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Home My WebLink AboutBLD2011-00066 • 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 #: BLD11-00066 SITE ADDRESS: 101 MARINER PL Issue Date: 04/4/2011 PORT LUDLOW, 98365 Final Date: 9/23/2011 APPLICANT: JAYNE W GIFFIN TRSTEE PHONE: 360-437-0438 JAYNE W GIFFIN REV TRUST 101 MARINER PL PORT LUDLOW WA 98365-8738 SUBDIVISION: BAYVIEW VILLAGE DIV 2 Block: Lot: 10 PARCEL NUMBER: 931900010 Section: 16 Township: 28 N Range: 01 E PROJECT DESCRIPTION: ADD 24SF KITCHEN ADDITION TO EXISTING SFR 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 no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON9/23/2011 I:\F_BLD_Occupancy.rpt 10/29/19 Jefferson County Building Dion Permit Num• BLD11-00066 Applicant: GIFFIN TRSTEE 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 °If ✓ Setbacks L-f / 3 K7/P- Foundation Footing LI, O l ✓,.r� FramingFtd Insulation: Walls Insulation: Floors Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing FINAL INSPECTION ' • ( ( FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR UILDING PERMIT APPLICA#)N MLA 56 Review T Typyp e:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD11-00066 Received Date: 3/22/2011 SITE ADDRESS: 101 MARINER PL PORT LUDLOW, 98365 OWNER: JAYNE W GIFFIN TRSTEE PHONE: 360-437-0438 JAYNE W GIFFIN REV TRUST 101 MARINER PL PORT LUDLOW WA 98365-8738 BAYVIEW VILLAGE DIV 2 SUBDIVISION: Block: Lot: 10 PARCEL NUMBER: 931900010 Section: 16 Township: 28 N Range: 01 E CONTRACTOR: JEREMY VANCE INC PHONE: 360-385-2560 46 VILLAGE WAY PMB 162 PORT LUDLOW WA 98365 Contractor's License JEREMVI001C4 Expires 10/28/2011 REPRESENTATIVE: JEREMY VANCE PHONE: (360) 385-2560 46 VILLAGE WAY/PMB 162 (360) 379-1121 PORT LUDLOW WA 98365 PROJECT DESCRIPTIOI' ADD 24SF KITCHEN ADDITION TO EXISTING SFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 24 VALUATION 8,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: SEW WATER SYSTEM: 68700 BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: ved/Date Permit $153.25 LYK 03/22/11 123319 �> v E D Plan Check $99.61 LYK 03/22/11 123319 State Building Code $4.50 LYK 03/22/11 123319 APR 4 ztJ11 Total: $257.36 Jefferson County Planning &Building Department • . CONDITIONS for Building Permit# :BLD11-00066 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.) 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.) 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. 0 APPROVED • . SITE PLAN 'e" APR 1 2.0111 1 1r 1 i__ i ood -. --- DE/PT.OF'O•;'4 O . • MENT SIGNA Pl.- /. k.►.. I 1t11111. -.-.- _ tte3/lf ,,1 ,1i. �p Avt 2 l c1f<6 ay5 - _.J 5# 12.550t. emit vrorose a .�1 �Add�fiov‘ -40-,// - i ::r.. I V �-f � ' __I _ells; ,,, ...t1 0, 4-7 _____ ......siti_t_ . \,,,t, 4 1 f\, _ ,_,,,,\,,,$),, \ ,t ,, q 31 ,coo i c7 I ,�: ., \ �� „J..NQ Q ___,„..,,,,, ,.-,e4 Kr; 5, Z I '---- \ 101 Il'10-ei- ' c,r Q'OE'r LUAi(cx.:) 1; &3+4 7 -7 Lt 3 a4 5� I ii= 2 D.—p` ,60> 1 1 — G ¢ E p• o�p rer&Li 1, � JEFFERSON COUNTY DCD • 3cc1-24o3 - \2; • • C.'I WM � ?A.r O Ka reiY"'red 'Mar 0 • I � ti 0 cice:Actl 2.00vv1 Bea t oow1 AAA It-01A fia►wa�( t Up4►� is .Jim �l otter • do • ( ON \ • JEFFERSON•UNTY iffiN% • DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ewww.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: I Project Description(include separate sheets as necessary): x,,At-� ki- L&\ out- Zr Tax Parcel Number. c13 noon 0 Property Side: 7/ ( cres/square feet}_ Site Address and/or Directions to Property: LO l fl\art gel` pi Por=+ 1..ut:,Q-�ow (..,?c\ �365 ' ' Property Owner(s)of Record. 'Sct./rte cc-G . Telephone: 36 0 'L? c2 c Fax: I-.7 email-i ,, Mailing Address: (Cl. /(\a.c:"`es LN1 Por# Lz:t(,y CJL.� `kcca 6SJ r.; L a , . i U L i'a'i t U" r Applicant/Agent(if different from owner): Sei-v,-N-Y kict"ce..- Telephone: 36-O .- O1r `e j Fax: ,t email: Octnce.d"+ .�„@ 67, /1.0Q4- L Mailing Address: `i(, r.(kcs- , �c fry 1L.,L -. f�d NA- U . `(E-365 What kind of Permit?(Check each box that applies 0 Lot or Road Segregation 1:16"uiilding ❑Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) 0-Single Family 0 Garage Attached/Detached ❑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)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address ❑ Road Approach 0 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 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** 0 Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 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: L l I/6kc\c DESIGNATION OF AGENT - I hereby designate ''^ to act as my agent in matters relating to is application for permit(s). )OWNER SIGNATURE Date: -/ `( ! 1 \ / 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 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. /� // I /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 riot 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 disclai er an ,signs and dates it below. /Signature: Date: 3 I 't 7 1 G:\PemutCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • 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: FAX: ii L V;k (oA4w u s t E,i- Jorl-L , L) i S NO . of-I-S03 ( ) MAILING ADDRESS:Liice , ' '(`% U':si o f rilC_ EMAIL: \110- Z i `�1 . (' el ytyvs..etC-I- CONTRACTORS LICENSE - WAINS' NUMBER: (Q_C(..!hV t- 1 00 kO f NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type f Sewage Disposal: ❑ New 8—Wood Existing: R ffSewer dition ❑ Steel Proposed: ( Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: ) Heig t: ❑ Individual System ❑ Repair GI Masonry /� SEP Permit# ❑ Demolition ❑ Other: Bedrooms; Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: pp tt 1� Total: 15 - Name lof System:t" kc^ 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_pennit,mark all items below that apply: 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. , D, .� •:,.fU1�33 12';1 11, ; rY A. r�5 w`F �lsr'f a t ,. � ]£ q ' Square Footage Current Proposed a 4i h �Xf.6:_ -' , ..,. t,.tpi° � }:_,. . �l �: : ma. a -- Main Floor Heated �( ,- r EH BId App Review: �I�1 (� A ,,,,,,„ •,_- , 2"d Floor Heated Consistency Review: l3 Other Heated � t Base fee: Mezzanine . - Additional Section: �� sE Plan Check fee: Q Heated Basement ; � 1 - <• State Surcharge fee: 1 Unheated Basement � 50 x ; Other Unheated R Pot Water Review fee: -, SUBTOTAL Garage/Carport 2 f -O.ap '>r� �'`•• 911/Rd Approach fee: �-- Decks ✓�S. vZ Other >,, ry TOTAL: $ 470 .3(0 tt c. Receipt Number: )a3,519 y - ------ -__ 0-� Y Cash/Check Number: ESTIMATED COST(REQUIRED) Date: � , 1 tea' msricet.value of all labor and m: : •undation to finish — - '" 0 Initials: / _ --_ —.._ /W G:\PerxnitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc