HomeMy WebLinkAboutBLD2010-00376 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#: BLD10-00376
SITE ADDRESS: 780 BOULTON RD Issue Date: 12/1/2010
QUILCENE, 98376 Final Date: 11/21/2011
APPLICANT: JOHN G BOULTON PHONE: 360-765-3394
3590 E QUILCENE RD
QUILCENE WA 98376-9598
SUBDIVISION: Block: Lot.
PARCEL NUMBER: 802141005 Section: 14 Township: 28 N Range: 02 W
PROJECT DESCRIPTION: NSFR TO REPLACE BURNED DOWN RESIDENCE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON11/21/2011
I:\F_BLD_Occupancy.rpt 1 0/29/1 9
Jefferson County Building DDsion Permit Nut r: BLD10-00376
Applicant: BOULTON
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
Erosion Control
Footing Drains —
Underground Plumbing
Under Floor Framing 7 S-. -
(
Straps(hold downs)
Ext. Shear Wall Nailing
Rough-in Plumbing `/
Framing
7-2- // cid • s— &.t C , 3--
Blocking f' 1
Airseal
Insulation:Walls 7- ply
Insulation: Floors
Insulation: Ceiling
/0 —27-1( '
Int. Shear Wall Nailing _
Wallboard Nailing
/0%2'1(
Gas Line: Interior l
Gas Line: Exterior
Propane Tank
Heat/Chimney Clearance 7
Drywell/Alt Drainage
Address Posted
fq/Z7/1/
FINAL INSPECTION s
FINAL INSPECTION UST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• MLA10-00393
BUILDING PERMIT APPLICATION Review Type:I
Jefferson County Department of
Townsend, WA Development98368
•
621 Sheridan Street
BLD10-00376 •
Received Date: 11/2/2010
PERMIT #: 780 BOULTON RD
SITE ADDRESS:
QUILCENE, 98376
PHONE: 360-765-3394
OWNER: JOHN G BOULTON
3590 E QUILCENE RD
QUILCENE WA 98376-9598
Block: Lot:
SUBDIVISION: Section: 14 Township: 28 N Range: 02 W
PARCEL NUMBER: 802141005
CONTRACTOR: 2727 HASTINGS AVE
ON
PHONE: (360)385-3199
PORT TOWNSEND WA 98368
Contractor's License STAPFC*249J8 Expires 2/12/2011
PHONE: (360) 301-6184
REPRESENTATIVE: 211 RICHSOUTH JJ STAPF JRARCOB MILLER RD (360) 385-6722
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOD NSFR W/ TO REPLACE BURNED DOWN RESIDENCE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,088 EEE
VALUATION 238,419.00 ADD'L: HEAT TYPE:
CODE EDITION: 2009 HEAT BASE: 1,153 HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER: SHORELINE:
CONST TYPE: 5N GARAGE: SETBACK:
CONST TYPE: DECK: 200 BANK HEIGHT:
SEWAGE DISPOSAL: ALT
URFACE
WATER SYSTEM:
BEDS BATHROOMS:
Exist 0 Exist: 0
Prop: 3 Prop: 2
Total: 3 Total: 2
Routing Date: '-- -- __,
i-2-(D
Amount ai. Bv: Date: Receipt:
Approved/Date
Type
Permit $1,772.15 LYK 11/02/10 120242 A��1 1.O v
Plan
Check $1,151.90 LYK 11/02/10 120242 L,_)
State Building Code $4.50 LYK 11/02/10 120242 \ 2010
Potable Water Application $98.00 LYK 11/02/10 120242 DEC
Total: $3,026.55 Jefferson County Plannint
& Building Department
CONDITIONS for Building Permit# :BLD10-00376
1.) Health approval of this building permit is to re-build the home as it was originally before it
was destroyed by fire. The capacity and functionality of the septic system has not been
determined. It is believed to have been installed prior to 1970 when permits became
required.
2.) 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.
3.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
4.) The building height is not to exceed 35 feet.
5.) The submitted site plan indicates the following:
Northern setback from Category 3 Wetland is 130'
Western setback to Type N Stream is 82'
Eastern setback to Boulton Rd is 60'
The house is being built on already existing foundation and meets UDC seback
requirements.
• I
/ cod JEFFERSON COUNTY
W . ' ` ' DEPARTMENT OF COMMUNITY DEVELOPMENT
'' 621 Sheridan Street • Port Townsend •Washington 98368
$ 360/379-4450 • 360/379-4451 Fax
www.co.jefferson.wa.us/commdevelopment
BrNa
Master Permit Application MLA: 10 - 3q B
Project Description(include separate sheets as necessary):
gE- "Ouli-D FIRS DAMAGE!) rR
Tax Parcel Number: 002 {LI l 00 ' Property Size: 40
(��t quare feet)
Site Address and/or Directions to Property:
-7So 1:?0uc.Tat.1 F.D tQutr_C OF , WA . 9a316
Property Owner(s)of Record: Tot}0 gp or—ran)
Telephone: (3 o) -no S- 33gy Fax: email:
Mailing Address: 3561 b E• Q U(i_CE�E gp. Q u(V(FEE , Wq. 9937v
Applicant/Agent(if different from owner): RI0-1 STAFF — STAFF Cd,15T �'latil !MC..
Telephone: (3 o) 30 I-io (gC Fax: (%0) 379- 5355 email: Stapf ea N sr i ncgi)citb1e5p. .Coo\
Mailing Address: Zit S. . cog MILLIR /LD. Pop- Towns 10 kJd. Qf3%8
,
What kind of Permit?(Check each box that applies ❑Lot or Road Segregation
ixtBuilding ❑Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use
)ie Single Family ,Garage Attache /Detached 0 Conditional Use[C(a),C(d),or C]** )
❑ Manufactured Home .0 Modular • 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* ❑Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
0 Address 0 Road Approach ❑Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan**
Propane 0 Long Plat**
❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments**❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration**
❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions**0 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 ❑Jefferson County Shoreline Master Program Amendment
*May require a Pie—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 Pr to act as my agent in matters relatingto this
i
pplication for permit(s).
OWNER SIGNATURE--1 ` Date: D / feD
By signing this a ip' tion 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 --a^-s and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any requires ater spection` -ffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicatio• h/ati.- or she w=i' pri•r notice.
Signature: _I!1// 4. / Date: �jL�/4'
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-transf res slbility her' o and co ing with the ESA. The Applicant has read this disclaims nd si s and dates it below.
Signature:
Date:ACC
6
• •
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.
Date:
Signature:
PHONE: FAX:GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: 301 — to(8 .
STAQF C0O5Tauc.?lon) NC.. (360) 385- 3l9 (360) 319 - 5355
ZII 5. TAWg MtL . 2p - EMAIL: 5-k-apf con s+ir'tc�Jc Cab1espeedl,cu
MAILING ADDRESS: WAINS
CONTRACTOR'S ?c*
LICENSE 1 TDrJ/JS -00 t `AJa 36 NUMBER
NUMBER: STAPFCI I I LI C K PHONE ( ) Fes'( )
ARCHITECT/ENGINEER: EMAIL
MAILING ADDRESS: of SewageDisposal:
Frame Type: Bathrooms: Shoreline: Type p
Project Type: K Wood Existing: 0 ❑ Sewer
O New ❑ Steel Proposed: 2 Bank 0 Community System
❑ Alteration/Remodel ❑ Concrete Total: Z. Height: X Individual System
O Alterati SEP Permit#
oRepairm ❑ Masonry Bedrooms: Water Supply:
❑ Demolition ❑ Other: Existing: D Setback: A Private well 0 Two Party
Proposed: �- ❑ Public
Type of Heat: Total. 3 Name of System:
•
ELEG'i'1'I�
If this is a Commercial Project you must answer the following: Number of ADA Parking Spaces:
Number of Parking Spaces: Current: Proposed:
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�nve around T Z
i Size of Propane Tank: 1
1 Heat Stove i Cook Stove i Woodstove ireDlace Inse i Hot Water Tank ► Pellet Stove i Other
Is this appliance being installed in a Manufactured I 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. r ,
Square Footage Current Proposed - #i e W a ss 1, .r. 4.P.
.t ' ,` 'P
EH BId App Review:
Main Floor Heated 0se i4 a�`7 75
. Consistency Review: {
�` Floor Heated Q2 i 3
J'
Other Heated
Base fee: ri1 2 15
Mezzanine
Additional Section:
Heated Basement �' Plan Check fee:
1 55 1.14.� 3 1I • gb
Unheated Basement
State Surcharge fee: 1 ,50
2,
Other Unheated� : ` � Pot Water Review fee: 'Jlp ---
}j Y�� SUBTOTAL
Garage/Carport HHt7 3350'
k 911/Rd Approach fee:Decks _ ZDO } ` -t 5 n K
TOTAL: $ >�c�-�59
Other �`_�..J�.J'
Receipt Number:
1202.4
- " I Ct j j Cash/Check Number: 1 ?p
ESTIMATED COST(REQUIRED) C Date: �0
•Fair market value f all labor and materials foundation to finish Initials: -- 1
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