HomeMy WebLinkAboutBLD2009-00242 • •
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
Al Scalf, Building Official
PERMIT #: BLD09-00242
SITE ADDRESS: 71 RANDOLPH ST Issue Date: 10/13/2009
PORT HADLOCK, 98339 Final Date: 10/5/2011
APPLICANT: PATRICIA 0 COPELAND PHONE: 360-385-7478
71 RANDOLPH ST
PORT HADLOCK WA 98339-9542
SUBDIVISION: PORT HADLOCK Block: 2 Lot: 6+
PARCEL NUMBER: 989400206 Section: 1 Township: 29 N Range: 01 W
PROJECT DESCRIPTION: CHANGE OF USE - UNHTD SHOP TO SATELLITE BDRM/ART STUDIO &
RE-LOCATE A/G 120 GAL PROP TANK
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes `_no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON10/5/2011
I:\F_BLD_Occupancy.rpt 10/29/19
� BLD09-00242.
UILDING PERMIT APPLICA LN Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00242 Received Date: 7/28/2009
SITE ADDRESS: 71 RANDOLPH ST
PORT HADLOCK, 98339
OWNER: PATRICIA 0 COPELAND PHONE: 360-385-7478
71 RANDOLPH ST
PORT HADLOCK WA 983399542
PORT HADLOCK
SUBDIVISION: Block: 2 Lot: 6+
PARCEL NUMBER: 989400206 Section: 1 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: HENRY M SOUZA PHONE: (360) 379-8338
DESIGNS BY SOUZA INC (360) 379-9136
164 SWANSON
PROJECT DESCRIPTIOt CHANGE OF USE - UNHTD SHOP TO SATELLITE BDRM/ART STUDIO
& RE-LOCATE A/G 120 GAL PROP TANK
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP COU MAIN: 640
VALUATION 75,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: # OF STORIES:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: OTHER
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 1 Prop: 1
Total: 1 Total: 1
Routing Date: L
—1-29--0c)
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $818.75 LYK 07/28/09 108845 APPROVED
Plan Check $532.19 LYK 07/28/09 108845
State Building Code $4.50 LYK 07/28/09 108845
Potable Water Application $62.00 LYK 07/28/09 108845 OCT 13 2009
Total: $1,417.44 Jefferson County Planning
& Building Department
Jefferson County Building D•sion Permit Nur.: BLD09-00242
Applicant: COPELAND
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
j
Erosion Control
Foundation Footing tm,4
Footing Drains
Foundation Stem Wall
Underground Plumbing / -2, (t, jett3
Under Floor Framing
Straps(hold downs) i',L?a C,K,t M kik (t J OVI bj
Ext. Shear Wall Nailing
Rough-in Plumbing �yv
Framing
(p--Z - lc r147
Blocking
Airseal
Insulation: Walls i NC/ IC ,¢Wiz,
Insulation: Floors //_(Cr_>C/ (7 ,1
Insulation: Ceiling 1/-( ,/lc/
Int. Shear Wall Nailing
Wallboard Nailing i ) i`, fj5
Gas Line: Interior
Gas Line: Exterior
-
Propane Tank
Heat/Chimney Clearance
Drywell/Alt Drainage
Address Posted (47 ,S, ( ± Jt;1122
4 .,
*, ,,,;, ,,tIt 1 atv- ,t-, -i.1' 0.
FINAL INSPECTION (CI-_S"-= ( ( ,02)
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• 1
CONDITIONS for Building Permit# :BLD09-00242
1.) PRIOR TO FINAL APPROVAL OF THE CHANGE OF USE TO A SATELLITE BEDROOM
THE EXISTING STRUCTURE SHALL BE VERIFIED TO BE OF NO MORE THAN 2
(TWO) BEDROOMS. A REPORT OF FINDINGS SHALL BE PROVIDED TO THE
JEFFERSON COUNTY PUBLIC HEALTH DEPT.
III
,�4.�"50NNcO JEFFERSON OUNTY
e.1 DEPARTMENT OF COMMUNITY DEVELOPMENT
' e i 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
k<q p www.co.jefferson.wa.us/commdevelopment
S�NG't
Master Permit Application ,IUL 2 8 200 LA: IJO Mc« i -EQ I IN
Project Description(include separate sheets as necessary): f
ibp
Tax Parcel Number: 61 el `1 4-00 2—C,Tb Property Size:,Seti (3t cjC,C: (acres/square feet)
Site Address and/or Directions to Property:
`\ \ 11; CLY\cc o\V • ) PCc'� \ \O C� . ,i,
Property Owner(s)of Record: 1Ji'^��rtr ,rti 0 ;�2\C`-\A.
Telephone: ''j 6- 11443 Fax: email:
Mailing Address: 1 \ '-)C.6-NGko\ON`aft• otk c (,a\Ex k1 \;:/�.-. Gt :-_-).3-1
Applicant/Agent(if different from owner): :tL J/ 17 Scw?4 2J',4 �/6r'J Ay 31,'M �, P `.
Telephone: �( j b35� Flx; email:
Mailing Address:j 6,¢ •Cc 4.4.j)iU ,4,/i. / iG2j %UC�N;S. q (----A 1 t Js
What kind of Permit?(Check each box that applies
C:uilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use)
...Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
0 Change of Use 0 Boundary Line Adjustment
0 Address 0 Road Approach 0 Short Plat'"
❑ Home Business 0 Cottage Industry 0 Binding Site Plan'`*
O Propane 0 Long Plat**
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
8 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 Tree Vegetation Request
**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_ ,_,�G L. .. to act a "my agent in matters relating to this application for permit(s).
OWNER SIGNATUR -: i �1^ �, C��. ,� Date: - )- 3 (_' C
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 its 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, wired later inspections. Staffs access and right of entry will assumed unless the applicant informs the County in writing at the
time of the applicati th the or she wa prior n ' .
Signature: Date: a) C J I
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-trans e ib(e.responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
•. 1
Signature: �.
L ''.��., -_,/r" _ , Date: 7 — 0- - ,
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
l
• •
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: � D- �
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS JUL 2 v ._„,,
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New 4-Wood Existing: 1 I Sewer
❑ Addition ❑ Steel Proposed: _ Bank ❑ Community System
. .Alteration/Remodel C Concrete Total: _ 1 _ Height: f -Individual System
❑ Repair C Masonry SEP Permit# 7S ail 5-2
Demolition C Other: Bedrooms: Water Supply:
Existing: _ _ Setback: II Private well ❑ Two Party
Type of Heat: Proposed: I S.Public
^,_, ,yi\,xv 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:
1 Underground Tank 1 Above ground Tank Size of Propane Tank:
1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 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 .4cc
,^''� � LTC EH Bld App Review:
2r Floor Heated ��lJ Consistency Review: '
A
Other Heated Base fee: G i i . 5
Mezzanine Additional Section:
Heated Basement Plan Check fee: 9
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee: OD
Garage/Carport SUBTOTAL '(, r
•
Decks 911/Rd Approach fee: �CJr—"
1(p -
Other TOTAL: $ 4 5/44 LI LF
Receipt Number: 00l4S
Cash/Check Number: 50
(
^
ESTIMATED COST(REQUIRED) Date:
•Fair market value of alt labor and matenalrfeundation to finish
Initials:
6---!
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• •
w49 °N Z, JEFFERSON COUNTY NTYti y DEPARTMENT OF COMMUNITY DEVELOPMENT
& ; ,, , 621 Sheridan Street • Port Townsend •Washington 98368
10
bi7N0 360/379-4450 . 360/379-4451 Fax
http://www.cojefferson.wa.us/commdevelopment/
Stormwater Calculation Worksheet
MLA# PROJECT/APPLICANT NAME: lam-(11A-A ace t,�<� f (AV-1 S uA e 'JL& fL. c r
DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first
to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction
with a stand-alone stormwater management permit application, building permit application, or other land use approval application that
involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required.
�r PARCEL SIZE(I.E.,SITE)
Size of parcel • .JV6� acres�l An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet I�t �CC sq/ft
Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and
non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling,
excavation,and compaction associated with stabilization of structures and road construction.
Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the
Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as
Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonberry,
and salal;herbaceous plants such as sword fern,foam flower,and fireweed.
LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL
Calculate the total area to be cleared,graded,filled, Answer the following two questions related to
excavated,and/or compacted for proposed development conversion of native vegetation:
project. Include in this calculation the area to be cleared for:
nn I Does the project convert%acres or more of
Construction site for structures aC a 4 sq/ft native vegetation to lawn or landscaped areas?
3�Drainfield,septic tank,etc. _ sq/ft Circle: Yes Now
Well,utilities,etc. sq/ft Does the project convert 2 1/2 acres or more of
Z. native vegetation to pasture?
IVODriveway, parking, roads,etc. sq/ft
Circle: Yes No J
Lawn, landscaping, etc. sq/ft
Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed:
Total Land Disturbance I31+ sq/ft Cut `-tom' Fill l-J (cu/yd)
[over]
stormwater calc worksheet—REV 2/20/2008 1
• •
Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions
prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow
from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof
tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater.
STORMWATER CALULATIONS—IMPERVIOUS SURFACE
NEW EXISTING2‘3 Q
Structures(all roof area) _ sq/ft Structures(all roof area) — sq/ft
Sidewalks sq/ft Sidewalks sq/ft
Patios sq/ft Patios sq/ft
Solid Decks sq/ft Solid Decks sq/ft
(without infiltration below) (without infiltration below)
Driveway, parking,roads,etc Jv sq/ft Driveway, parking, roads,etc 4/ Z- sq/ft
Other sq/ft Other _sq/ft
Total New Q sq/ft Total Existing _ ZS J&,, sq/ft
TOTAL NEW+TOTAL EXISTING* _ 43 I7 Za® _sq/ft *This amount will be used to check total lot coverage.
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v. REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: 2'-
Does the site have 35%or more of existing impervious surface? Circle: Yes No
FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be
used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the
attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum
Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements.
For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution
Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and
prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction
Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those
that must meet only Minimum Requirements #1 through #5—and for large" projects—those that must meet all 10 Minimum
Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan,
principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or
prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual.
APPLICANT SIGNATURE
By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and
correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all
owners of the affected property.
--)e,Qt,,• .C:erL_jz,} •
(LANDOWNER OR AUTHORIZED REPRESENTATI SIGNATURE) (DATE)
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�. LOT 5
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TOP OF BANK
120 GAL ABOVE GROUND
PROPANE TANK
5' REAR
5ETBACK
Designs by Souza, Inc.
164 Swanson Ave
Port Townsend, WA 98368
Henry M. Souza, AIBD
BUILDING & SITE INFORMATION
LOT SIZE: 13,500.00 SF
BUILDING FOOTPRINTS:
EXISTING
RESIDENCE 1222.00 SF
GARAGREISHOP 640.00 SF
TOTAL BUILDING FOOTPRINT
EXISTING 1862.00 SF
ROOF AREA:
EXISTING
RESIDENCE
859.00 SF
GARAGE/SHOP
1533.00 SF
TOTAL EXISTING ROOF AREA
2392.00
DRIVEWAY
EXISTING
123.00 SF
PROPOSED
540.00 SF
LEGAL DESCRIPTION
PORT HADLOCK, BLOCK 2 LOTS 6(Nt/2, ALL OF 7,
SECTION 1, TOWNSHIP 29 NORTH, RANGE 1 WEST,
WILLAMETTE MERIDIAN SITUATE IN THE COUNTY OF
.iEFFERSON, STATE OF WASHINGTON.
B D®R
Q
O
U
NATIONAL COUNCIL OP u
Date 7-28-2009
Drawn by hms
5 AM
Project Status Construction Documents
A1.1