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Home My WebLink AboutBLD2005-00446 CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 Carl Smith, Director/Building Official PERMIT #: BLD05-00446 SITE ADDRESS: 753 RHODODENDRON LN Issue Date: 09/12/2005 BRINNON, 98320 Final Date: 12/6/2013 APPLICANT: NORMA J ROBINSON PHONE: (360) 796-3296 RAYMOND P ROBINSON PO BOX 192 WASHOUGAL WA 98671-0192 SUBDIVISION: PLEASANT TIDES Block: Lot: 4 PARCEL NUMBER: 988500004 Section: 15 Township: 25 N Range: 02 W PROJECT DESCRIPTION: NO MLA REQ'D-NO CHANGE IN FOOTPRINT ADD SEMI-HEATED BATHROOM IN STORAGE BUILDING THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 12/6/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 12/17/2013 • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00446 Received Date 07/11/2005 SITE ADDRESS: 753 RHODODENDRON LN Issue Date 09/12/2005 BRINNON, 98320 APPLICANT: NORMA J ROBINSON PHONE: (360) 796-3296 RAYMOND P ROBINSON 630 RHODODENDRON LN BRINNON WA 98320 SUBDIVISION: PLEASANT TIDES Block: Lot: 4 PARCEL NUMBER: 988500004 Section: 15 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: NO MLA REQ'D-NO CHANGE IN FOOTPRINT ADD SEMI-HEATED BATHROOM IN STORAGE BUILDING CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: UFFER: Footing: Foundation: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathin : Framing: C. -210-1", Plumbing: ,1// /1 f}' Propane Tank// I ines: sv�J Insulation: (.^2rtb �v a Sheetrock: / 2 —36 Septic Sytem Final Approv' (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval:01. ( Z- — (3 HEALTH DEPARTMENT-AND PUBLIC WORKS 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 10/29/19 -00446 PILDING PERMIT APPLICATIP1 B RD iew Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00446 Received Date: 7/11/2005 SITE ADDRESS: 753 RHODODENDRON LN BRINNON, 98320 OWNER: NORMA J ROBINSON PHONE: (360) 796-3296 RAYMOND P ROBINSON 630 RHODODENDRON LN BRINNON WA 98320 PLEASANT TIDES SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 988500004 Section: 15 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NO MLA REQ'D-NO CHANGE IN FOOTPRINT ADD SEMI-HEATED BATHROOM IN STORAGE BUILDING TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 1,379.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: 39 CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: 1 Total: Total: 1 Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $50.95 KAS 07/11/05 76166 APPROVED Plan Check $33.12 KAS 07/11/05 73166 State Building Code $4.50 KAS 07/11/05 76166 SEP 1 2.2005 Potable Water Application $53.00 KAS 07/11/05 76166 efferson County Planning Total: $141.57 & Bu. . epartment 'Fa_ A I ,_ 4,' 500 004. Lot vv-;.01 -Lk-G.:tick- . rt, i< "1-' '`,-; i 1( / Ia.' (-77-1 --,7. .1 0 I/ 1 , 1 .4. 1 Ex ist 6,1. suorctje :. 1 fa.co rft B(.41a; rj I ci s' - Lot \At"i-tk tot 1 9arase Ii ,\, t)- E)eist;11 or sterq3e - 0 Bi.4;ld iti:j1 'It) / , < s 0 1 4 --- < ) ' 1 '...... \ .../... t / 1--- , _.. ________. \\ I ..._ ig 616rne.rs p o•-; ,+ Elev. LJ-2. 76' Elev.. /A < L .. R1,16(.1e...nc) roil La he. NochAQ (R,A, ,,,,,„,,, F-j) Et r; E., [1 ...r: [c.. V'') 753 Rtrlocio8endrcv) L cthe L. • ) ' 1 Bri n non . WA ci tg--.YO, Fil SEP - 8 2005 1, i E ()e) 94y- I--) c 1 L JEFIHH;N COL:NTY OEP1. 01 CrA1t_JT'Y E.EVELOHAENT 8 CD 05 4;OINT cG� JEFFERSON•UNTY le Ia' DEPARTMENT OF COMMUNITY DEVELOPMENT `' ` `"4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • ,. OV www.co.jefferson.wa.us/commdev360/379-4451Faxelopment 1,9 Master Permit Application MLA: IQ D 1 L.A 'V- Q Project Description(include separate sheets as necessary): LL'' j{ -J c:trl.'1- C�L c d i- ?i i k% v,o c.11 t V\ t-t_ Ste.0 cl cA L„ i I i i' 17 Tax Parcel a Pro Number: q ?� s 0 0 O o 4 S¢e 7(o X i 1 4 (acres/square feet) Site Address and/or Directions to Property: 7 5.'. ff P hA. o d t' (1y/, . L a to e q g`- `-/C Property Owner(s)of Record: r,t v- a_ tR c.b i In n I'1 Telephone: 3 Lo - 7 94 - '�y Fax: email: Mailing Address: t',3 b 1� to D Co CI t )C r CI) L.c,'4 B ,f,i ri'-Q id w 4 Q g• `D Q Applicant/Agent(if different from owner): — Telephone: Fax: — email: — Mailing Address: - What kind of Permit?(Check each thatapplie )__ - _ ''Building l ,'. !, I" • i thce(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ,! I ' ' L __ nditional Use[C(a),C(d),or C]** ❑ Single Family ❑i scretion a "D"or Unnamed Use se Classification 0 Garage Attached/Detached ❑;Special Use(Essential Public Facilities)** 0 Manufactured Home J U L 1 1 2005 0 Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑Commercial* _, ❑ Binding Site Plan** 0 Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane "'—lCI-PIaTVacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis El Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Re uires a Pre-A plication Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). POWNER SIGNATURE - y t „ � r; Date:_,.A,i-A.,_ "3.-I aUCLS By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent 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.A ss and right of entry to this properly shall be requested and shall occur only during regular business hours. Signature: 'YL �� .1t,= ,,..) Date:t i 'O._ c 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 actions)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 ad(erng to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: `� �-6 1 ...* 4,•J Date:' `'l I `D.O C 5 r G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc OWNER BUILDER STATEMENT The signer of this statement does hereby certify thill. ey are the Owners of the parcel referenced herein, they are not licensed contractors and that they will be assuming the responsibility of Ge eral Contractor for the proposed project. Signature: i) L•,-vim, �'� Date: J../.i Li i {C. GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: I Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: I Height: X Individual System ❑ Repair ❑ Masonry SEP Permit# J —6 b 5(. ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: I 1 Public Total: Ipc }YiG Nan1e of System:_? eo q 61 _i d Y I I es Lea, e ( p - If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: ii Underground Tank [1 Above ground Tank Size of Propane Tank: [[ Heat Stove [l Cook Stove [I Woodstove [I Fireplace Insert LI Hot Water Tank ❑ Pellet Stove O Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage For Office Use Only Current Proposed Amount Main Floor Consistency Review: 2Nu Floor Base fee: 3f0 Floor Additional Section: Mezzanine: rr- ' fee: jj 1 .r L TL C , J, T Heated Basement f IJ r— fat Surcharge fee: Unheated Basement 1 Li At 1 1 Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport TOTAL $ Decks Receipt Number: J {1 Other 3*h-, ' — Cash/Check Number• - 1319. ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish A r O _ Initials: G:\PemritCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc