HomeMy WebLinkAboutBLD2011-00099 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#: BLD11-00099
SITE ADDRESS: 341 MC MILLEN RD Issue Date: 11/2/2011
CHIMACUM, 98325 Final Date: 11/26/2012
APPLICANT: WARREN E OSMER PHONE: 360-732-4019
341 MCMILLAN RD
CHIMACUM WA 98325-9730
SUBDIVISION: Block: Lot: T 16+
PARCEL NUMBER: 801102013 Section: 10 Township: 28 N Range: 01 W
PROJECT DESCRIPTION: NSFR W/A/G 250 GAL PROP TANK
REVISION 9/17/12 - ADD DECK
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 ON 11/26/2012
\\tidemark\data\forms\F_B LD_Occu pancy.rpt 11/26/2012
Jefferson County BuildingDion Permit Numr: BLD11-00099
tYi`Jfs
Applicant: OSMER
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> SignatureSi Notes
Setbacks ///7 l j /`� ►ig%
Erg �I e.c.1� a r/�,fi4rt°/ /r // lFoundation FootingUr
/453 Coil.C�( l b�� / 0 e /f
Footing Drains �/� n0 U�rij /,qG n/rt4 t
Foundation Stem Wall It / % Kft, 4_ af�q I , ttr/1 LjjUnderground Plumbing /`
Under Floor Framing
Straps(hold downs) pt,Cu t c L(r'e4
Ext. Shear Wall Nailing 1
Rough-in Plumbing -442 I1
Framing :21-1(o` c.T o I I' R4 j, - doe. 1
Blocking— p/'
Airseal / � l
�-Ito 12.
Insulation: Walls 1111,L(1Insulation: Floors `L �' -v
Insulation:Ceiling [ �j
Int. Shear Wall Nailing
Wallboard Nailing 4/i1 12
1-1( yam'
Gas Line: Interior
Gas Line: Exterior
Propane Tank t 1 f Z
Heat/Chimney Clearance
Duct Test Cert (a_
Blower Airtight Test 1'-a(,1
Smoke&CO2
Drywell/Alt Drainage /
Address Pdsted I(-y l-1 L �✓
FINAL INSPECTION 1 _ \- 917
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•UILDING PERMIT APPLICA JN MLA1 1-00091
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD11-00099 Received Date: 4/26/2011
SITE ADDRESS: 341 MC MILLEN RD
CHIMACUM, 98325
OWNER: WARREN E OSMER PHONE: 360-732-4019
341 MCMILLAN RD
CHIMACUM WA 98325-9730
SUBDIVISION: Block: Lot: T 16+
PARCEL NUMBER. 801102013 Section: 10 Township: 28 N Range: 01 W
CONTRACTOR: LEXAR HOMES PHONE: 360-807-1849
1213 LONG RD
CENTRALIA WA 98531
Contractor's License LEXARH*909QT Expires 2/10/2012
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr NSFR W/A/G 250 GAL PROP TANK L tstcm—f,cj ckelL
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,307. lPk
VALUATION 270,137.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2009 HEAT BASE: 1,344 HEAT TYPE: WOD
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: 1 PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 3
Total: 2 Total: 3
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,951.35 LYK 04/26/11 123438 APPROVEC)
Plan Check $1,268.38 LYK 04/26/11 123438
State Building Code $4.50 LYK 04/26/11 123438
Potable Water Application $62.00 LYK 04/26/11 123438 NOV cQ 2011
Total: $3,286.23 Jefferson County Planning
& Building Department
• •
CONDITIONS for Building Permit# :BLD11-00099
1.) 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.
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.
4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
5.) 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.
6.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
7.) Building setback from McMillian Road right of way is no less than 20 feet. Side yard
setback from Rural Forest land to the east is no less than 100 feet. Side setback to pond
is no less than 5 feet but may involve a critical area buffer. Rear setback is no less than 5
feet.
8.) The building height is not to exceed 35 feet.
9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
•
40".5ON c e„. JEFFERSONUOUNTY
S� j DEPARTMENT OF COMMUNITY DEVELOPMENT
o .-C 521 Sheridan Street • Port Townsend •Washington 98368
�__,,.,..���� 360/379-4450 • 360/379-4451 Fax
"' O� www.co.jefferson.wa.us/commdevelopment
BINd'
Master Permit Application MLA: I ( --0
Project Description (include se arate�sheets as necessa
' C
t1,.SE to� A- ,i � . ) Cod rry IQ,x k
Tax Parcel Number: 001102013 Property Size: V• // A C r-eS (acres/square feet)
Site Address and/or Directions to Property:
341 / McM : Ilan RD ch;mac, um W4. ?A325'
Property Owner(s)of Record: (,0012(2.-Ff1 ( AJ{-J2._
Telephone:($ D) ?32 4r019 Fax: email:M . l o ia2 !J'Yr )1.cr
Mailing Address: 34/1 McMillan 1?IJ c h rh aC.v -i v✓.4. 48325
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
1B8uilding ❑Critical Areas Stewardship-PJan
❑ Demolition Permit 0 Variance(Minor,Major or s M I liV)
Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C
vv
❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unna a se Classification
0 Commercial* ❑Special Use(Essential P J cilities)**
❑ Change of Use 0 Boundary Line Adjustmen 1 APR 2 6 2011
❑ Address 0 Road Approach ❑Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan**
4 Propane 0 Long Plat**
❑Sign 0 Planned Rural Residential Develo_ md�i F i j p nts*•
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration*: DE OF C IMLN D Vtlut'm�IVT
0 Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use El Shoreline Management Variance
❑Wireless Telecommunication* El 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 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��(� to act as my agent in matters relating`to this application for permit(s).
/OWNER SIGNATURE V (;(JZfZI C.�j9 /�' �-Y C i Date: —_2-(D ^ 20//
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 applic ti n that he or she w s prior notice.
Signature: 1i�7/`Z -(i �- Z 4 - Z(� /l
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'Make"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 a ering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
/Signature: Date: '`I- Z 67 - 2-0//
G:\PermitCenter\###FORMS###\DRD FORMS\Master Pcrmit 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: t uer r i 1_ /1v tW C' Date:
X— GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
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 k Wood Existing: Li Sewer
0 Addition L] Steel Proposed: 3 Bank ❑ Community System
L1 Alteration/Remodel ❑ Concrete Total: 3 Height: /°Individual System
ii Repair ❑ Masonry SEP Permit# 9 -Ci
❑ Demolition 0 Other: Bedrooms: Water Supply:
Existing: Setback: LePrivate well 0 Two Party
Type of Heat: Proposed: 2 0 Public
Total:
WI0c. Name of System: —
If this is a Commercial Project you must an wer the following: F l J V a
E --\-)
Number of Parking Spaces: Current: Proposed: Number of ' •t' • ' `• J :
n (includes owners,to ants,employees,etc) Current • .d
Number of occupants ' '.'Y IBC Occupancy: _ IBC Type of construction: Will you have Fe.. icelr�ffs h t� 2011 I
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that a•a �n v
1 Underground T , bove ground Tank Size of Propane Tank: ;r 1/
_i \
I Heat Stove Cook Stove 1j'VVoodstove 1 Fireplace Insert 1 Hot Water Tank I Pellet St we i • eriEFEQen IrnIINTY
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No DEPT.OF COMMUNITY DEVELOPMENT
When applying for a permit to install a propane tank you must also submit a site plan showing a 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.
y ma's
, 4. �,, "+ �. xis on. ! i,
Square Footage Current Proposed For Off{c se�Onl11' ;, ,.,. Amount y
Main Floor Heated J.3•d-rat 4 _ ,`'- EH Bld App Review: 73 ,
2r0 Floor Heated Consistency Review:
Other Heated Base fee: 1 1 1615.35 i,'V'1 .
Mezzanine Additional Section: ___ __r_
Heated Basement 3 SO I�csi`.3t,. .' Plan Check fee: , -, f 0/ t; 33 r_ G
J 1 ( �J�
Unheated Basement State Surcharge fee: .4o
Other Unheated Pot Water Review fee: ,/
Garage/Carport SUBTOTAL t 2'Z
10
Decks �([ 4� ''' 911/Rd Approach fee:
Other tt«, �I � ''' TOTAL: $-mil.( ',' n. 3
5. Receipt Number: + ?
l Cash/Check Number:
\ESTIMATED COST(REQUIRED)) Date: .4__,_7j (�
Fel arket value of all or end materials foundation to finish -4(z--k
f -, Jsb C)�1 Initials:
GAPermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc `-
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____
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M LOWER FLOOR/ �— - ' n & Bonnie
�` �+ smer
o 0 0 1 UPPER FL00 " 41 McMillan Rd. HOMES —
all cn w a al o o T Irr urn, WA 98325
N (01; PLAN s m 1213 LONG RD., CENTRALIA, WA. 98531
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WASTEWATER PLANS 7.1
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ED TAX PARCEL #801-102-013 SOIL ': - �1�7""'LLC.
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0 863 CARLSBORG ROAD, SUITE A,
PRESSURIZED SYSTEM FOR SEQUIM, WA 98382
OSMER PH (360) 683-6300 FAX (360) 683-5652