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HomeMy WebLinkAboutBLD2003-00412 air BLD97-00250 • BUILDING PERMIT APPLIION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD03-00412 Received Date: 7/2/2003 SITE ADDRESS: 302 JUAN DE FUCA RD PORT TOWNSEND, 98368 OWNER: CHARLES H MAC NAB PHONE: ANN M POUGIALES 26 CASTLE ROCK DR MILL VALLEY CA 94941 SUBDIVISION: (415)381-6811 Block: Lot: T 2 PARCEL NUMBER: 101323006 Section: 32 Township: 31 N Range: 01 W CONTRACTOR: DISCOVERY BAY CONST CO INC PHONE: 385-4372 PO BOX 1410 PORT TOWNSEND WA 98368 Contractor's License DISCOBCO90B9 Expires 8/20/2003 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NO MLA REQ'D -ADDING BATHROOM INSIDE EXISTING GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 5,000.00 ADD'L: HEAT TYPE: 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: CON WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: 1 Seismic Streams Total: Total: 1 Flood Way Floodplain Routing Date: 7/03e 0 pet:3 Shoreline Lhoreline A uiferAquif r Forest: CommerceA p r- Type Amount Paid Bv: Date: Receipt: Approved rate Permit $111.25 MJA 06/30/03 57999 JUL - 9 2003 Plan Check $72.31 MJA 06/30/03 57999 Jefferson County Planning State Building Code $4.50 MJA 06/30/03 57999 & Building Department Potable Water Application $51.00 MJA 06/30/03 57999 Total: $239.06 ij ill Jefferson cornDepartment of Community Development �� Otv Oe., 621 Sluridan Street,Port Townsend WA 88368136111378 41450 ` `W �� r = wo prmôt A °__, _ o cal!oaiN 30�ING s�s Description: JEFFERSON COUNTY Project lDEPT eF CryA; ;-; '-,-) :-F-vo<,c,Pril'Y Building Type: Project Type: Frame Type: • Single Family ❑ New X Wood ' , Garage Attache. Detached ❑ Addition ❑ Steel ❑ Modular g. 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: 0 Existing: D ❑ Sewer ❑ Community System ❑ Electricity ❑ Oil Proposed: ) Proposed: 'Individual System ❑ Woodstove xr Propane Total: ' Total: = If not sewer,fill out the following: ❑ Heat Pump ❑ Conventional p Alterna' e ❑ Other l j b R i Permit# SEP Water Supply: XPrivate well ❑ Two Party Well 0 Public:Name of water system: Square Footage:, 12.,kA \'(‘� For Office Use Only Main Floor NI NUN { e,C) Consistency Review l 2ND Floor Base fee t(( - 2-5 3rd Floor Plan Check fee—65% 712`3 l Htd Basement State Surcharge fee y`.SCE Unhtd Basement Subtotal ( O S Garage/Carport Pot Water Review fee 82.0 o Decks 911/Rd Approach fee95 Commercial TOTAL -7O . G Industrial Receipt# 57 -1'1 1 Other Cash/Check# `1VOaZ I Total Valuation: Initials k.,//Or Date COfi O Estimated C t: i E v C> If within 200' of the Shoreli , Distance to Bank or Ordinary High ater 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 applilipcan``'s property or structure shall be requested and shall occur during regular business hours. Signature: g. Date: V :2 D Q OVER 0,- H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 BUILDING PERMIT• Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD03-00412 Received Date 07/2/2003 SITE ADDRESS: 302 JUAN DE FUCA RD Issue Date 07/9/2003 PORT TOWNSEND, 98368 APPLICANT: CHARLES H MAC NAB PHONE: (415)381-6811 ANN M POUGIALES 26 CASTLE ROCK DR MILL VALLEY CA 94941 SUBDIVISION: Block: Lot: T 2 PARCEL NUMBER: 101323006 Section: 32 Township: 31 N Range: 01 W CONTRACTOR: DISCOVERY BAY CONST CO INC PHONE: 385-4372 PO BOX 1410 PORT TOWNSEND WA 98368 Contractor's License: DISCOBC090B9 Expires: 08/20/2003 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: NO MLA REQ'D -ADDING BATHROOM INSIDE EXISTING GARAGE REQUIRED INSPECTIONS: [ ] SETBACKS /Footings: [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [t,j Framing/Plumbing: Wlc,oao - E-13-0g f 1 Propane Tank/Lines: [ ] Insulation: . 8-ot-03 f 1 Sheetrock: p_ g�a-I- o 3 f 1 Septic System Final Approval: _ [ ] Zoning Final Approval: Final/Occupancy Approval: ;, . � -v�'J.,(,;,/I 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. HOT LINE AVAILABLE 24 HOURS A DAY I:\F_BLD_Permit_Buildng.rpt 10/29/1999 KcsON' C °�, JEFFE SON COUNTY ONO MUI-- VOILP 44 440. 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 4, 'S1 621 Sheridan Street• Port Townsend • Washington 98368 '�s.4.1_NeO 360/379-4450 • 800/831-2678 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment j I �(( I i i •J 3 f k-1 Master Land Use Permit Application Form PROPERTY INFORMATION Tax Parcel Number: Min rommonnig Subdivision Name: -- Lot Number: Property Size: (acres/square feet) Existing Use of Property: _�5, I. di e,Vl ic ___ Site Address and/or Directions to Property: , © Z, L n d P 1.4 Cso, PQ,,,C ..r c 7 e-fi vc.) fAs L C' , APPLICANT& OWNER!INFORMATION 2,cb G R_u. 9 e_, b-.;e)) ^ (3 1 O/1 (--` Applicant(if applicable): T i.— [9 vQ� (dw e i elephone:"��0^���•- y,3<� Addre p• • J( 1 ,1 ��! City.` ( /Lj7 2i,, m Stated Zip Code:98.3.4 Email Address Applicant's Signature: QIA $ 1 /1/1 . t..t C?-A. Property Owner(s)of Record{ 4-4vl C 1t' - . /"`-+ le hone: ifI S'' ". g 1— C. i) I Address: o (Gc s t I,e -b C ' __Deft .,P— City: / v ! State:Cc Zip Code: e fe3y/ Email Addres c—,, ,Ga �, ,� I acknowledge that the applicant above is applying for a building permit on my property. J Owner's Signatu e: i I hereby designate CP,)^, C-P 1.-A Li 6' to act as my agent in matters relating to this application for permit(s). 1•2( 1 ROPERTY OWNER SIGNATURE) (DATE) DESCRIPTION OF PROPOSED USE OR ACTIVITY(include separate sheets as necessary) "Ir1 u,-)ea l .i`, vOf(c J +() YY\A,--c- Cti a, f b bAA Gtv : , [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) Type II Permits 0 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 Ill 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* Ordinance 06-071 UDC Section 3.6.42h) -99 UDC Appendix C ❑ Wirelessss Telecommunication ❑ 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 ( , � \ l e=. `1\ _ _ � � - l! Type V Permits t"- i� ,j. UDC Section 3.3.5 ❑ Special Use(Essential Public Facilities) `�'`, ,UN 3 O \ ❑ Jefferson County Comprehensive Plan/UDC/Land Use District Map UDC Section 9 4tt ; Amendment* , ❑ Jefferson County Shoreline Master Program Amendment* UDC Section 5 Section 8.10.12(d) L~-- - FER 01'1 CO ❑ Appeal of SEPA UDC ,Id) �E�R �: ti E,AL0F ' r__ 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. her agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of lication 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 e a licant's property sha equue ested and s II occur only during regular business hours lzrl 03 A 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 threatenec or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known a: the "Endangered Species Act" or "ESA." Jefferson County makes no assurances to the applicant that the actions that will be undertaker because this permit has been issued will not violate the ESA. Any individual, group or agency can file a lawsuit on behalf of an endangerec 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 has readlhis disclaimer an signs and dates it below. 2. QA' ham , (----(. ;� ( /Zl PROPERTY OWNER ,S (DATE)