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Name: BRUCE BRATTON 1 Finaled 1 General
Address. 293363 HWY 101 Quilcene Parcel I Case I
Updated: 12/29/2014 DLF Project I _ Tags: Warn ( 0 Constrocc
Description: MLA#:IBLD2005-00802 Review Type:I
NOTA CASE - CREATE FILE FOR FIRE ASSESSMENT
JBLDG /DWELLIN BURNED 2 01 05 -TOTAL LOSS Bldg Info
General Information SEPA: _ -- T Bldg Site
(� _ Determinations
Building Type. JNON
Improvement Type: IALT Received: (12/29/2014 Other
Census Cate o Issued:
9ry� (
Estimated Value: 1 S
Expires I
Hearing
Code Edition: 12003 I-Code _ Finaled: 112/29/2014
—
Contacts-
Zoning: (RR-5 Sewage Disposal: I Site
Directions
Primary Parcel: 1702114005 Water System: I
'iii Field Information X
I I NOT A CASE - CREATE FILE FOR FIRE
ASSESSMENT i OK 1 -M
BLDG / DWELLIN BURNED 2.01 05 -
TOTAL LOSS
., pescnption not available
Field: casemain-csm description
JEFFERSON COUNTY BUILDING DEPARTMENT
379-4450
RAPID EVALUATION SAFETY ASSESSMENT FORM
BUILDING DESCRIPTION {3eU LSE T3/z4,rro) OVERALL RATING: (Check One)
Owner's Name: Poin-
Mailing Addr : 2.1S14.3 !44,1 lb( INSPECTED (Green) 0
Phone Exterior only
Site Addr : 24 334.3 l.fwY to) _ Exterior & Interior
•
No. of Stories : 2. LIMITED ENTRY (Yellow) 0
Basement: Yes 0 No lig. Unk ❑ UNSAFE (Red) 'gt
Section Township Range
Parcel No. INSPECTOR:
Inspector ID .,,., ,,,,�
Primary Occupancy: Dwellingci Affiliation
Other Residential 0 Comm al ❑ Office ❑
Industrial 0 Public Assembly ❑ School ❑ INSPECTION DATE:
Government 0 Emer. Serv. ❑ Historic ❑ Mo/day/year oz,f e„Jor
Other Time /o:yo ", 6)13r1
Instructions: Review structure for the conditions listed below. A "yes" answer to 1, 2, 3 or 5
is grounds for posting entire structure UNSAFE. If more review is needed, post LIMITED ENTRY.
A "yes" answer to 4 requires posting AREA UNSAFE and/or barricading around the hazard.
Hazards such as a toxic spill or an asbestos release are covered by 6 and are to be posted and/or
barricaded to indicate AREA UNSAFE.
More
Review
Condition Yes No Needed
1(ollaps�partial collapse, or buiding off foundation ❑ ❑
2. Building or story noticably leaning 18 ❑ ❑
3. Severe racking of walls, obvious severe damage & distress g ❑ ❑
4. Chimney, parapet or other falling hazard Vl. ❑ ❑
5. Severe ground or slope movement present ❑
6. Other hazard present ubied/e t/CN❑ 0 ❑❑
Recommendations:
yI No further action required
❑ Detailed Evaluation required (circle one) Structural Geotechnical Other
Barricades needed in the following areas:
�-A msp.) �A-fl Q y 44A/,F O P
, r
❑ Other:
Posted at this Assessment: "Yes ❑ No
Comments:,ptpS w,¢5 4f roi1`L LOSS
r il v , 1 .
Ili '
li .` FEB 3 2005
I __
JEFFERSON COUNTY
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