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Home My WebLink AboutBLD2007-00213 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD07-00213 Received Date: 5/10/2007 SITE ADDRESS: 74 MOUNTAIN VISTA CT Issue Date 5/14/2007 Expiration Date 5/14/2008 OWNER: SAM BERRY PHONE: 206940-0564 SERENA BERRY 8598 BELLE HILL RD BAINBRIDGE ISLAND WA 98110 WOODLAND HILLS#2 PHASE 1 DIV SUBDIVISION: Block: Lot: 27 PARCEL NUMBER: 999900127 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: PACIFICA PHONE: 360-297-9778 OLD PORT GAMBLE MILLSITE PORT GAMBLE WA 98364 Contractor's License PACIFCL951OT Expires 9/30/2007 PROJECT DESCRIPTION: REMODEL EXISTING SFR - NO MLA REQ'D (WITHIN EXISTING FOOTPRINT) RsoTettt cri-itRiLioq - TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 45,000.00 ADD'L: HEAT TYPE EEE CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY. R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $593.25 LYK 05/10/07 89942 Exist: 3 Exist: 2 Plan Check $385.61 LYK 05/10/07 89942 Prop: 0 Prop: 0 State Building Code $4.50 LYK 05/10/07 89942 Total: 3 Total: 2 Total: $983.36 Directions to Site: 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 Jefferson County Building Di Lion Permit Num. BLD07-00213 Applicant: BERRY BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks ✓ 5210 Erosion Control Foundation Footing ✓ t A 111 Footing Drains �( lG Foundation Stem Wall 5‘61M Underground Plumbing Straps(hold downs) Ext. Shear Wall Nailing Rough-in Plumbing _C; C Framing G/i6/47 Airseal 41/8/07 Ql Insulation:Walls 4 fteei Insulation: Floors d (V Insulation: Ceiling oD \ Int. Shear Wall Nailing Wallboard Nailing Gas Line: Interior Yv 1 Gas Line: Exterior Propane Tank Drywell/Alt Drainage Address Posted FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD07-00213 SITE ADDRESS: 74 MOUNTAIN VISTA CT Issue Date: 05/14/2007 PORT TOWNSEND, 98368 Final Date: 6/10/2008 APPLICANT: PATRICIA STROMBERG PHONE: DON STROMBERG 303 33RD ST PORT TOWNSEND WA 98368-5023 SUBDIVISION: WOODLAND HILLS#2 PHASE 1 DIV Block: Lot: PARCEL NUMBER: 999900127 Section: 27 Township: 30 N Range: 01 W PROJECT DESCRIPTION: REMODEL EXISTING SFR - NO MLA REQ'D (WITHIN EXISTING FOOTPRINT) THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes (no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/10/2008 I:\F_BLD_Occupancy.rpt 10/29/19 • BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTORt-c- MANUFACTURED HOME INSTALLER: PHONE:cc) ,)C-6 `,HO-G51,4 FAX: C'c 1LC- ( 560 ) 291 • Sb3L ( 360 ) -)cj)-5 A(„ MAILING ADDRESS: f7C, 3 a .U 7 c f Gc� i , /i'� FMAIL. Y �o t 1..� ` ` S el^l Ct.)c c,•c o Sr o . c c..4" CONTRACTOR'S LICENSE WAINS NUMBER: t_ fit;c c L. I L, I`P L NUMBER ARCHITECT/ENGINEER: M, t L { ( ,Q-Ncf, ,„.., PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New t Wood Existing: A ❑ Sewer ❑ ddition ❑ Steel Proposed: Bank ❑ Community System Iteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: '*Public L ; c r,c Total: Name of System: 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: i Underground Tank i Above ground Tank Size of Propane Tank: I Heat Stove i Cook Stove I Woodstove 1 Fireplace Insert i Hot Water Tank I Pellet Stove I 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: U3Li1')(NI Fcisr. gtPi 2"tl Floor Heated Consistency Review: � Wt+httJ eu51• S• I• Other Heated Base fee: 5 Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: -z1 .SO Other Unheated Pot Water Review fee: K.3Ipi Garage/Carport SUBTOTAL _ q1c . 3(ci Decks 911/Rd Approach fee: Other TOTAL: $cps .&p Receipt Number: '3tq 4.2 Cash/Check Number: fPla) ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish tO 1 _ P Lj S r t.OC.> Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc ��4"Soly co�� JEFFERSOISUNTY ti �� A. DEPARTMENT OF COMMUNITY D.F.YE�IPMEIITi i ` ''C 621 Sheridan Street • Port Townsend •Washington 98613 360/379-4450 • 360/379-4451 Fax 3 www.co.jefferson.wa.us/commdevelopment 1sbt?N�rs Master Permit Application MLA: KO MlA E '1 Project Description (include separate sheets as necessary): ij (IV 411 x, 0-1 �� f f� - 1.0c(6, G f('u , F�c'�t cQC I Tax Parcel ' Property Number: 6-7 0I'1 Size: [ i l (acres/square feet) • Site Address and/or Directions to Property: -) `( /1'/G J•t. r j,S•tr‘ , G" --- ) / '* Tc ue c ,ktC Property Owner(s)of Record: 7c. 3e er 7 Telephone: )>6 `iyi S-Lta Fax: 34-c. `', �b email: (c et c5e .0 e'7 Mailing Address: >F/6 13,th r(;// �! �•,b"d.5 lsfet.„l , Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit? (Check each box that applies r2Building 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit 0 Conditional Use[C(a), C(d),or C]** Single Family 0 Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address El Road Approach 0 Binding Site Plan** ❑ Home Business 0 Cottagelndustry 0 Long Plat** ❑ Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Sign 0 Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use 0 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 0 Tree Vegetaion Request *May require a Pre-Application Conference **Requires a Pre-Application 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). OWNER SIGNATURE Date: 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. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior nonce. / • Signature: Date: ? ,�/ 0 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 has read this disclaimer an signs and dates it below. Signature: >—• Date: 5 disclaimer an C 7 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc