/ft TOTAL NEW+TOTAL EXISTING* a- 4 5 O 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 STORMWATER MGMT PERMIT.DOC REV.12/23/2002 PI' (---vioN ,a-. NCONTY • d ova ?Q�JEFF SO U y `► DEPARTMENT OF COMMUNITY DEVELOPMENT ---�-- -- • .'4 .ti 621 Sheridan Street• Port Townsend •Washington 98368 -� , f�" OWE 'qs ,N01,O 360/379-4450•800/831-2678 •360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment APR - 7 2003 Master Land Use Permit Application Form PROPERTY INFORMATION DEPT. OF COMMUNITY DEVN ELOPMENT Tax Parcel Number: Ill © ❑T L❑ ® ©i ❑S ❑c ® __. Subdivision Name: C_Gw,.,�, b \ `a Lot Number: 14 1.. Property Size: /3i 6 B 0 ‘ /square feet) Existing Use of Property: tge. , -cse.. Site Address and/or Directions tLo Property: 1K�L l� ®u�,.-. � � ) Q v.:,�{G2.�-�.e_ ., 11i A `1/4fi31 Lh a LA:.tt`C...z.-, I • -aSe.r �..A,a c„ ?G��v..o..<a ch• c30c.-4., APPLICANT& OWNER INFORMATION Applicant(if applicable): ��\. \ ��-�-e- Telephone: ^Z 7S- S 1 1S3 Address: V r 0 - o>< 23 _ City: "?::).6= -.-.r State: Zip Code: C1 ZY Email Address 't s e,/iv.,_.e K3`cw Applicant's Signature: 4-19-‘,2rz t""` c._;�� Property Owner(s)of Record: �°" `"E4--- ,si � Telephone: Z5 33 Address: Z C-, c al.iZ.i,wvA_ C- VN)�-- City: 1 State: JIA Zip Code: "\k' Z 5e Email Address ' I tell i,lncti Sc-wc{ I acknowledge that the applicantic�above is applying for a building permit on my property. .Lb""` Owner's Signature: •Vitt,--'�-�C-� I hereby designate e\S`t. C_ 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) CS i. �G.\A G- C-1-'-~—A-A Lo-Z, w �--y.._ 3 ,.V....r. \I erg r�-v �.» [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 .JK 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 ❑ 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) Type II Permits Refer to: • ❑ Discretionary"D"or Unnamed Use Classification UDC Sections 3.2.1,3.2.2 and Table 3-1 ❑ Cottage Industry UDC Section 7.3 and Table 3-1 ❑ Short Plat, Preliminary and Final* UDC Section 7.3 ❑ Binding Site Plan* UDC Section 7.5 ❑ Conditional(Administrative)"C(a)"Use UDC Table 3-1 and Section 8.8 ❑ Conditional(Discretionary)"C(d)"Use UDC Table 3-1 and Section 8.8 (Discretionary Permit Review Process Determined by Administrator) ❑ Variance, Minor* UDC Section 8.9 ❑ Wireless Telecommunication Ordinance 06-0712-99(UDC Appendix C) ❑ Shoreline Substantial Development(Primary Use) UDC Section 5 ❑ Forest Practices Act/Release of Six-Year Moratorium for Single- UDC Section 4.16.5(c) Family Residence ❑ Appeal UDC Section 8.4.2 SEPA 8.10.12(b) Type III Permits ❑ Conditional"C"Use UDC Section 8.8 ❑ Long Plat, Preliminary* UDC Section 7.4 ❑ Planned Rural Residential Development Preliminary Approval UDC Section 3.6.13(must be in conjunction with an (PRRD)and Major Amendments* underlying land division application) ❑ Plat Vacation/Alteration UDC Section 7.1.3(d) ❑ Variance,Major* UDC Section 8.9 ❑ Reasonable Economic Use Variance* UDC Section 3.6.4(h) ❑ Wireless Telecommunication Ordinance 06-0712-99 UDC Appendix C ❑ Shoreline Management Substantial Development,Secondary Use* UDC Section 5 ❑ Shoreline Management Conditional Use* UDC Section 5 ❑ Shoreline Management Variance* UDC Section 5 ❑ Appeal UDC Section 8.4.3 SEPA 8.10.12(c) Type IV Permits ❑ Long Plat, Final UDC Section 7.4 ❑ PRRD, Final UDC Section 3.6.13 Type V Permits ❑ Special Use(Essential Public Facilities) UDC Section 3.3.5 ❑ Jefferson County Comprehensive Plan/UDC/Land Use District Map UDC Section 9 Amendment* ❑ Jefferson County Shoreline Master Program Amendment* UDC Section 5 ❑ Appeal of SEPA UDC Section 8.10.12(d) Other Local,State or Federal Permits ❑ Please identify any other local,state or federal permits required for this proposal,if known: ACKNOWLEDGEMENTS [PLEASE NOTE THAT TWO SIGNATURES ARE REQUIRED] By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. 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 its employees, representatives or agents for the sole purpose of application review and any required later inspections. This right of entry shall expire when the County (through the Administrator or the Administrator's,representatives)concludes the application has complied with all applicable laws and regulations.Access and right of entry to the appli�gt's prope II be requestedan all occur only during regular business hours. 1. ,.\fi - , - -7 d' PROPERTY OWNER (DATE) The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act" or "ESA." Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual, group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code The Applicant acknowledges that he, she or it holds individual and non-transferable responsibility for adhering to and complying with the ESA. The Applicant s read this disclaimer a 'gns and dates it below. 2. •.� �� /'��" .2 ❑ PERTY OWNER (DATE) r ( 4 + 1N3WdO13A3Q A.0,NrIViV400 3O 1d30 I A. kLNf1O0 N0a3333r —0 ii £OOZL - Hdd (a W 61 U 3 A 0 El 3 3 ,r, ,..up _ o r .,-) 9 0 `' r 4 --c bra J0 fi (5Th_ L____ (o .i., ____,. +ti , ; 0 ... , 4 5 ___ el lrk & > >< r ,,k- N tid -' 6' s ‘„,p f i N (0 U P )- --ti lir N ! 1 1 I' t Jl ; vo ., o 5 (o 1 fi \il 6` s Q � L r 0 IQ - ' } r (,)CFI n `� 0 , a• ' , ej V) v% C N c 0 w 0 — 0 5' n 9 .a:-- vi1,S 1 i ri a. 0 n S. C - p �r' 04 v''1 Q' 5 Q s' m 'r s N V' m ... 5 re fO ...E T. co '!Ui 'U1 r asum ,. , } , -r ,- 1 d- 5 I i' DI 7 --- ) ...,3e,., --S. -1\-- C.._... L),; ' ._____ _c_ \,,,,_. ,-----223 e.,., e5e -z5,50,.. ._ NI4......16‘0..-- \,j,k . tesz,g v — -- - 1% I Ot "De_Ace.c.L2,L \-------" so.re---ersc- L 1 i I ,...„..---....... 1 2.01 t`\) I 0 E. 1\--0-G-51.c** • v J' ...<________y--- _ k•-t t .___,, ,.• _ • , , 4 .. . A 4, t .4) ( C_ fi '-'' S )?ck.S.,...0 .), SAtx.N.)•,Ak(-% , 1-1/4 L ,.. I P kl :Al (61 2.-11 ..- I 1 JEFFERSON COUNTY DEPT. OF COMMUNITY DEVELOPMENT f-1 ,y o