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Home My WebLink AboutBLD2012-00072 • 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 #: BLD12-00072 SITE ADDRESS: 4042 HASTINGS AVE W Issue Date: 04/10/2012 PORT TOWNSEND, 98368 Final Date: 5/10/2012 APPLICANT: ROBERT E LUNDGREN JR PHONE: 360-390-5712 NANCY L LUNDGREN 4042 HASTINGS AVE W PORT TOWNSEND WA 983689294 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001072005 Section: 7 Township: 30 N Range: 01 W PROJECT DESCRIPTION: CHANGE OF USE - M/H TO 3BDRM BED & BREAKFAST 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 ON5/10/2012 I:\F_BLD_Occupancy.rpt 10/29/19 Jefferson County Building Division Permit Null,: BLD12-00072 Applicant: LUNDGREN JR 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 Smoke&CO2 �—/ / Z 4;75 Miscellaneous S'/0 1 Z / ADA items FINAL INSPECTION , 'cr / Z //15 FINAL INSPECTIONi MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR � MLA12-00045 OUILDING PERMIT APPLICA�!►N Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00072 Received Date: 3/6/2012 SITE ADDRESS: 4042 HASTINGS AVE W PORT TOWNSEND, 98368 OWNER: ROBERT E LUNDGREN JR PHONE: 360-390-5712 NANCY L LUNDGREN 4042 HASTINGS AVE W PORT TOWNSEND WA 983689294 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001072005 Section: 7 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr CHANGE OF USE - M/H 3BDRM BED & BREAKFAST TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP COU VALUATION MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: EEE OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 4 Exist: 4 Prop: 0 Prop: 0 Total: 4 Total: 4 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Change of Use or $444.00 LYK 03/06/12 131527 APPROVEr Total: $444.00 APR 10 2012 Jefferson County Planning & Building Department • CONDITIONS for Building Permit# :BLD12-00072 1.) 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. 2.) A minimum of five (5) on-site parking spaces shall be provided for the Bed and Breadfast residence. 3.) (2) Bed and Breakfast Residence. The following standards apply to all bed and breakfast residences: (a) Bed and breakfast residences shall be restricted to owner-occupied single-family residences. (b) No more than three guest sleeping rooms shall be available for the accommodation of bed and breakfast residence guests. (c) Guest occupancies shall be limited to no more than 30 consecutive days. (d) Meals may only be served to overnight guests. (e) The bed and breakfast residence shall be operated in a way that will prevent unreasonable disturbance to area residents. (f) One off-street parking space shall be provided for each guest room in addition to parking required for the residence. (g)Approval shall be conditional upon compliance with all applicable building code requirements, state liquor laws, and state sanitation requirements. (h) No more than one sign is allowed, consistent with sign standards in JCC 18.30.150. 4.) (a) No sign or part thereof shall consist of rotating, revolving, or moving parts; consist of banners, streamers, or spinners; or involve flashing, blinking, or alternating lights. (b) Sign size shall not exceed six (6) feet as approved. (c)All signs shall be continuously maintained. Signs that present a public hazard as determined by the Jefferson County building official or department of public works shall be subject to abatement. (d) The design of freestanding signs shall include measures to restrict vehicles from passing beneath them, unless otherwise permitted by the Jefferson County department of public works. All freestanding pole signs or projecting signs shall provide pedestrian clearance to a minimum of eight feet, where applicable. (e) Signs should be incorporated into the landscaping of the site when landscaping is provided. (f) No sign shall be placed in the public right-of-way or in the vision clearance triangle of intersections and curb cuts, unless otherwise approved by the Jefferson County department of public works. .44' NcoO JEFFERSON COUNTY DEPARTMENT OF COMMUNITIEVELOPMENT 621 Sheridan Street `t9SdIN°�2 Port Townsend, WA 98368 (360) 379-4450 . LIFE / FIRE AND CONSISTENCY REVIEW APPLICATION Please check one: CHANGE OF USE REVIEW SITE ADDRESS: A/t7 /j i <15 g:( kV f rr YY rf ei*/— kvjr ZIP d" ' 9 DIGIT PARCEL ID NUMBER 0 en /0 7) 4/V S Legal Description: Subdivision Name Block Lot(s) Section Township North, Range WM APPLICANT 7- 4,6 Y,-r PL—/1i4 7 /G,'Viek/�y,,,r PHONE X .40-,7`/U -,�W2. MAILINGADDRESS 'l/ flo3 (7fT/.!/C�7 �t�r [mil/ -e.ST /�O rr Y'&i.KYIe"/ f'/v/7 ZIP g eS 6v r PROPERTY OWNER J1/'J,'/•{ /3' /SG✓'<— PHONE MAILING ADDRESS 1 / it It CURRENT USE(S) ' t Cie Y1c \\ T7= C L U V I_ h ) \s- SiI rPROPOSED USE(S) �D(4 . (nLf4 " , SEPTIC PERMIT NUMBER IBC OCCUPANCY IBC TYPE OF CONS_MU' TION 3kriPOCt-S Z Classification Classification .-J . ,i- COUNTY NUMBER OF BEDROO S NUMBER OF BATHROOMS WATER`' I�PP/I NT PROPOSED PROPOSED ElPublic Water EXISTING EXISTING Irivate Well TOTAL y TOTAL 4/ ❑ 2-party Well EXISTING#OF PARKING SPACES #OF HANDICAP PARKING SPACES CURRENT NUMBER OF OCCUPANTS includes owners, PROPOSED NUMBER OF OCCUPAN (includes owners, tenants, employees,etc) tenants,employees,etc) a CURRENT TOTAL SQUARE FOOTAGE(includes decks, porches,outbuildings, shed3�.etc) / (r PROPOSED TOTAL SQUARE FOOTAGE(includes decks, porches,outbuildings, shed...etc) rfrif Y APPLICANT SIGNATURE DATE / / FOR OFFICE USE ONLY ---------CONSISTENCY REVIEW $ BASE FEE ----- - RECEIPT# STATE SURCHARGE 4.50- __--- -- " SH/CK# TOTAL DATE �__ / / G:\PermitCenter\###FORMS###\BLDG FORMS\Life Fire and Consistency Review Form & Checklist.DOC • • i I '\''\ r I , _ .... ..... __ _._ , . masa \ .4b .4,- . 1 ', ,. ii f "�'at e1 (--- . . \ Cvi . ,c) ....... .-'''' 1 . , . r• 1.7, • it 1 t'. E ..1//ki\ r 1 I 1 .--i-i : 1' 3 4 ,. ..•..,a -.... ;r i.�'."�...�►--s. 1 ._ al 0. 171311 r Liq ' L �� 4� IDty il . iv ..SQ lii .0 as MUM (I) ® ,'O i t ii f. I 1;1 E cil is COIvcO JEFFERSOf�1�UNN • • ' '', \ DEPARTMENT OF COMMUNITY DEVELOPMENT ` '4621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax O� www.co.jefferson.wa.us/commdevelopment INGZ , r•Master Permit Application MLA: l c " c Project Description (include s parate sheets as necessary): e''(.6' C2-- / trii,/(7 / Tax Parcel Number: C7 2 1 0 776- 5 Property Size: 3 acr jquare feet) Site Address and/or Directions t Property: Property Owner(s) of Record: P eit /`G -t ,T,s/ir,' Telephone: J 6G' .7 e, - Ste/� Fax: email: i'l l�� c�jl,i (r ifee re ?i/C-; Mailing Address: �'f�� //*/>'�s .e. i r grl 2 v// P/� w' rel r Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance (Minor, Major or Reasonable Economic Use) ❑ Single Family ❑ Garage Attached/Detached 0 Conditional Use[Ccalgd1,_r-C].*--- ❑ Manufactured Horne . 0 Modular 0 Discretior ,arry D' or ynnarned s' lassification en O Commercial* 0 Special Ulse,(E ti PUblic a *.~_' O Change of Use ❑ Boundary!Line AdjusTment^ ❑ Address 0 Road Approach_ 0 Short Plat," 'Home Business 0 Cottage Industry 0 Binding Site Plan** ❑ Propane ❑ Long Plat(`* 3iyn 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alt FFERCO COUNTY ❑ Stormwater Management ❑Shoreline asterP4agram,Exemption/Penmit Revisions** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use ❑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 **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 Date: 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 I ter inspections.-Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applica• rg prior tire. Signature: Date:_27// / /� The action or actions Applicant will unde e as a result 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 • in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer ti Jbility f adherin to and mplying with the ESA. The Applicant has read this disclai er signs and dates it below. Signature: Date: g// is3--. • • 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: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: • New J Wood Existing: Sewer E Addition E Steel Proposed: Bank Community System C. Alteration/Remodel C Concrete Total: _ Height: D Individual System C Repair C Masonry SEP Permit# _ • Demolition Other: Bedrooms: Water Supply: Existing: Setback: C Private well C Two Party Type of Heat: Proposed: C Public 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: 1 Underground Tank i Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove 1 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 For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: r 1- 22 Floor Heated Consistency Review: n'aa Other Heated Base fee 3n - Oi Mezzanine Addrtlo al ct I'f seion: ; u y II . / i Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated' ._ . Pot Water Review fee: ' 1. Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ /91, Receipt Number: I i' I Cash/Check Number: L l 1 I ESTIMATED COST(REQUIRED) Date: _ • •Fair market value of all labor and materials foundation to finish 5 — Initials: ( , 1 Vc C.�3 66 11 T1'�113 EA' L CCH73 E.ED 4- eXEgA 161 s'r • , �'#iP;" m R0gkR7 t Ni1iv ` ),. 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