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Home My WebLink AboutBLD2009-00376 • 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 #: BLD09-00376 SITE ADDRESS: 427 ADELMA BEACH RD Issue Date: 12/10/2009 PORT TOWNSEND, 98368 Final Date: 10/11/2010 APPLICANT: SARAH TIFFANY PHONE: 360-344-3930 1240 W SIMS WAY#99 PORT TOWNSEND WA 983683058 SUBDIVISION: Block: Lot: T G+ PARCEL NUMBER: 001324064 Section: 32 Township: 30 N Range: 01 W PROJECT DESCRIPTION:ADDITION & REMODEL TO EXIST SFR &ADDITION OF BREEZEWAY W/ ATT GARAGE 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 no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/11/2010 I:\F_BLD_Occupan cy.rpt 10/29/19 Jefferson County Building lision Permit Nur: Applicant: BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: International Building Codes To schedule inspections, call (360)379-4455 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 l2 2t Z F(2.61"' 4/PO f=;- 77,,orcifire. FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR •UILDING PERMIT APPLICA•N MLLA09Revie -00p373 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00376 Received Date: 11/16/2009 SITE ADDRESS: 427 ADELMA BEACH RD PORT TOWNSEND, 98368 OWNER: SARAH TIFFANY PHONE: 360-344-3930 1240 W SIMS WAY#99 PORT TOWNSEND WA 983683058 SUBDIVISION: Block: Lot: T G+ PARCEL NUMBER: 001324064 Section: 32 Township: 30 N Range: 01 W CONTRACTOR: HOPE INC PHONE: (360)385-5653 DBA HOPE ROOFING PO BOX 1199/105 LOUISA AVE PORT TOWNSEND WA 98368 Contractor's License HOPER**043N7 Expires 2/16/2011 REPRESENTATIVE: HOPE ROOFING & CONSTRUCTION PHONE: 360-385-5653 PO BOX 1199 PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI ADDITION & REMODEL TO EXIST SFR & ADDITION OF BREEZEWAY W/ATT GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 208 VALUATION 60,000.00 ADD'L: 208 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: PRO OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: 77 CONST TYPE: 5N GARAGE: 528 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: e Exist: 2 Prop: C Prop: Q Total: 2 Tot l 2 Routing Date: Type Amount Paid Bv: Date: Receipt: APPROVED droved/ Permit $713.75 LYK 11/16/09 111223 Plan Check $463.94 LYK 11/16/09 111223 State Building Code $4.50 LYK 11/16/09 111223 DEC (0 2009 Potable Water Application $62.00 LYK 11/16/09 111223 Jefferson County Plannint, Total: $1,244.19 & Building Department • CONDITIONS for Building Permit# :BLD09-00376 1.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: • 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 2.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 3.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 4.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 5.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 6.) 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. 7.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 8.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 9.) The building height is not to exceed 35 feet. 10.) Building Setback from Adelma h right-of-way is no less than 20 ft., side ("rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. • • C'D C-0 8 — 0 ''-'' ----7,- in' CD ,..._-..- c n 0 a 0 a_ ..z.n 1.49 24 11,ZZ •-..----Zit Z-.8—41 2/I,11.-JrZ 11- 9 ;LJ .!...1 . 5'40 u.Igo v ci.-.9;13,Qt, L — — t" 8 E . -- E . 00=- -,,- .• 1 \ ..*: '8.2 2 §, e t O 1 . 8 8 b• e 4 4 \ g .. k .... g 17/ / . Ki r i r' 1 ... (17 I o• --""*. I-' .t' IT1 81 ki ' 11.11111111--1 - 1 ; i r I ; --we fl--.-..Z/L 0-.C'''..I.' ..e A g .t to MW= ' N 1 4:CX 16P G/•L, 1 75 I 4 .,, zn 1,i-zz ----zn rla .1,/e L''S—.....---.7./1.9-.9 .IIII.0-.£l ZJI,i. .9 1 111111111k • • D (-0 1:3 C 5)) CD 0 eL 2 a. EL\ I inummi 7e g. I 1 7 1;)1 ))t. E z (...) " ' fa w °°Nd,co JEFFERSO COUNTY w. • - 4; DEPARTMENT OF COMMUNITY DEVELOPMENT '•' ` r4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax kgSN��p� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: ' 73 Project D cription include separate sheets as necessary): Tax Parcel Number: Co t 2- c -1 roperty Size: (acres/square feet) Site Address and/or Directions roperty: �^ ma_ �C �K( PO(> - 3) (DA. s)Property Owne of Record: .- to l l - Afyi Telephone: �I t L Lk, < Fax: email: Mailing Address:-1 a 1p w. .LI`l1S L _.Cx_k -4-Cri Applicant/Agent(if different from owner): ' kJ h j k tt t- '�i� Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation ,!c134.111.ding 0 Critical Areas Stewardship Plan 0 Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) 0 Single Family ,X.QaragE-Attached'/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home .0 Modular 0 Discretionary"D"or Unnamed Use Classification i 0 Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address ❑ Road Approach 0 Short Plat** ❑ Home Business ❑ Cottage Industry ❑Binding Site Plan** ❑ Propane 0 Long Plat** ❑ Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑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 **R••uires a Pre-A••lication Conference Please identify any other local,state or federal permits required for this proposal, if known: ,------DESIGNATION OF AGENT I hereby designate 10021 Ili. , _ i to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE `1. h Date: By signing this application form,the owner agentttests 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 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. r____-Signature: ,d/tilok -falti Date: 1 ( f/h19 The action or actions Applicant wi Gndei ke as a result of the issuance of this permit may negatively impact upon on oone 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 and signs and dates it below. Signature: ,,! ti _LA � Xj , Date: (/ /�/Q ..•\PPrrnitCenter\###FARMS###\fRT)FORMS\Cur n rent T)Rn Frac\A4acte,PM,,,;r Ar...hrnr;r..,S_.)q_nm i,, 0 • 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: HOM GENE L CON R MANUFACTURED HOME,INSTALLER: PHONE: FAX: ( �Toxx� I__ NSC ( ) ( ) - MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: ' Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New Hood Existing: 2 ❑ Sewer ► •ddition 0 Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 'vidual System ❑ Repair ❑ Masonry SEP Permit# ❑ Other: Bedrooms: Water Supply: ❑ Demolition Existing: Setback: ❑ Private well ❑ Two Party Typeof Heat: Proposed: it - ❑' Public 4 J r`)2 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 A_ppIiance Installation permit,mark all items below that apply: 1 Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove 1 Cook Stove i Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 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 Force Useilay ^ Attiatitit Revision _ Main Floor Heated EH BId App Review: � 2 _ 20F zca"rc� '73 - - 2"d Floor Heated - Consistency Review: , Other Heated Base fee: Mezzanine Additional Section: Heated Basement Plan Check fee: �-;}`! 94 d� Unheated Basement State Surcharge fee: P - ~s- Pot Water Review fee: I C r- 1 -Garage/Carport SUBTOTAL `�f2F t 5 � < . i9 Decks 911/Rd Approach fee: ST1 Other TOTAL: $ 1 a g Receipt Number: 1 l ,223 rj , i< Cash/Check Number: l I `T, I `1_ ESTIMATED COST(REQUIRED) Date: Ij_-___-(___Olk__WI / .Fair market value of all labor and materials foundation to finish Initials: C.APemitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc --...IIIIIIInmiliiiiiiiiiiuuuuiiiii � li a� V. * T -I CDC) paoi goeag r?wlaPtl 0 03 cc CD � •cl • cl. — . l aa� co0 ch � N cO ` x ,,Cr 0- o. 3 D) , ) O 3Nn3, a m . sca ~v ; "' '-` mI 4,..... �_ `awI Apadad }sam NN. a N N po ' to m N m d .1 N r7 aOOWi� ° N. � 3 N C 2 'oo .k N N p co 0, 2DD A ...<CD CA N 0 (D N fqD 0i a, a N N 3 CD CO O c° N O`< a o co to Cut 4( CD Int 3 y 5N . 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