HomeMy WebLinkAboutBLD2008-00220 • •
• 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/l3uilding Official
PERMIT#: BLD08-00220
SITE ADDRESS: 944 LITTLE QUIL RD Issue Date: 10/20/2008
QUILCENE, 98376 Final Date: 12/27/2012
APPLICANT: KAREN BRINDLE PHONE: (425) 313-9318
TERRY ROBERTS
PO BOX 176
QUILCENE WA 98376-0176
SUBDIVISION: Block: Lot: TR 4+
PARCEL NUMBER: 702031002 Section: 3 Township: 27 N Range: 02 W
PROJECT DESCRIPTION: NEW SFR W/BASEMENT, ATTACHED GARAGE, ATTACHED CARPORT
ALSO A/G 500 GAL PROPANE TANK
THE PROJECT LISTED ABOVE COMPLIES WITH THE: REQUIREMENT OF THE BUILDING CODE 2006
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes f"no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 12/27/2012
\\tidemark\data\forms\F_BLD_Occupancy.rpt 1/16/2013
0254
•UILDING PERMIT APPLICA UN ML Revviewiew Type:
e: I
pe: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00220 Received Date: 5/27/2008
SITE ADDRESS: 944 LITTLE QUIL RD
QUILCENE, 98376
OWNER: KAREN BRINDLE PHONE: (425) 313-9318
TERRY ROBERTS
23920 SE 170TH ST
MAPLE VALLEY WA 98038-7101
SUBDIVISION: Block: Lot: TR 4+
PARCEL NUMBER: 702031002 Section: 3 Township: 27 N Range: 02 W
CONTRACTOR: TOSE DETERMINED• PHONE:
N con -}-rvc+,
REPRESENTATIVE: DAN NIEMAN PHONE: (360)434-0717 (Cell)
PO BOX 846 (360) 765-3529
QUILCENE WA 98376
PROJECT DESCRIPTION NEW SFR W/BASEMENT, ATTACHED GARAGE, ATTACHED
CARPORT
ALSO A/G 500 GAL PROPANE TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,817
VALUATION 376,372.00 ADD'L: 1,150 HEAT TYPE: RAD
CODE EDITION: 2006 HEAT BASE: 494 HEAT TYPE: PRO
OCCUPANCY: R-3 UNHEATED: 460 #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 1,273 SHORELINE:
CONST TYPE: DECK: 368 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 3 Prop: 4
Total: 3 Total: 4
Routing Date: C I a g I OC> l�
Type Amount Paid By: Date: Receipt: APPROVED
Permit $2,544.95 KAS 05/27/08 100218
Plan Check $1,654.22 KAS 05/27/08 100218
State Building Code $4.50 KAS 05/27/08 100218 OC1 2006
Potable Water Application $59.00 KAS 05/27/08 100218 Jefferson County Planning
Total: $4,262.67 & Building Department
Jefferson County Building Asion Permit Null,: BLD08-00220
Applicant: BRINDLE
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 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 ` b�b`'l 9 _ Little Quicene Rd ROW 20 feet. Side and rear are 5 feet. Min setback
from the stream is 105 feet&225 feet from wetlands
Erosion Control BMPs
Foundation Footing '
1( -Or1 �- "UJ�R- t b-2-U a T j C'i��1C
Footing Drains 5114 I fl y y,� 1 1,rjb S / /,/
Foundation Stem Wall
Underground Plumbing 40
i13s O K -3(3C(1
Under Floor Framing ,S—_12 j
Straps(hold downs) ff �tom
l�'
Ext. Shear Wall Nailingc_11—V(
"`:'
/ ),25/—�� l
Rough-in Plumbing -r-(Z ci` t, fo-.15' Z
Framing
Blocking S-(L (7-'i
Airseal , ,S� -f ..
Insulation:Walls
Insulation: Floors
(p — 7 �`Ct�L1nai)C ce-c-e ws-T�e 4n Nri-ei p J`T'
Insulation: Ceiling �tZ91 L ` \%\(,1.q
Int. Shear Wall Nailing J
3f1,111, f110
/�� �XGC�� s..71 S 1C{a `Wallboard NailingGas Line: Interior �
Gas Line: Exterior alL
Propane Tank
Heat/Chimney Clearance / .S -/Z-- (Z�j
Drywell/Alt Drainage t� Multiple catch basins to cistern. See plan.
Address Posted
444,16,,p1[2-1
T-,_,
) $OQ Onild � Pi lr CLCIO
FINAL INSPECTION IZ_01? j
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD08-00220
1.) The project shall comply with all conditions in the SPAAD, MLA06-00491/ZON06-00046.
2.) The identified Fish and Wildlife Habitat Area (Type 4 Stream), shall maintain a vegetative
buffer setback of 100-feet. The setback shall be measured horizontally from the Ordinary
High Water Mark (OHWM) to proposed development.
3.) An additional setback of five (5) feet is required from the edge of the stream buffer area to
proposed development.
4.) A permanent physical separation along the boundary of the buffer area shall be installed
and permanently maintained. Such separation can include installing logs, trees, a
hedgerow, or any other prominent physical marking approved by the UDC Administrator.
5.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or
every one hundred (100) feet, whichever is less. Signs shall be in place prior to and
during construction activities. The signs shall contain the following statement: "Buffer- Do
Not Remove or Alter Existing Vegetation."
6.) A Stormwater Plan has been submitted and approved by the Department of Community
Development. Once the subject permit has been issued the applicant shall fully
implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
8.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened
from view of neighboring dwellings and rights-of-way. Such screening shall meet all
applicable performance and development standards specific to the district in which the
storage is kept, and shall be in keeping with the character of the area. Screening shall
meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an automobile wrecking
yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter
18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile
wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor
vehicles be stored in a critical area.
9.) The building height is not to exceed 35 feet.
10.) A minimum of two (4) on-site parking spaces shall be provided for the single family
residence and ADU.
11.) Minimum setback from the Little Quicene Road right-of-way shall be 20 feet. Minimum
side and rear setbacks shall be 5 feet. Minimum setback from the Type 4 stream shall be
105 feet and 225 feet from the wetlands unless a wetland delineation is submitted at time
of application.
12.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
13.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the
finished grade, excepting when such lighting is an integral part of a building or structure.
Ground level lighting is encouraged.
14.) Lighting fixtures shall be designOnd hooded to prevent the light source frorliing
directly visible from outside the boundaries of the property. The intensity or brigntness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
s i ,
f 4i�'SON C0� JEFFERSONSUNTY •
W
' q� +j DEPARTMENT OF COMMUNITY DEVELOPMENT MAY 2 7 2808
'" - `4 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
1S p'� www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: (.) i-25'
Projec Description(include separate sheets as necessary):
1.��14 J . c5/4f�'/.._ .,- /Y1/4 'Ftc SH% --
Tax Parcel ,l Property
Number: 7oc' 03100 (rem?' `�_ Size: ` •�O (acres/ uare feet)
Site Address and/or Directions to Property: //i y(a 1 T 4O2D.S K' "1� �q / � ' ���
77 if L.-/T �t v/s- .� C)v/4-L' ril Gt i-- 753 se v
Property Owner(s)of Record: �F- Y Ii r4sTS .4N/D ,�inRAf i2.;W 6—
Telephone:42 3/3- 93/e Fax: email: f is a-Rae6r/,tiea`
Mailing Address: Z39mil'') Se-- /70 Sr A4Px-4-.✓A" /ffWnS'' /803g /
Applicant/Agent(if different from owner): 2'a �.
f r .m / 4 A&:0"r✓ dr,' ///VG.
Telephone:36a"43'f-07/7 6.-...44.- Fax: 36:0-766--352-;Y email:4lte0)04 c onsttuthion i/I&e/1t S&-C.6I
Mailing Address: f. -®•g- e'er- ) f2vt(.A/C) bt/ft• 418:5 74,
What kind of Permit?(Check each box that applies
Building 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Demolition Permit 0 Conditional Use[C(a),C(d),or C]**
sig Single Family )t Garage ttached/Detached 0 Discretionary"D"or Unnamed Use Classification
.0 Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
O Commercial* 0 Boundary Line Adjustment
O Change of Use 0 Short Plat**
❑ Address 0 Road Approach • 0 Binding Site Plan**
❑Home Business 0 Cottagelndustry 0 Long Plat*"
❑Propane . 0 Planned Rural Residential Development(PRRD)/Amendments**
0 Sign 19 Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions**
AStormwater 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 t]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 /t� to act as my agent in matters relating to this application for permit(s).
��
OWNER SIGNATURE ,:ice �" /-7(7 .l1"� ) il -17 _ - - e: -i 6'
By signing this application form,the owner/agent attes at the' l� ____
provided herein,and in any attachments,is true and correct to the best of
his,her or it's knowledge. Any material falsehood or ny 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 attomey'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 re ' d later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appf do that he or wants prior notice.
Signature: != 1 _ Date: fd 46
c
The actor actions Appl nt 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 fora .rig to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: — _ Date: `J"-"/ 7 --0
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
V
• BUILDER STATEMENT It
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:
1, Y 2 7
2r;Pt:f
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAIL NG 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: 0 Sever
❑ Addition 0 Steel Proposed: —4- Bank 0 Community System
❑ Alteration/Remodel 0 Concrete Total: 1 Hei Individual System
❑ Repair ❑ Masonry SEP Permit#i/1/f/lei 4'S.S
0 Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: X Private well ❑ Two Party
Proposed:Type of Heat: Pro p ,�r A 0 Public
?7.a-ra/~r-F-�er� Total: ;3 /v 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(Above ground Tank Size of Propane Tank: Cd d 6is-c._
I Heat Stove ®Cook Stove I Woodstove I Fireplace Insert ,OHot Water k I Pellet Stove ®Other f .
Is this appliance being installed in a Manufactured/Mobile Home? Yes / Nol eti .s
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 Offlc@'Use.Only Amount Revision
Main Floor Heated 46 EH Bld App Review:
/g/i
26°Floor Heated Consistency Review:
P5- i(____0(
Other Heated Base fee:
Mezzanine Additional Se or>R0
Heated Basement 4€,4 Plan phisEt fee: C(' Q
-15
Unheated Basement Hop
p..-State Surcharge fee:
Other Unheated ,- Pot Water Review fee:
Garages' arport' 4 :Jr. SUBTOTAL
Decks 3 911/Rd Approach fee:
Other
SG ari ?pr1zC./4 2_2-g TOTAL: $
Receipt Number:
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date:
'Fair market value of all labor and materials foundation to finish
Initials:
G:\PemutCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
vs arr
k.,� cod JEFFERSONWiUNTY
rrz
vi DEPARTMENT OF COMMUNITY DEVELOPMENT i
`'Q 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax MAY 2 7 2008
www.co.jefferson.wa.us/commdevelopment
1.4t`SHINO�O
Master Permit Application MLA: : .
Project Description(include separate sheets as necessary):
Tax Parcel Property
Number: Size: (acres/square feet)
Site Address and/or Directions to Property:
Property Owner(s)of Record:
Telephone: Fax: email:
Mailing Address:
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
❑Building 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 ❑ Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home 0 Modular 0 Special Use(Essential Public Facilities)**
❑ Commercial* 0 Boundary Line Adjustment
❑ Change of Use ❑ Short Plat**
❑ Address 0 Road Approach 0 Binding Site Plan**
❑ Home Business ❑ Cottagelndustry 0 Long Plat**
❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendments**
❑ Sign ❑ Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions**
❑ Stormwater Management ❑ Shoreline Management Substantial Development**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Variance
❑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:
DESIGNATION OF AGENT
I hereby designate to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: J -I 0 8'
By signing this appllcaf caner/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 notice.
Signature: Date:
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 respons f to a complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: i -7 _-` 9 .-
Date: Cti
G:\PermitCenter\###FORMS###\DAD FORMS\Master Permit Application 12-19-2006.doc
V
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:
7 ma-
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: 11FAX:g
( ) ( ) .
MAILING ADDRESS: EMAIL: ,, z i i U61.3
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 0 Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System
0 Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
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 l Cook Stove i Woodstove i 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 $ .. w.�'a 4it'''' 4°� lr t; :'4, ..: I , 4, ., ..: -,r
Main Floor Heated A ' } " EH BId App Review:
2nd Floor Heated 'y A Consistency Review:
�j 5 . c
Other Heated ��� to Base fee: 1111.
Mezzanine -�7 �;_ Additional Section:
Heated Basement 4qq ° ' .321 ,flan Check fee: •16. :a D
Unheated BasementI " ' yState Surcharge fee:
4G0 ��pfl 4.50
Other Unheated 1 Pot Water Review fee:
Garag arp `" SUBTOTAL _
4G,3 ; 1 � 9 45,5_�-
Decks ` 1 (111/Rd Approach fee:
l 40 ,)t
Other SCX a B 5"• TOTAL: $ 45a35,421
Receipt Number: loba1
; '%3 J• a h/Check Number:
3 �5'
ESTIMATED COST(REQUIRED) 21 V tY ' t : KJ {�
.Fair market value of all labor and materials foundation to finish J d"
Initials:
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc
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