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HomeMy WebLinkAboutBLD2003-00366 UILDING PERMIT APPLICAON ReviewSEP81-00038 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00366 Received Date: 6/12/2003 SITE ADDRESS: 140 N BEACH DR PORT LUDLOW, 98365 OWNER: STEPHEN A MEREDITH PHONE: (425)486-9170 16040 169TH AVE NE WOODINVILLE WA 98072 SUBDIVISION: BRIDGEHAVEN DIV 7 Block: Lot: 3 PARCEL NUMBER: 935700003 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: CRANSTON CONSTRUCTION PHONE: 732-7208 PO BOX 944 PORT HADLOCK WA 98339 Contractor's License CRANSCC070J7 Expires 3/10/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NO MLA REQ'D --- INTERIOR REMODEL TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT IO, MAIN: VALUATION 75,OgB 9ff` ADD'L: HEAT TYPE: EEE CODE EDITION: ^ '" 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: 2 OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BRIDGEHVN PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES_ NO _AREA _ Exist: 2 Exist: 2 Wetland_ Erosion Prop: Prop: 1 Seismic _ Streams _ Total: 2 Total: 3 Flood Way _ Floodplain Routing Date: y F&WLandslide ( /��03 Shoreline _Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: A C r AI/ /E D Permit $818.75 RAC 06/12/03 57917 /`'� r" n �,J �/ Plan Check $532.19 RAC 06/12/03 57917 JUL 1 4 2003 State Building Code $4.50 RAC 06/12/03 57917 Potable Water Application $51.00 RAC 06/12/03 57917 Jefferson County Planning & Building Department Total: $1,406.44 ft, jil ,. 3 eflal # aff) BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD03-00366 Received Date 06/12/2003 SITE ADDRESS: 140 N BEACH DR Issue Date 07/14/2003 PORT LUDLOW, 98365 APPLICANT: STEPHEN A MEREDITH PHONE: (425)486-9170 16040 169TH AVE NE WOODINVILLE WA 98072 SUBDIVISION: BRIDGEHAVEN DIV 7 Block: PARCEL NUMBER: 935700003 Section: 16 Township: Lot: 3 27 N Range: 01 E CONTRACTOR: CRANSTON CONSTRUCTION PO BOX 944 PHONE: 732-7208 PORT HADLOCK WA 98339 Contractor's License: CRANSCC070J7 Expires: 03/10/2004 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: NO MLA REQ'D ---INTERIOR REMODEL REQUIRED INSPECTIONS: [ ] SETBACKS /Footings: GKS �J�A ( ] Foundation: ��'� 4K / ;�3 � Tt�/� [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] Framing/Plumbing: ,?, ..-- .tfr, I Propane T nk/Lines: [ ] Insulation. ( /- 9-0 y t f 1 Sheetro : //2a/d40 f 1 Septic System Final Approval: [ ] Zoning Final Approval: f 1 Final/0 .ancy Approval: i/ L�/9J�[� HEALTH DEPART NT 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 I:\F_BLD_Permit_Buildng.rpt 10/29/1999 ,w)N c, 410 Jefferson Count iartment of Community Development per M 1 t 621 Sheridan Str ,t,Port Townsend WA 88368(360I 370-4450 5,.. A op _. . , . Ac ©n Project Description: Building Type: Project Type: Frame Type: Single Family New Wood Garage Attached/Detached 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: t hoose one: Existing. Existing: .2„_ Sewer Community System Electric' Oil Proposed: I Proposed: — Individual System We odstove Propane Total: �j Total: ..,.,t sewer,fill out the following: Heat Pump Conventional Alternative Other ermit# SEP Water Supply: - 1 1 Private well Two 'arty Well Pu ' : ame of water system: Square Footage: i For Office Use Only Main Floor I t Consistency Review 2ND Floor 1, : Base fee 41613.75 ''I .. l /es 00 3rd Floor Plan Check fee (00Q•�/� S3a• I 7 tog►o5 Htd Basement State Surcharge fee • 2 t_ SO ` 73 ,a, Unhtd Basement _ Subtotal I J SS• Li Garage/Carport ::�T=i-P Pot Water Review fee - --. --,- Decks 911/Rd Approach fee0.41S-kVei Commercial TOTAL 1 q 31. Industrial Receipt# S [ 9 1 l ) Other Cash/Check# 3 —1 S U o a ation: Initials JJJJ goiott.);;;_st,„ 0 ( 1I210 OxDate I Estimated Cost: , !l►�3105 f within 20 a Shoreline, I Distance to ank 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 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 t pphcant's prope or structure shall be requested and shall occur during regular business hours. Signature: ( ,/ ,/ Date: 6//kr0,3 -- OVER ► H:HOME'\PLNCNI"R\INFO: Ill ' 'kFORMS\BLDpermitApplication 11-8-01 f JEFFERSON COUNTY ►-. . ' ,, DEPARTMENT OF COMMUNITY DEVELOPMENT 'z• y • 621 Sheridan Street• Port Townsend•Washington 98368 \-/s , + 360/379-4450• 800/831-2678•360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Land Use Permit Application Form PROPERTY INFORMATION �-7 Tax Parcel Number: ❑ ❑ ❑ ❑ ❑ I 1 ❑ ❑ Subdivision Name: Lot Number: '''"'' { Property Size: -72D C\ (acres/square feet) Existing Use of Property: Site Address and/or Directions to Property: 1 Li C !. , '' APPLICANT&OWNER(INFORMATION Applicant(if applicable): rjj EP.t erN A , fr\t '1_ trt4 Telephone: ti a- 4 glo- 5 17d Address: 1100 4 0 1 b q AVE- tie City: n t , !1 ,_C, State: l jr.. Zip Code: 97 07. Email Address SAM 3 3 IY+ — Applicant's Signature: ..---^^ -r-- -r vel:2.f^'`' CO M Property Owner(s)of Record: S AM L. Telephone: Address: City: State: Zip Code: Email Address I acknowledge that the applicant above is applying for a building per ' n my property. Owner's Signature,,- / _ .•. Ieo designatz- .' Z, 01_ GP.AN rokJ__ ___to act as my agent in matters relating to this application for permit(s). lir- •• RT OWNER IGNATURE) (DATE) DESCRIPTION OF PROPOSED USE OR ACTIVITY(include separate sheets as necessary) (r [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 ❑ 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.02/25/2002 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 El Binding Site Plan* UDC Section 7.5 ❑ Conditional(Administrative)"C(a)"Use UDC Table 3-1 and Section 8.8 El 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) El 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 El 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) El Plat Vacation/Alteration UDC Section 7.1.3(d) ❑ Variance, Major* UDC Section 8.9 El Reasonable Economic Use Variance* UDC Section 3.6.4(h) El 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 El Shoreline Management Variance* UDC Section 5 El Appeal UDC Section 8.4.3 SEPA 8.10.12(c) Type IV Permits El 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 El Jefferson County Comprehensive Plan/UDC/Land Use District Map UDC Section 9 Amendment* El Jefferson County Shoreline Master Program Amendment* UDC Section 5 El 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 agre- •rovide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application t and any required later inspections. This right of entry shall expire when the County (through the Administrator or the Administr.y. representatives) 'ncl •es the application has complied with all applicable laws and regulations.Access and right of entry to the applic.'�1',,•roda rty shall • . `1 a *'shall o cur only during regular business hours. (PROPERTY OWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (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 p cant acknowledges that he, she or it holds individual and non-transferable responsibility for adhering to and complying with the ESA. T e Applicant s r d th's disclaimer and signs and dates it below. 2. --� 2�II-- (PROPERTY OWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) MASTER LAND USE PERMIT.DOC REV.02/25/2002