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Home My WebLink AboutBLD2007-00294 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 #: BLD07-00294 SITE ADDRESS: 51 HARMS LN Issue Date: 06/13/2007 PORT LUDLOW, 98365 Final Date: 7/18/2008 APPLICANT: MICHAEL & MARY NILSSEN TRSTEES PHONE: 916-849-8929 M&M NILSSEN FAMILY TRUST 201 JARVIS CIR SACRAMENTO CA 95834-1049 SUBDIVISION: PORT LUDLOW NO. 2 Block: Lot: PARCEL NUMBER: 990603199 Section: 9 Township: 28 N Range: 01 E PROJECT DESCRIPTION: REMODEL OF EXT HOME ADDING CANTILVEVER OF 42 SQ FT/ 120 GAL A/G PROPANE TANK 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 7/18/2008 I:\F_BLD_Occupancy.rpt 10/29/19 .•UILDING PERMIT APPLICAWN BReview00pe294 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00294 Received Date: 6/7/2007 SITE ADDRESS: 51 HARMS LN PORT LUDLOW, 98365 OWNER: MICHAEL N NILSSEN PHONE: 916-849-8929 MARY J NILSSEN 201 JARVIS CIR SACRAMENTO CA 958341049 PORT LUDLOW NO. 2 SUBDIVISION: Block: Lot: PARCEL NUMBER: 990603199 Section: 9 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI REMODEL OF EXT HOME ADDING CANTILVEVER OF 42 SQ FT TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 42 VALUATION 90,000.00 ADD'L: HEAT TYPE: 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: SEW WATER SYSTEM: LUDLOW BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 Total: 2 Routing Date: 621710.1 Type Amount Paid By: Date: Receipt: AINVOVED Permit $923.75 CJZ 06/07/07 91165 Plan Check $600.44 CJZ 06/07/07 91165 State Building Code $4.50 CJZ 06/07/07 91165 JUN i5 2007 Total: $1,528.69 Jefferson County Planning &Building Department Jefferson County Building Difsion Permit Num.: BLD07-00294 Applicant: NILSSEN BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2003 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:0C)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 Underground Plumbing 06 Under Floor Framing y8/08 Ext. Shear Wall Nailing 6 Rough-in Plumbing Framing /&7�/Dt. 4Qy Airseal 3//9/� Insulation:Walls /4 21�7/ Insulation: Floors „/*. AV Insulation: Ceiling Z/,L/Df fv Int. Shear Wall Nailing VA Wallboard Wallboard Nailing r/off Gas Line: Interior ///yl/O� Gas Line: Exterior /4/n _ N/A Propane Tank 2/8 68 Heat/Chimney Clearance Z 08 trY Address Posted FINAL INSPECTION lid FINAL IN PECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR FueimeE) /fr° �/�- ON co� JEFFER COUNTY re� ti . ,a DEPARTMENT OF COMMUNITY DEVELOPMENT �• j' SFr 77.11 '` ' ''4 621 Sheridan Street- Port Townsend • Washington 98368 ! 360/379 4450• 360/379-4451 Fax f gS,xINGSO www.co.jefferson.wa.us/commdevelopment V; JUN - 7 2007 Master Permit Application M A: No ML�A�{�'= Project Description(include separate sheets as necessary): : r M: ... F;'`'JT REMvvEL o, Ex/Sr,,VG /oM 4 2. S.F. CAA-)T., Z.�a PL/2, Tax Parcel Property Number. , .,0 g03 I ,� Size: 12,000 S. F. (acres/square feet) Site Address and/or Directions to Property: 51 HARMS LANE, PORT LUDLOW, WA 98365-9610 Property Owner(s)of Record: MICHAEL AND MARY NILSSEN Telephone:916-849-8929 Fax: email: NILSSEN_I@SBCGLOBAL.NET Mailing Address: 201 JARVIS CIRCLE,SACRAMENTO,CA 95834 Applicant/Agent(if different from owner): TEA r L , C KE,e Telephone: 206• 7/R - 6'782 Fax: email: 7kRRti'L 1k/.dC�C ',4 acbMCA.T !✓5-T Mailing Address: 2/7/2 2/ sr Ave ' /e /gRi , �� ?6 J 3 What kind of Permit?(Check each box that applies wilding 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 0 Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** 0 Address ❑Road Approach ❑Binding Site Plan** ❑Home Business 0 Cottagelndustry ❑ Long Plat** ❑Propane ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management 0 Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑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: wive. KnJow,t( DESIGNATION OF AGENT I hereby designate .t.t Y G , to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: 6- 30' 2�7 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 pr ide acces and righ of entry to Jeff rson County and its employees,representatives or agents for the sole purpose of application review and any re red later i pection . Staff cce and right of entry will be assumed unless the applicant informs the County in writing at the time of the applica )tat he he wa t�prio n re //� Signature: //L 1` Date: ..?b - 26e, 7 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 E Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if yo are in com i nce with he Jeff on unty development code.The Applicant acknowledges that he,she or it holds individual and non-transfer I rpsponsibil for dh ri g t a o I with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: Il t t {.UiJ t'- 30 2d r 1 Date. D 7 C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc BUILDER STATEMENT r ? ( , -' L , ,,,_ , The signer of this statement does hereby certify that they are the Owners of tie parcel referenced herein,tit tl.qy remrrDTllcensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. • Signature: Date: L _ 7 2007 Afj , GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: 7b 6E ASs/c,. 'HONE: FAX: • ( ) ( ) 'L'.. ,-:T MAILING ADDRESS: EMAIL: _- CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Fame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New Wood Existing: 2. RI Sewer ❑ Addition Steel Proposed: Bank ❑ Community System Alteration/Remodel ❑ Concrete Total: 2. Height: ❑ Individual System Repair ❑ Masonry SEP Permit# Bedrooms: Supply: ❑ Demolition ❑ Other: Water Su 1 Existing: 2- Setback: D Private well ! Two Party Type of Heat: Proposed: Public PROPAijE F:A.G(. Total: 2 Name of System: If this is a Commercial Proiect 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 Tan and/or Appliance Installation permit,mark all items bel at ❑l}rrderground Tank Above gr d Tank Size ofPropane Tank. I n 'T/3- 0. Heat Stove ook Stove oodstove ❑ Fireplace Insert D-Plot Water Tank Pellet Stove 0 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes 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 fines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated Uqp Z EH Bid App Review: _- 2"n Floor Heated Consistency Review: Other Heated Base fee: Mezzanine Additional Section: Heated Basement 6 70 Plan Check fee: (000•,44 Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: ��' Garage/Carport SUBTOTAL ‘2.a Mill Decks / 911/Rd Approach fee: 4-XIST4 _ -i Other TOTAL: $ - l Receipt Number: I. `C Cash/Check Number: C ESTIMATED COST(REQUI Date: 5(D � � .Fair market value of all I an/materials foundation to fi D`��0 7 )'0 000 u c Initials: C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc