HomeMy WebLinkAboutBLD2010-00365 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/Building Official
PERMIT#: BLD10-00365
SITE ADDRESS: 941 SHINE RD Issue Date: 12/6/2010
Final Date: 12/11/2013
APPLICANT: JOHN B SIMPSON PHONE: 360-437-2676
KATHERINE SIMPSON
941 SHINE RD
PORT LUDLOW WA 98365-9286
SUBDIVISION: HOUSE SHORT PLAT Block: Lot:
PARCEL NUMBER: 821343027 Section: 34 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: NEW DETACHED GARAGE - UNHTD, NO PLMB
REVISION 10/29/12 - ATTACHED COVERED SHED - UNHTD, NO PLMB
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 12/11/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 12/17/2013
Jefferson County Building DOsion Permit Null: BLD10-00365
Applicant: SIMPSON
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2009 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 1,2y/r i/
Erosion Control (( ��
Foundation Footing jV/et t
kceC"-L,
Footing Drains 6
Foundation Stem Wall /6) 7IL v It
Underground Plumbing
Straps(hold downs) /_{ I 6
Ext. Shear Wall Nailing ,1 I
Rough-in Plumbing '�l
Framing -/6. // ( e 7 r� ����- �1 d
�/' _/ /1 �i
/
Blocking (�r V /1T �.J V /.,.L,r/
Wallboard Nailing
Drywell/Alt Drainage
Address Posted // /
kee- I1 I t CarIto �` hea
13.ee q daid
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
UILDING PERMIT APPLICA•N MLA
Review Type:
83
I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00365 Received Date: 10/18/2010
SITE ADDRESS: 941 SHINE RD
PORT LUDLOW, 98365
OWNER: JOHN B SIMPSON PHONE: 360-437-2676
KATHERINE SIMPSON
889 LEBRUN RD
SNYDER NY 142264224 HOUSE SHORT PLAT
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 821343026 Section: 34 Township: 28 N Range: 01 E
CONTRACTOR: NORDLAND CONST NW INC PHONE: (360)379-6950
123 PONDEROSA PL
NORDLAND WA 98358
Contractor's License NORDLCN953NT Expires 11/17/2011
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NEW DETACHED GARAGE - UNHTD, NO PLMB
a 345 tcy I c0;117 L j.a r--r- r e (i she(k t�
TYPE OF WORK GAR SQUARE FOOTAGE / GV
TYPE OF IMP NEWMAIN:
)-v1 PI L— l
(
VALUATION 95,000.00 ADD'L: 7 —1%1 HEAT PE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 800 SHORELINE:
CONST TYPE: DECK: SETBACK:
075 BANK HEIGHT:
SEWAGE DISPOSAL: CMY
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 0 Prop: 0
Total: 0 Total: 0
Routing Date:
10«- 10
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $958.75 LYK 10/18/10 120204 APPROVED
Plan Check $623.19 LYK 10/18/10 120204
State Building Code $4.50 LYK 10/18/10 120204 DEC (p 2010
Total: $1,586.44 Jefferson Comity r tannin.,
Building Department
• •
CONDITIONS for Building Permit# :BLD10-00365
1.) No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. Additional requirements may apply if plumbing is proposed.
2.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
3.) 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.
4.) 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.
5.) MANDATORY MEASURES FOR COASTAL SIPZ:
1. For proof of potable water on a building permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirement:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
6.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water
quality degradation. The submitted proposal does not require additional aquifer
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined in
the Stormwater Management Manual for the Puget Sound Basin.
7.) 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.
8.) Stormwater shall be retained and infiltrated on site. The owner shall control all
sedimentation and erosion on the property.
9.) The project shall comply with Colikction Stormwater Pollution Prevention (SOP)
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.
10.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
11.) 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.
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.) The building height is not to exceed 35 feet.
14.) Setback from Shine Road right-of-way is no less than 20 ft., side and rear setbacks are no
less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more
restrictive setback shall apply.
15.) 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.
16.) Lighting fixtures shall be designed and hooded to prevent the light source from being
directly visible from outside the boundaries of the property. The intensity or brightness of
all lighting, during construction and after project completion shall not adversely affect the
use of surrounding properties or adjoining rights-of-way.
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FILE COPY
• 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 CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: 77 - l2'7I- FAX:
Nta Val, WWI COALSi tic-f ,,J Will mac- Cho ) 371 -1 L. ( )
MAILING ADDRESS: Iz.3 ?4,/tiO'20SA PL /vtaR0).AA/b h(1J qr3 0 EMAIL: lvfl2DLit-Mba6AtS7Rytr/alVA/A/C//V w/1t'-G9/1j
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Prefect Type: Fi me Type: Bathrooms: Shoreline: Type of Sewage Disposal:
V New V Wood Existing: ./--\ U Sewer
❑ Addition ii Steel Proposed: / Bank 0 Community System
❑ Alteration/Remodel ❑ Concrete Total: / Height: 0 Individual System
El Repair ❑ Masonry SEP Permit# `10`a
❑ Demolition ❑ Other. Bedrooms: Water Supply:
Existing: Setback: LI Private well 0 Two Party
Type of Heat Proposed: llblic
ask 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 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 Foota s e Current P ••osed x�: a s 1 C1 ' y h 1 `�' , k * tr" t 1. .� I:;' ,. F
Main Floor Heated -.Plitign,'A EH Bld App Review: ri-3'
2na Floor Heated r, 4 Consistency Review: ' -) -,-VI A k-S, . ,,m,„,,,,..„,,..„...„,..„.A
Other Heated A , = Base fee:
Mezzanine ; .k Additional Section:
Heated Basement �,.; . ae Plan Check fee: / 2 `q
Unheated Basement itv State Surcharge fee: `I 5°
Other Unheated P-,.." 4 Pot Water Review fee:
Garage/Carport VS *: SUBTOTAL 1
Decks ` .... 911/Rd Approach fee:
c)15 ��� ' y
Other ,' iOi ^-�, t
•1 Y TOTAL $ L �2
Li
i : Receipt Number: 1 7{ 2CO
OCT n I
i ,- Cash/Check Number: -)Ct32-
('`SST TED ST( QUIRED) Date:
tvalue of ma ndation to finish .--(0 LO
14 IS Clod Initials: -_
G'\Penrn er\### S###\DRD FORMS\Master Permit Application 5-29-08.doc
4,0°N cob JEFFERSO OUNTY •
r'V
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
Owett ,, 360/379-4450 • 360/379-4451 Fax
%Sep www.cojefferson.wa.us/commdevelopment
Master Permit Application MLA: 10 " 3
Project Description(include separate sheets as necessary):
c <,(26 Q (noiP - I )nhirS, / nc.) p9�t9
Tax Parcel Number. g`j" 3`i. t.) Property Size: 3,3 Z/1I pq (acres/square feet)
Site Address and/or Directions to Property: T Sg i/J R0/ PD r2,.-rU►- D f-b /
Property Owner(s)of Record: bN N if. f "rij e- i r(6 -Si M PSp n!
Telephone: Fax: email:
Mailing Address:
Applicant/Agent(if different from owner): 'di o M/YS -.n j-i-,j SIMI
Telephone:360 -37Q- /357- / 77+.1'214 Fax: email: Wvkai-A"(A CoNISTR(C-lton/Wm/
Mailing Address: 173 ?vn(AGRDspt- Pam/ /v"kfii-' JD )Nnh 983S S t4 M,-66Ai
hat kind of Permit?(Check each box that applies
Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
0 Single Family Garage Attached -Eo�ached_ El Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home 0 Modular �._ ❑ Discretionary"V or Unnamed Use Classification
❑ Commercial* ❑Special Use(Essential Public Faciliities)**
❑ Change of Use 0 Boundary Line Adjustment
❑ Address ❑ Road Approach Cl Short Plat**
❑Home Business ❑Cottage Industry 0 Binding Site Plan"
❑Propane 0 Long Plat**
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes'Use Consistency Analysis 0 Plat Vacation/Alteration**
0 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
❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Ad/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
'May require a Pre-Application Conference ❑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 /'a�'(AS .-I►HA'Sa eV to act as my agent in matters relating to this application for permit(s).
i OWNER SIGNATURE__')14/11 ji/Y �_ td N,Sirli?Soil Date: S6{ IC —i4
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 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 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 app do that he ��syb�e,�w,aants prior notice.
/Signature:"C �_`_—_. Date: 16 - 1.(-to
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 rab respo )ility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date: I U — I tO
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
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